Physical Status Score Improves Predictions Of Survival After Endovascular Aneurysm Repair

Over the years, surgery has made tremendous progress while changing human perspective; viewed as “no more science than butchery” a couple of centuries ago to now considered to be a solution for many health care problems, such as cancer, heart disease and kidney failure. Nevertheless, surgery has not been perfected to a level that provides great results every time it is performed on patients. For example, surgery done on cancer patients to remove tumors has a forty-five percent success rate (Cancer Research UK, 2013). However, in order to be successful, the surgical procedure has to be performed very precisely. And incomplete removal of tumors can decrease the patient’s survival rate and potential of future build up.

A course assignment presented to the College of Graduate Health Studies in partial fulfillment of the requirements for the Doctor of Health Science Degree A. T. Still University

It was not until the development of safe blood transfusions and antibiotics such as penicillin in the early 1940s that surgery became relatively safe.” (R Cooter, 1993, L Davis, 1955, J Duffin, H Ellis, 2001, J Le Fanu, 1999, S H Greenblatt, 1997, R Holmes, 2002, L Klenerman, 2002, C Lawrence, 1992, T Treasure, 2003, R Porter, 1997, F G Slaughter,

The appropriate assessment of patients prior to surgery to identify coexisting medical problems and to plan peri-operative care is of increasing importance. The goals of peri-operative assessment are to identify important medical issues in order to optimise their treatment, inform the patient of the risks associated with surgery, and ensure care is provided in an appropriate environment secondly to identify important social issues which may have a bearing on the planned procedure and the recovery period and to familiarise the patient with the planned procedure and the hospital processes.(American Society of Anaesthesiologists)

Abstract of this article offer clear overview of the study, by explaining what was accomplish and what was the significant of the study. (Kagnovi et al Peer Research October 2017)

More investigative studies are needed to test the variation of tissue tolerance during prolonged surgery

The agenda was quite clear that during their observations the recovery showed needs were decreased according to age and BMI. They stated older patients were in need of more assistance and longer stay in the hospital as opposed to younger adults. I found it interesting that they saw patients with bilateral knees had decreased needs and that unilateral were in need of more assistance before discharge. Managing pain was their first priority during research and rehabilitation, followed by instructing care of their own surgical wound. The aim of this study was to actively reinforce assessment and management after this procedure and giving guidance to those in health care.

According to the CDC, in the United States there have been 51.4 million inpatient procedures performed. This shows how relevant surgery is, it is very common for a person in the U.S. to have a procedure

Like others in New York, you may have, at one point or another, needed surgery to repair internal damage or treat a medical condition, among other reasons. When undergoing such procedures, you, and other patients, put your life and wellbeing in the hands of your medical provider. All too often, however, surgical errors occur that could be prevented.

National Institute for Health and Clinical Excellence (2012): Center for Public. London: National Institute for Health and Clinical Excellence

All patients should undergo risk assessment prior to a non-cardiac surgery. The goal of the assessment is to weigh the pros and cons of the surgery and adjust the timing of the surgery by postponing it if needed. The assessment will reveal any silent, chronic or neglected conditions that need attention and treatment. Physicians use information gained from history, physical examination, and type of surgery to develop initial evaluation of perioperative cardiac risk.

Aim: The aim of study was to compare the influence of either general anaesthesia(GA) or combined spinal epidural anaesthesia (CSEA) on post operative cognitive dysfunction (POCD) in elderly (60 to 70 years) subjects undergoing hip surgery and to note the impact of preoperative hospitalization on POCD. Methods: A total of 60 ASa physical status 1 & 2patients were recruited for a Prospective Randmoized Parallel-group study, comparable in age and sex. Subjects were enrolled and randomized to receive either GA ( Group A, n=30) or CSEA (Group B, n=30).All of them screened using Mini Mental State Examination (MMSE) and Clock Drawing Test (CDT)preoperatively. The operated patients Re-Evaluated by same scale on 3rd postoperative day for POCD. The impact of preoperative hospitalization on POCD also noted. The data collected were analyzed to assess statistical significance. Results: We observed no statistical difference in cognitive behaviour in either group pre-operatively, which were comparable with respect age and sex. Postoperatively a significant difference was seen between the two groups in MMSE scores and CDT scores. No association of POCD and pre operative days of hospital stay seen. Conclusions: We observed a significant Postoperative Cognitive Dysfunction with GA in comparison to CSEA. Gender and preoperative hospitalization have no association with POCD.

Acknowledgements The author wishes to acknowledge Dr. Helen Moore for advice on research design and Dr. Satoru Iwase for advice on interpreting the results of this study.

Participants will be no more than two weeks post-operative at time of initial evaluation. The study will take place over a 3 month period with in initial data collection at the beginning. Data will then be collected at the 2 week, 1 month, 2 month, and 3 month re-evaluations. Each patient will be seen three times a week for the first month. After the 1 month data collection they will change to being seen in Physical Therapy two times a week for the remaining two months. The study will take place at the Carl R. Darnall Army Medical Center in Fort Hood, Texas; which is a military hospital servicing a military outpatient setting.

According to Ashish Chandra and Zachary D. Frank, surgeons have been trying to find a more effective method of performing