Robert Simon, Cristina Petrisor, Constantin Bodolea, Adela Golea, Sara Hora Gomes, Oana Antal, Horațiu Nicolae Vasian, Orlanda Moldovan, Cosmin Ion Puia
Efficiency of Simulation-Based Learning Using an ABC POCUS Protocol on a High-Fidelity Simulator
Diagnostics (Basel, Switzerland)
increasing amount elective spine fusion patients presenting cardiac disease congestive heart failure becoming difficult assess safe proceed surgery assessing severity heart failure hf ejection fraction may provide insight patients short longterm risks purpose study assess severity hf perioperative outcomes spine fusion surgery patients retrospective cohort study pearldiver database enrolled 670526 patients undergoing spine fusion surgery thirtyday 90day complication rates discharge destination length stay los physician reimbursement hospital costs patients undergoing elective spine fusion surgery isolated stratified preoperative hf preserved ejection fraction pef reduced ejection fraction ref international classification diseases9 42832 chronic diastolic hf 42822 chronic systolic hf means comparison tests chisquared independent samples ttests appropriate compared differences demographics diagnoses comorbidities procedural characteristics los 30day 90day complication outcomes total hospital charges diagnosed pef ref binary logistic regression assessed odds complication associated hf controlling levels fused odds ratio 95 confidence interval statistical significance set p 005 totally 670526 elective spine fusion patients included four thousand seventyseven diagnosed pef 2758 ref overall pef patients presented higher rates morbid obesity chronic kidney disease chronic obstructive pulmonary disease diabetes mellitus hypertension p 0001 relation nohf pef patients higher rates 30day major complications including pulmonary embolism pneumonia cerebrovascular accident cva myocardial infarctions mi sepsis death p 0001 furthermore pef associated significantly increased odds pneumonia 207 164256 p 0001 sepsis 209 162266 p 0001 relative nohf ref associated significantly higher odds mi 366 234547 cva 270 167415 pneumonia 185 140240 p 0001 postoperative within 30 days adjusting prior history mi cad presence pacemaker ref significant predictor mi 30 days postoperatively 22 114432 p 0021 adjusting history cabg stent placement ref associated higher odds cva 211 109419 p 0028 mi 227 120443 p 0013 evaluating severity hf spine surgery ref associated higher risk major complications especially occurrence myocardial infarction 30 days postoperatively preoperative risk assessment congestive hf considered thoroughly thinking postoperative outcomes emphasis ref