Pub Date : 2025-04-01DOI: 10.1016/j.redare.2025.501733
M.A. Gómez-Ríos , A.A.J. Van Zundert , M.A. Fernández-Vaquero
{"title":"The relentless pursuit of excellence in airway management","authors":"M.A. Gómez-Ríos , A.A.J. Van Zundert , M.A. Fernández-Vaquero","doi":"10.1016/j.redare.2025.501733","DOIUrl":"10.1016/j.redare.2025.501733","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 4","pages":"Article 501733"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.redare.2025.101636
Ana Álvarez Bartolomé , Álvaro Mingote , María Casado Salcedo , Javier García Fernández
Cardiac contractility modulation (CCM) is a treatment based on electrical impulses that is used in patients with moderate-to-severe heart failure. This therapy has shown a small improvement in exercise tolerance and quality of life in heart patients. Guidelines on the management of implantable cardiac devices do not include any recommendations on CCM, and only 1 article refers to anaesthesia management in these patients. We present a case report on the anaesthesia management of a patient with a CCM device. We believe that it will become increasingly common for anaesthesiologists to encounter patients with similar devices in their routine practice.
{"title":"Anaesthesia management in a patient with a cardiac contractility modulation device","authors":"Ana Álvarez Bartolomé , Álvaro Mingote , María Casado Salcedo , Javier García Fernández","doi":"10.1016/j.redare.2025.101636","DOIUrl":"10.1016/j.redare.2025.101636","url":null,"abstract":"<div><div>Cardiac contractility modulation (CCM) is a treatment based on electrical impulses that is used in patients with moderate-to-severe heart failure. This therapy has shown a small improvement in exercise tolerance and quality of life in heart patients. Guidelines on the management of implantable cardiac devices do not include any recommendations on CCM, and only 1 article refers to anaesthesia management in these patients. We present a case report on the anaesthesia management of a patient with a CCM device. We believe that it will become increasingly common for anaesthesiologists to encounter patients with similar devices in their routine practice.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 4","pages":"Article 101636"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.redare.2024.501656
F. Dexter , M.Á. Gómez-Ríos , R.H. Epstein
This report shows how the results of a literature search for studies on healthcare management decision-making can help anaesthesiologists improve operating room (OR) turnover. The Scopus database was searched to obtain relevant studies on increasing surgical case numbers. References and citations were then examined. The search identified strategies to reduce OR downtime time, facilitate overlapping surgeries, and optimize OR scheduling. Key findings show that reducing anaesthesia-controlled times alone is insufficient to reliably add extra surgical cases within an 8-hour workday. Instead, significant productivity gains are achieved by managing OR turnover times, using induction rooms, and revising workflows to maximize efficiency. Studies show that overlapping surgeries and strategic use of adjacent spaces can significantly increase the number of surgical cases performed daily. Most surgical growth is driven by accommodating low caseload surgeons across multiple specialties. Facilitating OR time access for these surgeons through flexible scheduling and re-sequencing of cases is crucial. Additionally, anaesthesiologists should be engaged in daily OR scheduling and case sequencing, particularly within 2 days of surgery. The dual goals are to increase OR utilization and reduce patient wait times. These results from the management case report underscores the importance of evidence-based OR management practices and proactive involvement of anaesthesiologists in scheduling decisions to enhance surgical productivity effectively.
{"title":"Literature search for healthcare management decision-making on how to increase productivity by performing more surgical cases in the same staffed time","authors":"F. Dexter , M.Á. Gómez-Ríos , R.H. Epstein","doi":"10.1016/j.redare.2024.501656","DOIUrl":"10.1016/j.redare.2024.501656","url":null,"abstract":"<div><div>This report shows how the results of a literature search for studies on healthcare management decision-making can help anaesthesiologists improve operating room (OR) turnover. The Scopus database was searched to obtain relevant studies on increasing surgical case numbers. References and citations were then examined. The search identified strategies to reduce OR downtime time, facilitate overlapping surgeries, and optimize OR scheduling. Key findings show that reducing anaesthesia-controlled times alone is insufficient to reliably add extra surgical cases within an 8-hour workday. Instead, significant productivity gains are achieved by managing OR turnover times, using induction rooms, and revising workflows to maximize efficiency. Studies show that overlapping surgeries and strategic use of adjacent spaces can significantly increase the number of surgical cases performed daily. Most surgical growth is driven by accommodating low caseload surgeons across multiple specialties. Facilitating OR time access for these surgeons through flexible scheduling and re-sequencing of cases is crucial. Additionally, anaesthesiologists should be engaged in daily OR scheduling and case sequencing, particularly within 2 days of surgery. The dual goals are to increase OR utilization and reduce patient wait times. These results from the management case report underscores the importance of evidence-based OR management practices and proactive involvement of anaesthesiologists in scheduling decisions to enhance surgical productivity effectively.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 4","pages":"Article 501656"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.redare.2024.101648
R. Navarro-Suay , L.E. Togores-Sánchez , R. García-Cañas , F. Gilsanz-Rodríguez
{"title":"History lessons for an uncertain future? Anaesthesiology and resuscitation during the Ifni-Sahara conflict (1957–1958)","authors":"R. Navarro-Suay , L.E. Togores-Sánchez , R. García-Cañas , F. Gilsanz-Rodríguez","doi":"10.1016/j.redare.2024.101648","DOIUrl":"10.1016/j.redare.2024.101648","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 4","pages":"Article 101648"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.redare.2025.501673
C.Y. Salinas-Ulloa , R. Gopar-Nieto , E. García-Cruz , G. Rojas-Velasco , D. Manzur-Sandoval
Introduction
Despite the latest innovations in surgical and cardiopulmonary bypass techniques, atrial fibrillation remains a common occurrence in patients undergoing heart surgery, and has been shown to increase the incidence of intra- and postoperative complications. For this reason, it is among the top 10 research topics in cardiovascular surgery.
Method
Observational, analytical, retrospective study carried out at the largest cardiovascular centre in Mexico. Adult patients (>18 years) with no history of atrial fibrillation who underwent on-pump heart surgery between 1 January 2022 and 31 December 2023 were included. Variables that have previously been correlated with postoperative atrial fibrillation (POAF) were evaluated.
Results
A total of 544 patients were included. The incidence of POAF was 23.8%. Overall in-hospital mortality was 5.9%. There was a significant difference in age between patients that developed postoperative atrial fibrillation and those that maintained sinus rhythm (62 years vs 57 years, p = < 0.01). Using a univariate logistic regression model, we found that POAF significantly predicts the occurrence of hospital-acquired pneumonia (OR 3.12, 95% CI 1.61−6.02, p = <0.01) and the requirement for renal replacement therapy (OR 3.04, 95% CI 1.34−6.86, p = <0.01).
Conclusions
Atrial fibrillation is a common arrhythmia in the postoperative period of on-pump heart surgery, and is a predictor of adverse outcomes. Prevention, early detection and treatment of POAF may have prognostic implications.
{"title":"Clinical characteristics and prognostic implication of atrial fibrillation in the postoperative period of cardiac surgery with cardiopulmonary bypass","authors":"C.Y. Salinas-Ulloa , R. Gopar-Nieto , E. García-Cruz , G. Rojas-Velasco , D. Manzur-Sandoval","doi":"10.1016/j.redare.2025.501673","DOIUrl":"10.1016/j.redare.2025.501673","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite the latest innovations in surgical and cardiopulmonary bypass techniques, atrial fibrillation remains a common occurrence in patients undergoing heart surgery, and has been shown to increase the incidence of intra- and postoperative complications. For this reason, it is among the top 10 research topics in cardiovascular surgery.</div></div><div><h3>Method</h3><div>Observational, analytical, retrospective study carried out at the largest cardiovascular centre in Mexico. Adult patients (>18 years) with no history of atrial fibrillation who underwent on-pump heart surgery between 1 January 2022 and 31 December 2023 were included. Variables that have previously been correlated with postoperative atrial fibrillation (POAF) were evaluated.</div></div><div><h3>Results</h3><div>A total of 544 patients were included. The incidence of POAF was 23.8%. Overall in-hospital mortality was 5.9%. There was a significant difference in age between patients that developed postoperative atrial fibrillation and those that maintained sinus rhythm (62 years vs 57 years, <em>p</em> = < 0.01). Using a univariate logistic regression model, we found that POAF significantly predicts the occurrence of hospital-acquired pneumonia (OR 3.12, 95% CI 1.61−6.02, <em>p</em> = <0.01) and the requirement for renal replacement therapy (OR 3.04, 95% CI 1.34−6.86, <em>p</em> = <0.01).</div></div><div><h3>Conclusions</h3><div>Atrial fibrillation is a common arrhythmia in the postoperative period of on-pump heart surgery, and is a predictor of adverse outcomes. Prevention, early detection and treatment of POAF may have prognostic implications.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 4","pages":"Article 501673"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Post-dural puncture headache (PDPH) after an accidental dural puncture (ADP) is a common complication in obstetric analgesia. It has been proposed that inserting an intrathecal catheter (ITC) after an ADP may reduce PDPH incidence and the need for therapeutic epidural blood patch (EBP). Our primary objective was to assess if the insertion of an ITC after an ADP reduces the incidence of PDPH in obstetric patients. Secondary objectives included evaluating EBP requirements and ITC-related complications.
Methods
We conducted a retrospective study of all obstetric patients with a documented ADP during their labour analgesia between January 2018 to December 2022. Data from the patients in whom an ITC was inserted and those with a repeated epidural were compared.
Results
Over our 5-year study period, 35 cases of ADP were documented. Of these, 16 patients (45.7%) received an ITC for 24 hours, while 19 (54.3%) underwent epidural re-siting. No significant difference was observed in PDPH incidence between ITC and re-sited epidural groups (62.5% vs 68.4%; RR 0.84; P = 0.713), nor in EBP requirement (18.8% vs 31.6%; RR 0.84; P = 0.387). Follow-up duration did not differ significantly between groups and no ITC-related complications were reported within 1 month.
Conclusions
Our findings align with previously reported literature, indicating a trend favoring ITC utilization. In addition to the potential benefit of reducing CPPD incidence, their use is safe and provides quality analgesia with rapid onset.
IRB number
IIBSP-CEF-2022-146.
背景：意外硬膜穿刺（ADP）后硬膜穿刺头痛（PDPH）是产科镇痛的常见并发症。有研究表明，ADP后插入鞘内导管（ITC）可能降低PDPH的发生率和治疗性硬膜外血贴（EBP）的需要。我们的主要目的是评估ADP后插入ITC是否能降低产科患者PDPH的发生率。次要目标包括评估EBP要求和与tc相关的并发症。方法：我们对2018年1月至2022年12月期间分娩镇痛期间记录在案的所有ADP产科患者进行了回顾性研究。将ITC与重复硬膜外麻醉患者的数据进行比较。结果：在我们5年的研究期间，记录了35例ADP。其中，16例（45.7%）患者接受了24小时的ITC， 19例（54.3%）患者接受了硬膜外重新定位。ITC组与硬膜外组的PDPH发生率无显著差异(62.5% vs 68.4%；RR 0.84;P = 0.713)， EBP需求也没有差异(18.8% vs 31.6%；RR 0.84;P = 0.387)。随访时间组间无显著差异，1个月内未见tc相关并发症。结论：我们的发现与先前报道的文献一致，表明了有利于ITC使用的趋势。除了减少CPPD发病率的潜在益处外，它们的使用是安全的，并提供快速起效的高质量镇痛。Irb编号：IIBSP-CEF-2022-146。
{"title":"Intrathecal catheter after accidental dural puncture in obstetric patients: Safety and effectiveness reducing post-dural puncture headache","authors":"Gerard Moreno Giménez, Martha Cristina Melo Cruz, Marta Ferrándiz Mach, Sergi Sabaté Tenas","doi":"10.1016/j.redare.2024.501671","DOIUrl":"10.1016/j.redare.2024.501671","url":null,"abstract":"<div><h3>Background</h3><div>Post-dural puncture headache (PDPH) after an accidental dural puncture (ADP) is a common complication in obstetric analgesia. It has been proposed that inserting an intrathecal catheter (ITC) after an ADP may reduce PDPH incidence and the need for therapeutic epidural blood patch (EBP). Our primary objective was to assess if the insertion of an ITC after an ADP reduces the incidence of PDPH in obstetric patients. Secondary objectives included evaluating EBP requirements and ITC-related complications.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of all obstetric patients with a documented ADP during their labour analgesia between January 2018 to December 2022. Data from the patients in whom an ITC was inserted and those with a repeated epidural were compared.</div></div><div><h3>Results</h3><div>Over our 5-year study period, 35 cases of ADP were documented. Of these, 16 patients (45.7%) received an ITC for 24 hours, while 19 (54.3%) underwent epidural re-siting. No significant difference was observed in PDPH incidence between ITC and re-sited epidural groups (62.5% vs 68.4%; RR 0.84; <em>P</em> = 0.713), nor in EBP requirement (18.8% vs 31.6%; RR 0.84; <em>P</em> = 0.387). Follow-up duration did not differ significantly between groups and no ITC-related complications were reported within 1 month.</div></div><div><h3>Conclusions</h3><div>Our findings align with previously reported literature, indicating a trend favoring ITC utilization. In addition to the potential benefit of reducing CPPD incidence, their use is safe and provides quality analgesia with rapid onset.</div></div><div><h3>IRB number</h3><div>IIBSP-CEF-2022-146.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 4","pages":"Article 501671"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.redare.2025.501672
L. Alcover Navarro , C.S. Romero García , E. Mateo Rodríguez , P. Granero Castro , J. De Andrés Ibáñez
Introduction
Abdominal laparoscopic surgery to treat colorectal cancer has been shown to be more effective than open surgery in terms of mobility, hospital stay, tumour recurrence and long-term survival. This surgical approach requires pneumoperitoneum and the Trendelenburg position (35−45º), both of which have a negative effect on the cardiovascular system and can even change the cerebrovascular physiology, leading to an increase in intracranial pressure (ICP). Ultrasound measurement of optic nerve sheath (ONS) diameter has shown excellent correlation with invasive ICP measurement.
Objective
To correlate the increase in ONS diameter with surgical time and time to emergence after anaesthesia. The incidence of visual disturbances (visual acuity) and/or neurological complications (agitation, cognitive dysfunction) in the immediate postoperative period was also evaluated.
Material and methods
30 consecutive patients undergoing laparoscopic surgery for rectal or sigmoid adenocarcinoma were recruited. Pre-, intra- and postoperative ONS measurements were obtained and the Snellen test for visual acuity, Mini Mental Test for cognitive function, and the Richmond Agitation and Sedation Scale (RASS) were administered.
Results
ONS increased intraoperatively in both eyes compared to baseline. However, this was not correlated with total surgical time or time to emergence, and there was no statistically significant correlation between ONS and postoperative neurological or visual alterations.
{"title":"Utility of optic nerve sheath ultrasound during laparoscopic colorectal surgery","authors":"L. Alcover Navarro , C.S. Romero García , E. Mateo Rodríguez , P. Granero Castro , J. De Andrés Ibáñez","doi":"10.1016/j.redare.2025.501672","DOIUrl":"10.1016/j.redare.2025.501672","url":null,"abstract":"<div><h3>Introduction</h3><div>Abdominal laparoscopic surgery to treat colorectal cancer has been shown to be more effective than open surgery in terms of mobility, hospital stay, tumour recurrence and long-term survival. This surgical approach requires pneumoperitoneum and the Trendelenburg position (35−45º), both of which have a negative effect on the cardiovascular system and can even change the cerebrovascular physiology, leading to an increase in intracranial pressure (ICP). Ultrasound measurement of optic nerve sheath (ONS) diameter has shown excellent correlation with invasive ICP measurement.</div></div><div><h3>Objective</h3><div>To correlate the increase in ONS diameter with surgical time and time to emergence after anaesthesia. The incidence of visual disturbances (visual acuity) and/or neurological complications (agitation, cognitive dysfunction) in the immediate postoperative period was also evaluated.</div></div><div><h3>Material and methods</h3><div>30 consecutive patients undergoing laparoscopic surgery for rectal or sigmoid adenocarcinoma were recruited. Pre-, intra- and postoperative ONS measurements were obtained and the Snellen test for visual acuity, Mini Mental Test for cognitive function, and the Richmond Agitation and Sedation Scale (RASS) were administered.</div></div><div><h3>Results</h3><div>ONS increased intraoperatively in both eyes compared to baseline. However, this was not correlated with total surgical time or time to emergence, and there was no statistically significant correlation between ONS and postoperative neurological or visual alterations.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 4","pages":"Article 501672"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.redare.2024.101632
P. Martín Serrano , A. Ferraz Pérez , C. Medina Hernández , V. Prieto Hidalgo
Factor XI (FXI) deficiency is a rare bleeding disorder characterized by a quantitative or qualitative deficiency of FXI. The symptoms are highly variable, and the severity and site of bleeding is unpredictable and does not necessarily correlate with FXI levels. FXI deficiency is classified by phenotype: bleeding or non-bleeding, depending on the clinical manifestations.
We present the case of a woman in her twenties diagnosed with FXI with a bleeding phenotype. The patient requested labour analgesia, but the haematology department contraindicated neuraxial techniques, given her history. An ultrasound-guided lumbar erector spinae plane (ESP) block was performed, achieving pain relief after 45 min.
ESP block could be an alternative to consider when neuraxial analgesia is contraindicated in labour.
{"title":"Erector spinae plane block for obstetric analgesia in a patient with factor XI deficiency: a case report","authors":"P. Martín Serrano , A. Ferraz Pérez , C. Medina Hernández , V. Prieto Hidalgo","doi":"10.1016/j.redare.2024.101632","DOIUrl":"10.1016/j.redare.2024.101632","url":null,"abstract":"<div><div>Factor XI (FXI) deficiency is a rare bleeding disorder characterized by a quantitative or qualitative deficiency of FXI. The symptoms are highly variable, and the severity and site of bleeding is unpredictable and does not necessarily correlate with FXI levels. FXI deficiency is classified by phenotype: bleeding or non-bleeding, depending on the clinical manifestations.</div><div>We present the case of a woman in her twenties diagnosed with FXI with a bleeding phenotype. The patient requested labour analgesia, but the haematology department contraindicated neuraxial techniques, given her history. An ultrasound-guided lumbar erector spinae plane (ESP) block was performed, achieving pain relief after 45 min.</div><div>ESP block could be an alternative to consider when neuraxial analgesia is contraindicated in labour.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 4","pages":"Article 101632"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.redare.2025.501674
V. Moratalla Sasu, N. Bakhshaliyeva, J. Fernández González, E. Alday Muñoz
Background and objectives
Hip fractures typically affect elderly individuals with multiple comorbidities. Early surgical intervention within the first 48 hours has been shown to improve outcomes. However, when on antiplatelet therapy, surgery is often delayed preventing bleeding complications. This study aims to compare the incidence of perioperative complications, the need for blood transfusions, and the length of hospital stay between two groups of patients: those with delayed surgery more than 72 h due to antiplatelet use and those who had surgery within the first 48 h.
Methods
A retrospective cohort study was conducted on 110 patients who underwent hip fracture surgery between December 2012 and April 2018. Patients who had a delay of more than 72 h in the surgery were selected. A 1:1 randomized sampling was made to obtain a control group with surgery within the first 48 h.
Results
The baseline clinical characteristics were similar between the two groups, except for a higher rate of ischemic heart disease, cerebrovascular accidents and use of antiplatelet medication in the delayed surgery group. The early surgery group had a higher rate of acute renal failure (14.6% vs. 1.8%). The rest of the postoperative complications were higher in the delayed group (5.5% vs. 20%). The hospital stay was longer in the delayed group (15.2 vs. 8.93 days), although this difference accounted for the preoperative stay.
Conclusion
This study found that delayed surgery was linked to a higher incidence of medical complications and a longer hospital stay due to the wait time for surgery.
{"title":"Complications associated with delayed hip fracture surgery due to antiplatelet therapy","authors":"V. Moratalla Sasu, N. Bakhshaliyeva, J. Fernández González, E. Alday Muñoz","doi":"10.1016/j.redare.2025.501674","DOIUrl":"10.1016/j.redare.2025.501674","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Hip fractures typically affect elderly individuals with multiple comorbidities. Early surgical intervention within the first 48 hours has been shown to improve outcomes. However, when on antiplatelet therapy, surgery is often delayed preventing bleeding complications. This study aims to compare the incidence of perioperative complications, the need for blood transfusions, and the length of hospital stay between two groups of patients: those with delayed surgery more than 72 h due to antiplatelet use and those who had surgery within the first 48 h.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted on 110 patients who underwent hip fracture surgery between December 2012 and April 2018. Patients who had a delay of more than 72 h in the surgery were selected. A 1:1 randomized sampling was made to obtain a control group with surgery within the first 48 h.</div></div><div><h3>Results</h3><div>The baseline clinical characteristics were similar between the two groups, except for a higher rate of ischemic heart disease, cerebrovascular accidents and use of antiplatelet medication in the delayed surgery group. The early surgery group had a higher rate of acute renal failure (14.6% vs. 1.8%). The rest of the postoperative complications were higher in the delayed group (5.5% vs. 20%). The hospital stay was longer in the delayed group (15.2 vs. 8.93 days), although this difference accounted for the preoperative stay.</div></div><div><h3>Conclusion</h3><div>This study found that delayed surgery was linked to a higher incidence of medical complications and a longer hospital stay due to the wait time for surgery.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 4","pages":"Article 501674"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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