Background :
Time between symptoms onset and treatment initiation is crucial in Acute aortic dissection (AAD). An anti-hypertensive treatment can be rapidly initiated before the arrival in Emergency Department (ED). A better understanding of the chain of care between symptoms onset and surgery could lead to a reduction of morbi-mortality. Our study have the objective to describe the chain of care of patients with AAD in the ED.
Methods :
This is an observational, retrospective, multicenter study. Patients were detected with a discharge of diagnostic of aortic dissection (ICD I71.0) in university medical center of Besançon. Data collection : patients records in the 8 hospitals centers of the area Franche-Comté.

Start Date01 Mar 2020

Sponsor / Collaborator

Centre Hospitalier Universitaire de Besancon

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100 Clinical Results associated with CENTRE HOSPITALIER DE SAINT-PALAIS

0 Patents (Medical) associated with CENTRE HOSPITALIER DE SAINT-PALAIS

Literatures (Medical) associated with CENTRE HOSPITALIER DE SAINT-PALAIS

01 Aug 2016·Aging Clinical and Experimental ResearchQ3 · MEDICINE

A new caring by the ground for severe stage of dementia

Q3 · MEDICINE

Article

Author: Vincent, A ; Igier, S ; Montagne, P A

Patients with severe stage of dementia present several psycho-behavioral disorders, caused by an altered perception of their environment and a feeling of isolation. Most of them are bedridden because of the advanced stage of Alzheimer's disease which causes cognitive dysfunctions and physical disorders, including coordination movement problems. Consequently, their freedoms of movement are limited as well as the quality of their communication. In this study, a new care support using activities on the ground is proposed to compensate for the massive cognitive and psychological losses and enhance their communication skills. The results of this study show that ground activities seem to be a promising way to reduce psycho-behavioral disorders and recreate communication link of the patients presenting with a severe stage of dementia.

01 Dec 2014·The KneeQ4 · MEDICINE

Alignment of the tibial component of the unicompartmental knee arthroplasty, assessed in the axial view by CT scan: does it influence the outcome?

Q4 · MEDICINE

Article

Author: Iriberri, Iker ; Aragón, José Francisco

BACKGROUNDThe ideal position of the unicompartmental knee arthroplasty (UKA) in the axial plane remains undefined the medical literature. The aim of this study was to observe how tibial components are placed in the axial plane and identify whether this could influence the postoperative clinical outcome.METHODSA retrospective transversal study of 101 UKA was performed in 88 patients by a single surgeon. Postoperative CT scans were performed at a mean follow-up period of 71 months (36 to 150), and clinical and functional outcomes were assessed by the WOMAC and the KSS scores. Patients were divided several times in two groups depending on a different WOMAC or KSS value each time, and differences in axial angulation were analyzed in every comparison. Distribution of data and influence on outcomes were also analyzed.RESULTSThe tibial component was positioned with a mean angulation of 11.9° (-1 to 32) of external rotation (ER). A lower angle of ER was observed in all comparisons in the groups with better outcomes. Differences between groups were statistically significant when a good result was defined as a WOMAC score lower than 10.CONCLUSIONSVariability in axial positioning (33°) is higher than in other planes due to the free-hand technique. A trend towards better outcomes is observed when the tibial component is placed in a lower angle of ER. Rotational alignment in UKA should be investigated in subsequent studies with larger sample sizes.LEVEL OF EVIDENCELevel III, retrospective comparative study.

01 Oct 2014·British Journal of AnaesthesiaQ1 · MEDICINE

Preoperative estimated glomerular filtration rate and the risk of major adverse cardiovascular and cerebrovascular events in non-cardiac surgery

Q1 · MEDICINE

Article

Author: Sierra, P ; Castillo, J ; Fau, M ; Bover, J ; Sadurní, M ; Mases, A ; Canet, J ; Rojo, A ; Arroyo, R ; Sabaté, S ; Guilera, N

BACKGROUNDChronic kidney disease is an independent predictor of perioperative cardiovascular morbidity and mortality. We analysed the preoperative estimated glomerular filtration rate (eGFR) as a risk factor for perioperative major adverse cardiovascular and cerebrovascular events (MACCE) in non-cardiac surgery.METHODSIn a post hoc analysis of the ANESCARDIOCAT database, patients were classified into six stages of eGFR calculated with the abbreviated Modification of Diet in Renal Disease Study and the Chronic Kidney Disease Epidemiology Collaboration equations: >90 (1), 60-89.9 (2), 45-59.9 (3a), 30-44.9 (3b), 15-29.9 (4), and <15 (5) ml min(-1) 1.73 m(-2). We analysed differences in MACCE, length of hospital stay, and all-cause mortality between eGFR stages.RESULTSThe eGFR was available in 2323 patients. Perioperative MACCE occurred in 4.5% of patients and cardiac-related mortality was 0.5%. Five hundred and forty-three (23.4%) patients had an eGFR of <60 ml min(-1) 1.73 m(-2) and 127 (5.4%) had an eGFR below 45 ml min(-1) 1.73 m(-2). Logistic regression analysis showed that MACCE increased with eGFR impairment (P<0.001), with a marked increase from stage 3b onwards (odds ratio 1.8 vs 3.9 in 3a and 3b, respectively, P=0.047). All-cause mortality was not related to eGFR (P=0.071), but increased substantially between stages 3b and 4. The length of stay correlated with eGFR (P<0.001).CONCLUSIONSPerioperative MACCE increase with declining eGFR, primarily when <45 ml min(-1) 1.73 m(-2). We recommend the use of preoperative eGFR for cardiovascular risk assessment.

100 Deals associated with CENTRE HOSPITALIER DE SAINT-PALAIS

100 Translational Medicine associated with CENTRE HOSPITALIER DE SAINT-PALAIS

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