• MeSH
• externí fixátory MeSH
• fixace fraktur metody   MeSH
• fraktury kostí * komplikace   rehabilitace   terapie   MeSH
• fyzioterapie (techniky) MeSH
• konzervativní terapie škodlivé účinky   MeSH
• lidé MeSH
• protetické prostředky MeSH
• protézy a implantáty MeSH
• umělé končetiny MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

• MeSH
• antikoagulancia terapeutické užití   MeSH
• heparin aplikace a dávkování   terapeutické užití   MeSH
• incidence MeSH
• krvácení epidemiologie   prevence a kontrola   MeSH
• lidé MeSH
• náhrada kyčelního kloubu * škodlivé účinky   MeSH
• perioperační období MeSH
• pooperační komplikace * epidemiologie   prevence a kontrola   MeSH
• rizikové faktory MeSH
• totální endoprotéza kolene * škodlivé účinky   MeSH
• tromboembolie epidemiologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH

INTRODUCTION: The study objective was to ascertain the incidence of bleeding and ischemic complications related to acute and planned orthopedic surgery in patients with known cardiovascular diseases. MATERIALS AND METHODS: The study conducted between 2010 and 2013 enrolled 477 patients (289 women, 188 men) with a diagnosed cardiovascular disease or a history of thromboembolic event. Aside from gender, age, height and weight, the study observed other anamnestic data and perioperative laboratory test results that may impact on a bleeding or ischemic event. RESULTS: Two hundred seventy-two (57 %) patients had acute surgery, and 205 (43 %) patients had elective surgery. Complications arose in 55 (11.6 %) patients, 32 (6.9 %) had bleeding complications, 19 (4.0 %) ischemic complications, and both complications were experienced by 4 (0.8 %) patients. Bleeding developed in 14 (5.1 %) patients who had acute surgery, and in 22 (10.7 %) who had elective surgery. Twenty-two (8.1 %) patients having acute surgery and one (0.1 %) undergoing elective surgery suffered from ischemic complications. The incidence of bleeding complications was significantly higher in elective surgery (p = 0.026, OR 2.22), and when adjusted (general anaesthesia, gender, and use of warfarin), the difference was even higher (p = 0.015, OR 2.44), whereas the occurrence of ischemic complications was significantly higher in acute surgery (p = 0.005, OR 18.0), and when adjusted (age), the difference remained significant (p = 0.044, OR 8.3). CONCLUSIONS: The study noted a significantly higher incidence of bleeding complications in elective orthopedic surgery when compared with acute surgery. Conversely, the incidence of ischemic complications was significantly higher in patients having acute orthopedic surgery when compared with those operated on electively.

• MeSH
• dospělí MeSH
• elektivní chirurgické výkony škodlivé účinky   MeSH
• incidence MeSH
• ischemie epidemiologie   etiologie   MeSH
• kardiovaskulární nemoci komplikace   chirurgie   MeSH
• krvácení epidemiologie   etiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• ortopedické výkony škodlivé účinky   MeSH
• pooperační komplikace epidemiologie   MeSH
• prospektivní studie MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH

Prospective registry of all consecutive cardiac patients undergoing non-cardiac surgery. Patients have to meet all three inclusion criteria: (1) Any kind of non-cardiac surgery (acute or elective) performed under general or neuroaxial anaesthesia in three surgical departments - General surgery, Orthopedics-Trauma and Neurosurgery. (2) History of cardiac disease with risk of arterial, intracardiac or vein thrombosis or embolism. (3) Signed Informed consent. All operated patients who meet the inclusion criteria will be enrolled, i.e. all consecutive cardiacs, who signed Informed consent. Inclusion of cca 2000 - 3000 patients is expected. Baseline clinical indicators, chronic and perioperative medication, ECG, echocardiography, laboratory tests and all complications (especially ischemic and bleeding) will be registered. The second phase (randomized study) will include cca 1000 patients. Inclusion/exclusion criteria will be defined on the basis of results of the first phase.

Prospektivní registr všech konsekutivních kardiaků, postupujících nekardiální chirurgický výkon: pacienti musí splnit všechna tři vstupní kriteria: (1) Jakákoli operace (elektivní nebo akutní) v celkové nebo v neuroaxiální anestezii, prováděná na Chirurgické, Ortopedické nebo Neurochirurgické klinice. (2) Anamneza kardiovaskulárního onemocnění s rizikem arteriální, intrakardiální či žilní trombozy nebo embolie. (3) Podepsaný informovaný souhlas. Zařazeni budou všichni nemocní, splňující vstupní kriteria, tj. všichni operovaní kardiaci, kteří podepsali informovaný souhlas. Předpokládáme zařazení 2000 až 3000 nemocných. Budou sledovány základní klinické ukazatele, chronická i perioperační medikace, EKG, echokardiografie, laboratoř a samozřejmě veškeré komplikace (zejména ischemické a krvácivé). Ve 2. fázi (randomizovaná studie) předpokládáme zařazení cca 1000 nemocných. Vstupní / vylučovací kriteria pro tuto fázi budou definována na základě výsledků 1. fáze.

• MeSH
• inhibitory agregace trombocytů MeSH
• kardiovaskulární nemoci MeSH
• koronární trombóza MeSH
• krvácení při operaci MeSH
• multivariační analýza MeSH
• nemoci koronárních tepen MeSH
• onemocnění periferních arterií komplikace   MeSH
• peroperační komplikace MeSH
• rizikové faktory MeSH

• Konspekt
• Ortopedie. Chirurgie. Oftalmologie
• NLK Obory
• chirurgie
• kardiologie
• farmacie a farmakologie
• NLK Publikační typ
• závěrečné zprávy o řešení grantu IGA MZ ČR

PURPOSE OF THE STUDY: The aim of the study was to investigate the occurrence of avascular necrosis (AVN) of the femoral head following the osteosynthesis of intracapsular fracture of the femoral neck in relation to the time interval between injury and surgery and the type of fracture. MATERIAL AND METHODS: The data of patients with intracapsular fractures of the femoral neck surgically treated in the period from 2001 to 2011 were reviewed. Of 1555 patients treated for this fracture, 125 (7%) underwent osteosynthesis. The evaluated group included 115 patients who came for examination at one-year follow-up. There were 59 (52%) women and 56 (48%) men. Dynamic hip screw (DHS) osteosynthesis with an anti-rotation screw was performed in 103 patients and lag-screw osteosynthesis involving three parallel cannulated cancellous screws was employed in 12 patients. The patients were allocated to groups according to the injury-to-surgery interval and to sub-groups on the basis of the Garden classification of femoral fracture stage. RESULTS: In the group of 58 patients treated within 6 h of injury, AVN developed in 10 (17%). When the type of fracture was considered, 4% of the non-displaced fractures and 30% of the displaced fractures developed AVN. The patients with Garden stage I and II (non-displaced) fractures treated within 6 h of injury had a significantly lower risk of AVN development than those with Garden stage III or IV (displaced) fractures. The group treated between 6 and 24 post-injury hours comprised 21 patients, of whom four (19%) had AVN. In non-displaced and displaced fracture sub-groups, 25% of the patients in the former and 16% in the latter had AVN. The stage of displacement had no effect on AVN development. The two groups together (patients treated by 24 h) had a significantly lower AVN incidence than the patients treated after 24 h (p = 0.0025). In this group of 36 patients, 16 had AVN (44%) and the fracture stage made no significant difference (p = 0.6985; nondisplacement sub-group, 41%; displacement sub-group, 55%). CONCLUSIONS: The study showed a significantly lower AVN occurrence in the patients surgically treated within 24 h of injury. In the patients treated within 6 h of injury, AVN incidence was significantly lower in the patients with non-displaced fractures, as compared with those who had displaced fractures. This was not true for the two patient groups treated later (6-24 and later than 24 h) in which the differences between AVN development after non-displaced fractures and that after displaced fractures were similar.

• MeSH
• fraktury femuru patologie   chirurgie   MeSH
• fraktury krčku femuru patologie   chirurgie   MeSH
• hlavice femuru patologie   chirurgie   MeSH
• hojení fraktur MeSH
• incidence MeSH
• kostní šrouby MeSH
• krček femuru patologie   chirurgie   MeSH
• lidé MeSH
• nekróza hlavice femuru etiologie   patologie   chirurgie   MeSH
• peroperační komplikace etiologie   MeSH
• rizikové faktory MeSH
• vnitřní fixace fraktury škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

• Publikační typ
• abstrakt z konference MeSH