PURPOSE OF THE STUDY: Intertrochanteric hip fractures in elderly patients are a significant cause of morbidity and mortality, with increasing incidence due to the aging population. Despite advancements in intramedullary nailing (IMN) technology, fixation failure remains a concern. This study aims to evaluate pre-and postoperative radiographic risk factors for varus collapse in geriatric intertrochanteric fractures treated with twin interlocking derotation and compression screw cephalomedullary nail (InterTAN, Smith & Nephew). MATERIAL AND METHODS: This retrospective study included patients over 60 years with AO 31A1 and 31A2 intertrochanteric femur fractures treated with InterTAN at a tertiary referral center from August 2012 to August 2017. Patients with high-energy fractures, AO 31A3 fractures, or those requiring open reduction were excluded. Data on demographics, fracture classification, implant sizes, imaging studies, and follow-up were collected. Radiographic assessments included Chang's medial cortical support concept, tip-apex distance (TAD), calcar-referenced TAD (CalTAD), neck-shaft angles (NSA), and screw placement according to Cleveland zones. Varus collapse was defined as a >5° change in NSA within three months postoperatively. Multivariate logistic regression analysis was used to identify risk factors for varus collapse. RESULTS: The study included 136 patients with a mean age of 79.8 years, of whom 38.2% were male. The early postoperative tipapex distance (TAD) averaged 21.9mm, with 30.1% of patients experiencing varus collapse greater than 5°. Positive medial cortical support (PMCS) or neutral position (NP) type reduction was highly protective against varus collapse (p < 0.001), as well as TAD less than 25mm (p < 0.001). Additionally, the placement of screws in the central-central or central-inferior zones provided a protective effect against varus collapse (p = 0.031). Conversely, having an OTA/AO type A2.2 or A2.3 fracture significantly increased the risk of varus collapse (p = 0.030). Other factors, such as CalTAD and the nail width to medullary canal ratio, did not significantly predict varus collapse (p = 0.831 and p = 0.952, respectively). DISCUSSION: Our findings align with previous studies highlighting TAD and screw placement as critical factors in preventing fixation failure. The protective effect of PMCS or NP reduction and the increased risk associated with OTA/AO type A2.2 and A2.3 fractures are noteworthy. Unlike previous studies, CalTAD was not significantly associated with varus collapse in our cohort. The study underscores the importance of surgical technique and radiographic parameters in optimizing outcomes for elderly patients with intertrochanteric fractures. CONCLUSIONS: In elderly patients treated with InterTAN nails, varus collapse is influenced by fracture type, TAD, reduction quality, and screw placement. Ensuring a TAD <25mm, achieving PMCS or NP reduction, and placing screws in central-central or central-inferior zones are crucial for minimizing varus collapse. These findings highlight the importance of meticulous surgical technique and radiographic assessment in managing intertrochanteric fractures in the elderly. KEY WORDS: hip fractures, intertrochanteric fractures, internal Fixation, geriatrics, cephalomedullary nail.

• MeSH
• fraktury kyčle * chirurgie   MeSH
• intramedulární fixace fraktury * metody   přístrojové vybavení   škodlivé účinky   MeSH
• kostní hřeby * MeSH
• kostní šrouby * škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• pooperační komplikace etiologie   epidemiologie   MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• selhání protézy MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Hypoalbuminemia, a biomarker of malnutrition, has been associated with adverse surgical outcomes;, however, its impact on breast reduction surgery is not yet well-documented. METHODS: We queried the American college of surgeons national surgical quality improvement program database to identify patients who underwent breast reduction surgery between 2008 and 2022. Patients were grouped by preoperative normal albumin levels (≥3.5 g/dL) and hypoalbuminemia (<3.5 g/dL). Preoperative, intraoperative, and 30-day postoperative outcomes, including complications and readmissions, were compared using the univariate tests and multivariable logistic regression. RESULTS: We included a total of 7277 cases, among whom 96% (n = 6964) had normal albumin values and 4% (n = 298) had hypoalbuminemia (n = 298). Patients with hypoalbuminemia showed a significantly higher body mass index (37.1 ± 8.1 vs. 33.3 ± 6.3 kg/m2, p < 0.001) and were more likely to be Black or African American (49.0 vs. 27.8%, p < 0.001). Comorbidities such as diabetes (14.7 vs. 7.4%, p < 0.001), chronic obstructive pulmonary disease (4.0 vs. 1.0%, p < 0.001), and hypertension (35.2 vs. 26.3%, p = 0.002) were significantly more prevalent in the hypoalbuminemia group. Hypoalbuminemia was associated with a significantly increased risk of complications (13.8 vs. 6.1%, p < 0.001), with higher rates of superficial incisional infections (7.0 vs. 2.6%, p = 0.001) and unplanned readmissions (3.4 vs. 1.4%, p = 0.05). Multivariable analysis confirmed hypoalbuminemia as an independent predictor of postoperative complications (OR 1.96, p = 0.001), medical complications (OR 2.62, p = 0.02), and surgical complications (OR 1.91, p = 0.02). CONCLUSION: Hypoalbuminemia significantly raises the risk of 30-day postoperative complications in breast reduction surgery. Preoperative nutritional assessment and optimization are crucial in improving surgical outcomes, particularly in patients with high body mass index and comorbidities.

• MeSH
• biologické markery krev   MeSH
• dospělí MeSH
• hypoalbuminemie * komplikace   krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mamoplastika * škodlivé účinky   metody   MeSH
• pooperační komplikace * epidemiologie   etiologie   krev   MeSH
• předoperační období MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• znovupřijetí pacienta statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Systematické šetření epidemie výskytu případů septických onemocnění devíti osob operovaných na operačních sálech nemocnice primárního typu v období od 26. do 28. 11. 2018 bylo zaměřeno na zjištění rozsahu události, vehikula a cesty přenosu nákazy. Komplexní šetření zahrnovalo metody epidemiologické, mikrobiologické, molekulárně biologické a environmentální. Retrospektivní kohortová studie byla uplatněna pro průkaz asociace jednotlivých expozičních faktorů a výsledků, případů septických onemocnění. Z 24 operovaných osob onemocnělo devět (AR 37,5 %). V biologickém materiálu dvou nemocných osob byl nalezen identický kmen Acinetobacter calcoaceticus. Kombinované šetření neodhalilo vehikulum ani cestu přenosu. Okamžitě uplatněná protiepidemická opatření zamezila výskytu dalších případů septických onemocnění.

A systematic investigation of an outbreak of postoperative sepsis in nine patients following surgery in the operating rooms of a primary-type hospital between November 26 and 28, 2018 was conducted to determine the extent of the outbreak, the vehicle, and the route of transmission. The comprehensive investigation included epidemiological, microbiological, molecular biological, and environmental methods. A retrospective cohort study was used to find associations between individual exposure factors and outcomes, the respective septic conditions. Nine of 24 surgery patients were infected (AR 37.5 %). An identical strain of Acinetobacter calcoaceticus was found in biological specimens of two infected patients. The combined investigation did not reveal the vector or route of transmission. Immediate infection prevention and control measures avoided new cases of postoperative sepsis.

• MeSH
• epidemie * prevence a kontrola   MeSH
• epidemiologické metody MeSH
• infekce spojené se zdravotní péčí chirurgie   epidemiologie   MeSH
• klinické laboratorní techniky metody   MeSH
• kontrola infekčních nemocí metody   MeSH
• lidé MeSH
• operační sály MeSH
• pooperační komplikace * chirurgie   epidemiologie   mikrobiologie   MeSH
• přenos infekční nemoci prevence a kontrola   MeSH
• retrospektivní studie MeSH
• sepse * chirurgie   epidemiologie   etiologie   MeSH
• trasování kontaktů metody   MeSH
• Check Tag
• lidé MeSH

Diabetic foot (DF) can develop in diabetic patients after organ transplantation (Tx) due to several factors including peripheral arterial disease (PAD), diabetic neuropathy and inappropriate DF prevention. Aim: To assess the occurrence of DF and associated risk factors in transplant patients. Methods: Fifty-seven diabetic patients were enrolled as part of this prospective study. All patients underwent organ Tx (01/2013-12/2015) and were followed up for minimum of 12 months up to a maximum of 50 months. Over the study period we evaluated DF incidence and identified a number of factors likely to influence DF development, including organ function, presence of late complications, PAD, history of DF, levels of physical activity before and after Tx, patient education and standards of DF prevention. Results: Active DF developed in 31.6% (18/57) of patients after organ Tx within 11 months on average (10.7 ± 8 months). The following factors significantly correlated with DF development: diabetes control (p = .0065), PAD (p<0.0001), transcutaneous oxygen pressure (TcPO2;p = .01), history of DF (p = .0031), deformities (p = .0021) and increased leisure-time physical activity (LTPA) before Tx (p = .037). However, based on logistic stepwise regression analysis, the only factors significantly associated with DF during the post-transplant period were: PAD, deformities and increased LTPA. Education was provided to patients periodically (2.6 ± 2.5 times) during the observation period. Although 94.7% of patients regularly inspected their feet (4.5 ± 2.9 times/week), only 26.3% of transplant patients used appropriate footwear. Conclusions: Incidence of DF was relatively high, affecting almost 1/3 of pancreas and kidney/pancreas recipients. The predominant risk factors were: presence of PAD, foot deformities and higher LTPA before Tx. Therefore, we recommend a programme involving more detailed vascular and physical examinations and more intensive education focusing on physical activity and DF prevention in at-risk patients before transplantation.

• MeSH
• cvičení fyziologie   MeSH
• diabetická noha * epidemiologie   prevence a kontrola   etiologie   MeSH
• dospělí MeSH
• hodnocení rizik metody   MeSH
• incidence MeSH
• lidé středního věku MeSH
• lidé MeSH
• pooperační komplikace epidemiologie   prevence a kontrola   etiologie   MeSH
• prospektivní studie MeSH
• rizikové faktory MeSH
• transplantace ledvin * škodlivé účinky   metody   MeSH
• transplantace slinivky břišní * škodlivé účinky   metody   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Conservative treatment of chronic pancreatitis has only a limited effect in most patients. Surgery offers very good long-term results, even in the early stages of the disease. Unfortunately, only a minority of patients undergo surgical treatment. The aim of this work was to summarise the current treatment options for patients with an inflammatory mass of the pancreatic head. Data from patients in our study demonstrates that the surgery is a safe method, and here we compare the perioperative and early postoperative outcomes of patients who underwent a pancreatoduodenectomy and duodenum-preserving pancreatic head resection for chronic pancreatitis. METHODS: All patients who underwent a pancreaticoduodenectomy or a duodenum-preserving pancreatic head resection in our department between 2014 and 2022 were included in this study. Perioperative and early postoperative results were statistically analysed and compared. RESULTS: Thirty-eight pancreaticoduodenectomies and 23 duodenum-preserving pancreatic head resections were performed. The overall mortality was 3%, whereas the in-hospital mortality after pancreaticoduodenectomy was 5%. The mortality after duodenum-preserving pancreatic head resection was 0%. No statistically significant differences in the hospital stay, blood loss, and serious morbidity were found in either surgery. Operative time was significantly shorter in the duodenum-preserving pancreatic head resection group. CONCLUSIONS: Both pancreatoduodenectomy and duodenum-preserving pancreatic head resection are safe treatment options. Duodenum-preserving pancreatic head resection showed a statistically significant superiority in the operative time compared to pancreaticoduodenectomy. Although other monitored parameters did not show a statistically significant difference, the high risk of complications after pancreaticoduodenectomy with a mortality of 5%; maintenance of the duodenum and upper loop of jejunum, and lower risk of metabolic dysfunctions after duodenum-preserving pancreatic head resection may favour duodenum-preserving pancreatic head resection in recommended diagnoses. Attending physicians should be more encouraged to use a multidisciplinary approach to assess the suitability of surgical treatment in patients with chronic pancreatitis.

• MeSH
• chronická pankreatitida * chirurgie   MeSH
• délka operace * MeSH
• délka pobytu statistika a číselné údaje   MeSH
• dospělí MeSH
• duodenum chirurgie   patologie   MeSH
• léčba šetřící orgány metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mortalita v nemocnicích MeSH
• pankreas * chirurgie   patologie   MeSH
• pankreatektomie metody   škodlivé účinky   MeSH
• pankreatoduodenektomie * metody   škodlivé účinky   MeSH
• pooperační komplikace etiologie   epidemiologie   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Cíl: Našim cílem bylo sledovat frekvenci výskytu axiálních příznaků (axial symptoms, AS) po modifikované expanzivní open-door laminoplastice (EOLP) a vyhodnotit faktory ovlivňující AS. Metody: Bylo vybráno 80 pacientů, kteří od května 2020 do května 2022 podstoupili modifikovanou EOLP. Pacienti byli sledováni 12 měsíců po operaci a rozděleni na skupinu s AS a skupinu bez AS. Byla zaznamenána jejich výchozí data. Faktory ovlivňující AS po modifikované EOLP byly zkoumány pomocí binární logistické regresní analýzy. Výsledky: Během 12měsíčního sledování po modifikované EOLP se AS vyskytly u 26 (32,5 %) z 80 případů. Ve skupině s AS byla předoperační míra komprese míchy (preoperative spinal cord compression rate, PSCR) vyšší než u skupiny bez AS, pooperační vzdálenost posunu míchy vzad byla delší a pooperační rozsah pohybu (range of motion, ROM) při meziobratlové flexi-extenzi byl statisticky signifikantně menší (p < 0,05). Rizikovými faktory pro AS po modifikované EOLP byly zvýšená PSCR a zvýšená pooperační vzdálenost posunu míchy vzad (poměr šancí [OR] > 1; p < 0,05) a ochranným faktorem byl zvýšený pooperační ROM při meziobratlové flexi-extenzi (OR < 1; p < 0,05). Závěr: PSCR, pooperační vzdálenost posunu míchy vzad a pooperač

im: We aimed to observe the incidence of axial symptoms (AS) after modified expansive open- -door laminoplasty (EOLP), and to analyze the influencing factors for AS. Methods: Eighty patients undergoing modified EOLP from May 2020 to May 2022 were selected. They were followed up for 12 months after operation and divided into an AS group and a non-AS group. Their baseline data were recorded. The influencing factors for AS after modified EOLP were explored through binary logistic regression analysis. Results: During the 12-month follow-up after modified EOLP, AS occurred in 26 (32.5%) of the 80 cases. In the AS group, the preoperative spinal cord compression rate (PSCR) was higher than that of the non-AS group, the postoperative spinal cord posterior displacement distance was longer, and the postoperative intervertebral flexion-extension range of motion (ROM) was statistically significantly smaller (P < 0.05). Increased PSCR and increased postoperative spinal cord posterior displacement distance were risk factors for AS after modified EOLP (odds ratio [OR] > 1; P < 0.05), and elevated postoperative intervertebral flexion-extension ROM was a protective factor (OR < 1; P < 0.05). Conclusion: PSCR, postoperative spinal cord posterior displacement distance and postoperative intervertebral flexion-extension ROM are closely associated with the incidence of AS after modified EOLP

• MeSH
• komprese míchy MeSH
• laminoplastika * metody   škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• pooperační komplikace * epidemiologie   MeSH
• senioři MeSH
• statistika jako téma MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• klinická studie MeSH

BACKGROUND: There are conflicting data on the relationship between preoperative electrocardiogram and postoperative mortality. We aimed to assess the predictive value of preoperative ECG on postoperative all-cause mortality in patients undergoing non-cardiac surgery (NCS). METHODS: We retrospectively reviewed records of hospitalized patients who underwent an internal preoperative examination and subsequent NCS in the years 2015-2021. We recorded patient comorbidities, vital functions, results of biochemical tests, ECG. The primary end point was 90-day postoperative all-cause mortality, acquired from the hospital records and the nationwide registry run by the Institute of Health Information and Statistics of the Czech Republic. RESULTS: We enrolled a total of 2219 patients of mean age 63 years (48% women). Of these, 152 (6.8%) died during the 90-day postoperative period. There were statistically significant associations between increased 90-day postoperative all-cause mortality and abnormal ECG findings in resting heart rate (≥ 80 bpm, relative risk [RR] = 1.82 and ≥ 100 bpm, RR = 2.57), presence of atrial fibrillation (RR = 4.51), intraventricular conduction delay (QRS > 0.12 s, RR = 2.57), ST segment changes and T wave alterations, left bundle branch hemiblock (RR = 1.64), and right (RR = 2.04) and left bundle branch block (RR = 4.13), but not abnormal PQ and QT intervals, paced rhythm, incomplete right bundle branch block, or other ECG abnormalities. A resting heart rate (≥ 80 bpm, relative risk [RR] = 1.95 and ≥ 100 bpm, RR = 2.20), atrial fibrillation (RR = 2.10), and right bundle branch block (RR = 2.52) were significantly associated with 90-day postoperative all-cause mortality even in subgroup of patients with pre-existing cardiac comorbidities. CONCLUSIONS: Patients with abnormal preoperative ECG findings face an elevated risk of all-cause mortality within 90 days after surgery. The highest mortality risk is observed in patients with atrial fibrillation and left bundle branch block. Additionally, an elevated heart rate, right bundle branch block, and atrial fibrillation further increase the risk of death in patients with pre-existing cardiac conditions.

• MeSH
• elektrokardiografie * metody   MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• pooperační komplikace * mortalita   epidemiologie   MeSH
• prediktivní hodnota testů MeSH
• předoperační péče metody   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

PURPOSE: To evaluate biopsy-related complications and detection rates of any PCa and clinically significant PCa (csPCa, intended as grade group ≥ 2) between MRI-targeted TP fusion biopsies (TPBx) and TR ones (TRBx). METHODS: We performed a multicentric study on 4841 patients who underwent fusion biopsy between 2016 and 2023. A case-control matching was performed to find comparable cohorts of 646 TPBx and 646 TRBx. Mean T test and Pearson chi-square tests were used to compare continuous and categorical variables. RESULTS: Baseline characteristics were comparable between the cohorts, except for target location with a higher rate of anterior lesions in TPBx group. Complications were rare and no difference was found between the groups, with similar rates of infections after TRBx and TPBx (N = 5 (0.8%) vs N = 2 (0.3%), p 0.45). All patients in TRBx and 90.1% in TPBx group received antibiotic prophylaxis. A higher csPCa detection rate was found in TPBx over the group (50.5% vs 36.2%, p < 0.001). On average, positive targeted cores were increased in TPBx group, for any PCa (1.6 vs 1.4, p 0.04) and csPCa (1.0 vs 0.8, p 0.02). Among the limitations of study, we acknowledge the retrospective design and the possible under-reporting of complications. CONCLUSIONS: MRI-targeted fusion TPBx achieves a significantly higher csPCa detection than TRBx, with a diagnostic advantage for apical and anterior lesions. No significant differences were found in terms of complications that were rare in both groups, considering a widespread adoption of antibiotic prophylaxis.

• MeSH
• analýza párové shody MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• nádory prostaty * patologie   MeSH
• perineum MeSH
• pooperační komplikace epidemiologie   MeSH
• prostata * patologie   MeSH
• rektum MeSH
• reprodukovatelnost výsledků MeSH
• retrospektivní studie MeSH
• senioři MeSH
• studie případů a kontrol MeSH
• ultrazvukem navigovaná biopsie * metody   škodlivé účinky   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• srovnávací studie MeSH

STUDY OBJECTIVE: Male sex has inconsistently been associated with the development of postoperative pulmonary complications (PPCs). These studies were different in size, design, population and preoperative risk. We reanalysed the database of 'Local ASsessment of Ventilatory management during General Anaesthesia for Surgery study' (LAS VEGAS) to evaluate differences between females and males with respect to PPCs. DESIGN, SETTING AND PATIENTS: Post hoc unmatched and matched analysis of LAS VEGAS, an international observational study in patients undergoing intraoperative ventilation under general anaesthesia for surgery in 146 hospitals across 29 countries. The primary endpoint was a composite of PPCs in the first 5 postoperative days. Individual PPCs, hospital length of stay and mortality were secondary endpoints. Propensity score matching was used to create a similar cohort regarding type of surgery and epidemiological factors with a known association with development of PPCs. MAIN RESULTS: The unmatched cohort consisted of 9697 patients; 5342 (55.1%) females and 4355 (44.9%) males. The matched cohort consisted of 6154 patients; 3077 (50.0%) females and 3077 (50.0%) males. The incidence in PPCs was neither significant between females and males in the unmatched cohort (10.0 vs 10.7%; odds ratio (OR) 0.93 [0.81-1.06]; P = 0.255), nor in the matched cohort (10.5 vs 10.0%; OR 1.05 [0.89-1.25]; P = 0.556). New invasive ventilation occurred less often in females in the unmatched cohort. Hospital length of stay and mortality were similar between females and males in both cohorts. CONCLUSIONS: In this conveniently-sized worldwide cohort of patients receiving intraoperative ventilation under general anaesthesia for surgery, the PPC incidence was not significantly different between sexes. REGISTRATION: LAS VEGAS was registered at clinicaltrial.gov (study identifier NCT01601223).

• MeSH
• celková anestezie * škodlivé účinky   MeSH
• délka pobytu * statistika a číselné údaje   MeSH
• dospělí MeSH
• incidence MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• plicní nemoci * epidemiologie   etiologie   MeSH
• pooperační komplikace * epidemiologie   etiologie   MeSH
• rizikové faktory MeSH
• senioři MeSH
• sexuální faktory MeSH
• tendenční skóre MeSH
• umělé dýchání statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• pozorovací studie MeSH

PURPOSE: The significance of dental status and oral hygiene on a range of medical conditions is well-recognised. However, the correlation between periodontitis, oral bacterial dysbiosis and visceral surgical outcomes is less well established. To this end, we study sought to determine the influence of dental health and oral hygiene on the rates of postoperative complications following major visceral and transplant surgery in an exploratory, single-center, retrospective, non-interventional study. METHODS: Our retrospective non-interventional study was conducted at the Department of General, Visceral, and Transplant Surgery, University Hospital Heidelberg, Germany. Patients operated on between January 2018 and December 2019 were retrospectively enrolled in the study based on inclusion (minimum age of 18 years, surgery at our Department, intensive care / IMC treatment after major surgery, availability of patient-specific preoperative dental status assessment, documentation of postoperative complications) and exclusion criteria (minor patients or legally incapacitated patients, lack of intensive care or intermediate care (IMC) monitoring, incomplete documentation of preoperative dental status, intestinal surgery with potential intraoperative contamination of the site by intestinal microbes, pre-existing preoperative infection, absence of data regarding the primary endpoints of the study). The primary study endpoint was the incidence of postoperative complications. Secondary study endpoints were: 30-day mortality, length of hospital stay, duration of intensive care stay, Incidence of infectious complications, the microbial spectrum of infectious complication. A bacteriology examination was added whenever possible (if and only if the examination was safe for the patient)for infectious complications. RESULTS: The final patient cohort consisted of 417 patients. While dental status did not show an influence (p = 0.73) on postoperative complications, BMI (p = 0.035), age (p = 0.049) and quick (p = 0.033) were shown to be significant prognostic factors. There was significant association between oral health and the rate of infectious complications for all surgical procedures (p = 0.034), excluding transplant surgery. However, this did not result in increased 30-day mortality rates, prolonged intensive care unit treatment or an increase in the length of hospital stay (LOS) for the cohort as a whole. In contrast there was a significant correlation between the presence of oral pathogens and postoperative complications for a group as a whole (p < 0.001) and the visceral surgery subgroup (p < 0.001). Whilst this was not the case in the cohort who underwent transplant surgery, there was a correlation between oral health and LOS in this subgroup (p = 0.040). Bacterial swabs supports the link between poor oral health and infectious morbidity. CONCLUSIONS: Dental status was a significant predictor of postoperative infectious complications in this visceral surgery cohort. This study highlights the importance preoperative dental assessment and treatment prior to major surgery, particularly in the case of elective surgical procedures. Further research is required to determine the effect of oral health on surgical outcomes in order to inform future practice. TRIAL REGISTRATION: Trial registered under the ethics-number S-082/2022 (Ethic Committee of the University Heidelberg).

• MeSH
• délka pobytu statistika a číselné údaje   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• orální hygiena MeSH
• orální zdraví MeSH
• pooperační komplikace * epidemiologie   etiologie   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• transplantace orgánů škodlivé účinky   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• Geografické názvy
• Německo MeSH