User:Celena21/sandbox

I would like to contribute in the “Cardiac Surgery” Wikipedia Page, specifically under the header of “Complication risk reductions.” There is many complication risks that can be reduced by surgeons even though sometimes they don’t agree with some of the patient’s decisions, such as smoking. Surgeons try their best to reduce risk complications. Accordingly to Germano Di Sciascio in “Randomized Trial of Atorvastatin for Reduction of Postoperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery,” Atrial Fibrillation increases risk complications. Sciascio introduces one of his trials that he has been working on, related to reducing complication risks. He states his method and results in his trial and discovers that by undergoing with “statin therapy” it has lower Atrial Fibrillation. As stated in the conclusion, “Treatment with atorvastatin 40 mg/d, initiated 7 days before surgery, significantly reduces the incidence of postoperative AF after elective cardiac surgery with cardiopulmonary bypass and shortens hospital stay. These results may influence practice patterns with regard to adjuvant pharmacological therapy before cardiac surgery” (Sciascio). With this trial Sciascio has discovered how patients can shorten their stay at the hospital after cardiac surgery. Even though this trial has been tested on a few amount of people, it may not work on everyone. However, discovering this saves a huge percentage of patient’s lives.

Another trial was done at Washington University School of Medicine in St. Louis, by a couple of doctors; Charles W. Hogue Jr, MD; Suzan F. Murphy, RN, BSN; Kenneth B. Schechtman, PhD; Victor G. Dávila-Román, MD. Their main purpose of this trial was to identify risk factors after and before cardiac surgery. “Data were obtained from 2972 patients undergoing coronary artery bypass graft and/or valve surgery” (Charles W. Hogue, Jr, MD). In their trial 48 patients had a stroke and 31 of them had delayed strokes. As a result, “Most strokes after cardiac surgery occurred after initial uneventful recovery from surgery. Women were at higher risk to suffer early and delayed perioperative strokes. Atrial fibrillation had no impact on postoperative stroke rate unless it was accompanied by low cardiac output syndrome” (Hogue). From this trial, it was discovered when strokes occurred and who has a higher risk. In this case, women were at higher risk and now surgeons are aware of that. Trails help doctors a lot because it helps them know what triggers any complications and it helps them in advance what do to if their have such a complication like a stroke.

Apart from many other complications, there was a study performed at Journal Of The American College Of Cardiology about strains if it decreases cardiac complications. The title of the article is, “Statins decrease perioperative cardiac complications in patients undergoing noncardiac vascular surgery” by O'neil-Callahan, Kristin, George Katsimaglis, Micah R. Tepper, Jason Ryan, Carla Mosby, John P.a. Ioannidis, and Peter G. Danias. As a result, “Complications occurred in 157 of 1,163 eligible hospitalizations and were significantly fewer in patients receiving statins (9.9%) than in those not receiving statins (16.5%, p = 0.001)” (Callahan). It was proven that strains do help and is “protective against perioperative cardiac complications in patients undergoing vascular surgery” (Callahan). With so many trials being performed, little by little this kind of things help reduce complications. As shown, fewer patients are having complications. The more surgeons are careful and take their time to see if the patients are at risks of anything else the own surgeons can prevent a patient from dying from a complication.

References Hein, Ortrud Vargas, Jürgen Birnbaum, Klaus Wernecke, Michael England, Wolfgang Konertz, and Claudia Spies. "Prolonged Intensive Care Unit Stay in Cardiac Surgery: Risk Factors and Long-Term-Survival." The Annals of Thoracic Surgery 81.3 (2006): 880-85. Web. 11 May 2015. Hogue, C. W., S. F. Murphy, K. B. Schechtman, and V. G. Davila-Roman. "Risk Factors for Early or Delayed Stroke After Cardiac Surgery."Circulation 100.6 (1999): 642-47. Web. 11 May 2015. Lee, T. H., E. R. Marcantonio, C. M. Mangione, E. J. Thomas, C. A. Polanczyk, E. F. Cook, D. J. Sugarbaker, M. C. Donaldson, R. Poss, K. K. L. Ho, L. E. Ludwig, A. Pedan, and L. Goldman. "Derivation and Prospective Validation of a Simple Index for Prediction of Cardiac Risk of Major Noncardiac Surgery." Circulation 100.10 (1999): 1043-049. Web. 11 May 2015. O'neil-Callahan, Kristin, George Katsimaglis, Micah R. Tepper, Jason Ryan, Carla Mosby, John P.a. Ioannidis, and Peter G. Danias. "Statins Decrease Perioperative Cardiac Complications in Patients Undergoing Noncardiac Vascular Surgery." Journal of the American College of Cardiology 45.3 (2005): 336-42. Web. 11 May 2015. Qaseem, Amir. "Risk Assessment for and Strategies To Reduce Perioperative Pulmonary Complications for Patients Undergoing Noncardiothoracic Surgery: A Guideline from the American College of Physicians." Annals of Internal Medicine 144.8 (2006): 575. Web. 11 May 2015. Sciascio, Germano Di. "Randomized Trial of Atorvastatin for Reduction of Postoperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery." Circulation. N.p., 25 Sept. 2006. Web. 11 May 2015.