Journal of Acute Disease

52-58

Authors: Duygu Akyol1 , Zafer Cukurova2 , Evrim Kucur Tulubas2 , Güneş Özlem Yıldız 2 , Mehmet Süleyman Sabaz

Objective: To investigate the effects of perioperative goal-directed fluid therapy (GDFT) on intraoperative fluid balance, postoperative morbidity, and mortality. Methods: This is a prospective randomized study, and 90 patients who underwent elective open gastrointestinal cancer surgery between April 2017 and May 2018 were included. Patients were randomized into 2 groups that received liberal fluid therapy (the LFT group, n=45) and goal-directed fluid therapy (the GDFT group, n=45). Patients’ Colorectal Physiologic and Operative Severity Score for the enUmeration of Mortality and Morbidity (CR-POSSUM) physiological score, Charlson Comorbidity Index (CCI), perioperative vasopressor and inotrope use, postoperative AKIN classification, postoperative intensive care unit (ICU) hospitalization, hospital stay, and 30-day mortality were recorded. Results: The volume of crystalloid used perioperatively and the total volume of fluid were significantly lower in the GDFT group compared to the LFT group (P<0.05). CR-POSSUM physiological score and CCI were significantly higher in the GDFT group (P<0.05). Although perioperative vasopressor and inotrope use was significantly higher in the GDFT group (P<0.05), postoperative acute kidney injury development was not affected. Postoperative mortality was determined to be similar in both groups (P>0.05). Conclusion: Although GDFT was demonstrated to be a good alternative method to LFT in open gastrointestinal cancer surgery, and it can prevent perioperative fluid overload, and the postoperative results are comparable in the two groups.

65-70

Authors: Hamissou Moussa Maman Roufai, Jun Yang, Guang-Fu Song , Fu-Yi Yang

Objective: To investigate the effect of cold weather on carotid artery stenosis and occlusion. Methods: We conducted a retrospective observational study, in which 145 patients with carotid artery stenosis and occlusion were enrolled [115 men and 30 women; the mean age was 61.08 years (95% CI 59.27-62.88)]. Patients were divided into the lowtemperature group (n=98) (≤12曟) and the non-low temperature group (n=47) (>12曟). Clinical characteristics, blood pressure, National Institutes of Health Stroke Scale (NIHSS), blood fat, and blood viscositys were compared between the two groups. Correlation between NIHSS and mean daily temperature was analyzed. Results: There was no significant difference in the systolic and diastolic blood pressure between the two groups (P>0.05). The NIHSS score was slightly higher in the non-low temperature group compared to that of the low-temperature group (U=2 984, P<0.01). Glycemia, cholesterol level, prothrombin time, fibrinogen, and International Normalized Ratio did not show any significant difference (P>0.05). Correlation analysis showed a very low positive and statistically significant correlation between ambient temperature and NIHSS score (r=0.18, P=0.029). Conclusion: Cold weather does not impact blood pressure, blood cholesterol, and coagulation factors of patients with carotid artery stenosis and occlusion. The neurological deficit is more severe in the non-low ambient temperature group. A potential relationship exists between ambient temperature and the level of neurological impairment.

71-76

Authors: Nalini Ramesh Humaney, Shilpa Sachin Kuthe, Shamim Akhtar, Vivek K Pande

Objective: To determine the association between body weight and COVID-19 outcomes. Methods: This is a retrospective cohort study of COVID-19 patients admitted in a dedicated COVID-19 hospital, a tertiary health care center, between May and June 2021. Demographic data and baseline variables, including age, sex, body mass index (BMI), and comorbidities were collected. Outcomes (death or mechanical ventilation) of the patients with different BMI, age, comorbidities, and qSOFA scores were compared. Besides, the risk factors for death or mechanical ventilation were determined. Results: The mean age of the subjects was (51.8±14.7) years old, and 233 (74.2%) were male. There were 103 (32.8%) patients with normal weight, 143 (45.5%) patients were overweight, and 68 (21.7%) patients were obese. In-hospital deaths and need of mechanical ventilations were significantly higher in the obese and the overweight group compared to the normal weight group, in age group ≥65 years compared to <65 years, in patients with ≥1 comorbidities compared to patients without comorbidities, in patients with qSOFA scores≥2 compared to patients with qSOFA scores<2. There was a significantly increased risk of death (RR: 4.1, 95% CI 1.0-17.4, P=0.04) and significantly increased need of mechanical ventilation (RR: 5.2, 95% CI 1.8-15.2, P=0.002) in the obese patients compared with those with normal weight after controlling other covariates. Conclusion: Obesity is one of the significant risk factors for adverse outcomes in COVID-19 patients and should be considered during management

88

Authors: Godpower Chinedu Michael

Non