We hypothesized that the Surgical Procedure Assessment score would predict intensive care unit length of stay, discriminate preoperatively
between fast-track and prolonged-stay patients, and compare favorably with more complex risk scores.
Methods: After institutional review board approval, 1201 cardiac surgical patients were preoperatively assigned a Surgical SC75741 manufacturer Procedure Assessment score, as well as a Parsonnet, Tuman, Tu, and Cardiac Anesthesia Risk Evaluation score. We compared these scores with regard to prediction of intensive care unit length of stay, as well as their concordance in predicting intensive care unit length of stay of less than 48 hours (fast track) and more than 7 days (prolonged stay).
Results: Intensive care unit length of stay increased significantly selleck chemical with increasing Surgical Procedure Assessment scores (P < .01, Cuzick’s test for trend). The lowest Surgical Procedure Assessment score (1A) predicted intensive care unit length of stay of less than 48 hours, and the higher Surgical Procedure Assessment scores (2B or 3) predicted intensive care unit length of stay of more than 7 days more accurately than the Parsonnet, Tuman, Tu and Cardiac Anesthesia Risk Evaluation scores.
Conclusions: The Surgical Procedure Assessment score predicts intensive care unit length of stay better than other comparable scores.
It is simple, intuitive, and easily understood by all caregivers and can preoperatively discriminate fast-track from prolonged-stay patients. It is a useful tool to facilitate intensive care unit triage. (J Thorac Cardiovasc Surg 2011; 142: 443-50)”
“In the recent years, atherogenesis has increasingly been linked to inflammatory processes in the injured vessel wall. Recruitment
and arrest of monocytes, T cells, and neutrophils via the concerted actions of multiple chemokines and their chemokine receptors have been the subject of intense research and are being appreciated as key events underlying atherosclerotic lesion formation and progression. The evolutionary conserved cytokine macrophage migration inhibitory factor (MIF) exhibits prominent proinflammatory and proatherogenic functions, and the latest findings on its chemotactic selleck chemicals and chemokine-like properties imply MIF as a crucial drug target for the treatment of inflammatory diseases. In this review, the role of MIF in atherosclerosis and injury-induced neointima formation is discussed. We place an emphasis on its proinflammatory and chemokine-like functions in the context of underlying extra- and intracellular signaling mechanisms. These findings clearly distinguish MIF from other cytokines in atherosclerosis and justify the intensive search for inhibitors targeting MIF in the treatment of inflammatory diseases, including advanced atherosclerosis. (Trends Cardiovasc Med 2009; 19:76-86) (C) 2009, Elsevier Inc.”
“Background: Both type 2 diabetes and hyperinsulinemia have been related to diminished cognition.