A5023280693- Cardiac, Anesthesia and Surgical Outcomes
- Hemodynamic Monitoring and Therapy
- Innovations in Medical Education
- Anesthesia and Sedative Agents
- Clinical Reasoning and Diagnostic Skills
- Intensive Care Unit Cognitive Disorders
- Radiology practices and education
- Electronic Health Records Systems
- Blood transfusion and management
- Simulation-Based Education in Healthcare
- Health Literacy and Information Accessibility
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Blood Pressure and Hypertension Studies
- Surgical Simulation and Training
- Cardiac Health and Mental Health
- Venous Thromboembolism Diagnosis and Management
- Sepsis Diagnosis and Treatment
- Obstructive Sleep Apnea Research
- Diversity and Career in Medicine
- Pancreatic and Hepatic Oncology Research
- Health and Medical Research Impacts
- Interprofessional Education and Collaboration
- Mobile Health and mHealth Applications
- Ultrasound in Clinical Applications
- Gallbladder and Bile Duct Disorders
University Health Network
2010-2024
Toronto General Hospital
2011-2023
University of Toronto
2006-2022
Women's College Hospital
2022
Sinai Health System
2022
University of Pennsylvania Health System
2013-2021
Dalhousie University
2013-2017
Information Management Services
2015
University of Pennsylvania
2014
Toronto Western Hospital
2014
Previous studies, which relied on hypothetical cases and chart reviews, have questioned the inter-rater reliability of ASA physical status (ASA-PS) scale. We therefore conducted a retrospective cohort study to evaluate its validity in clinical practice.The included all adult patients (≥18 yr) who underwent elective non-cardiac surgery at quaternary-care teaching institution Toronto, Ontario, Canada, from March 2010 December 2011. assessed by comparing ASA-PS scores assigned preoperative...
Preoperative anemia is an important risk factor for perioperative red blood cell transfusions and has been shown to be independently associated with adverse outcomes after noncardiac surgery. The objective of this observational study was measure the prevalence preoperative assess relationship between postoperative mortality.Data were retrospectively collected on 7,759 consecutive surgical patients at University Health Network 2003 2006. defined as a hemoglobin concentration less than 12.0...
The use of normal saline is associated with hyperchloremic metabolic acidosis. In this study, we sought to determine the incidence acute postoperative hyperchloremia (serum chloride >110 mEq/L) and whether electrolyte disturbance an increase in length hospital stay, morbidity, or 30-day mortality.Data were retrospectively collected on consecutive adult patients (>18 years age) who underwent inpatient, noncardiac, nontransplant surgery between January 1, 2003 December 31, 2008. impact patient...
Early recognition and timely intervention significantly reduce sepsis-related mortality.Describe the development, implementation, impact of an early warning response system (EWRS) for sepsis.After tool derivation validation, a preimplementation/postimplementation study with multivariable adjustment measured impact.Urban academic healthcare system.Adult non-ICU patients admitted to acute inpatient units from October 1, 2011 31, derivation, June 6, 2012 July 5, September 4, 2013 analysis.An...
Abstract Background: Perioperative metoprolol increases postoperative stroke. Animal studies indicate that the mechanism may be related to attenuated β2-adrenoreceptor-mediated cerebral vasodilatation. The authors therefore conducted a cohort study whether highly β1-specific β-blocker (bisoprolol) was associated with reduced risk of stroke compared less selective β-blockers (metoprolol or atenolol). Methods: single-center on 44,092 consecutive patients age 50 yr more having noncardiac,...
Objectives The aim of this study was to evaluate the usability e-Ouch electronic chronic pain diary in adolescents with juvenile idiopathic arthritis. Methods A qualitative testing approach semistructured, audiotaped interviews two iterative cycles used. purposive sample 10 per cycle drawn from a rheumatology clinic university-affiliated pediatric tertiary care center. Participants were provided brief demonstration and then asked use "thinking aloud" record they experienced: (1) when woke up...
Background Despite decreasing cardiac events, perioperative beta-blockade also increases stroke and mortality. Major bleeding and/or hypotension are independently associated with these outcomes. To investigate the hypothesis that limits reserve to compensate for acute surgical anemia, authors examined relationship between events anemia in patients without beta-blockade. Methods The records of all noncardiac, nontransplant March 2005 June 2006 were retrospectively retrieved. primary outcome...
Coagulopathy leading to excessive blood loss and large volume red cell transfusion is a frequent complication of cardiac surgery with cardiopulmonary bypass (CPB) that may be caused by low perioperative fibrinogen levels. We explored the relationship between post-CPB levels transfusion.Patients who underwent CPB from 2005 2011 at single institution had level measured after were included in this retrospective observational study. The (defined as ≥5 units transfused on day or surgery) was...
Background Perioperative beta-blockade and anemia are independent predictors of increased stroke mortality by undefined mechanisms. This study investigated the effect on cerebral tissue oxygen delivery in an experimental model blood loss fluid resuscitation (hemodilution). Methods Anesthetized rats were treated with metoprolol (3 mg x kg) or saline before undergoing hemodilution pentastarch (1:1 volume exchange, 30 ml kg). Outcomes included cardiac output, flow, brain (PBrO2) kidney (PKO2)...
BACKGROUND: Aprotinin is superior to other antifibrinolytic drugs for preventing major blood loss after cardiac surgery but may also increase perioperative mortality. It remains unclear whether its risk-benefit profile differs among low-, moderate-, and high-risk surgical patients. METHODS: In this retrospective single-center cohort study, we included 15,365 patients who underwent with cardiopulmonary bypass from 2000 2008. Of these, 1017 received aprotinin (6 × 106 U) 14,358 tranexamic acid...
BACKGROUND Identification of patients at high risk for readmission is a crucial step toward improving care and reducing readmissions. The adoption electronic health records (EHR) may prove important to strategies designed stratify introduce targeted interventions. OBJECTIVE To develop implement an automated prediction model integrated into our system's EHR that identifies on admission within 30 days discharge. DESIGN Retrospective prospective cohort. SETTING Healthcare system consisting 3...
Current guidelines on perioperative care recommend the prophylactic use of β blockers in high-risk patients undergoing noncardiac surgery. However, recent studies show that, some instances, blockade can cause harm. Furthermore, chronic blockade, titrated to effect before surgery, may be superior acute blockade. The primary objective this study was compare major cardiac outcomes who underwent surgery with blocker therapy those β-blocker therapy.Data were collected for 10,691 consecutive...
We implemented an electronic early warning and response system (EWRS) to improve detection of severe sepsis. Sustainability such a requires stakeholder acceptance. hypothesized that clinicians receiving alerts perceive them be useful effective.To survey after EWRS notification about perceptions the system.For 6-week study period 1 month implementation in large tertiary referral medical center, bedside clinicians, including providers (physicians, advanced practice providers) registered nurses...
Sankar, A.; Johnson, S. R.; Beattie, W. S.; Tait, G.; Wijeysundera, D. N. Author Information