Cocaine-Positive Patients Undergoing Elective Surgery: From Avoiding Case Cancellations to Treating Substance Use Disorders.

Published on Feb 1, 2021in Anesthesia & Analgesia5.178
· DOI :10.1213/ANE.0000000000004969
Karsten Bartels19
Estimated H-index: 19
,
Joseph P. Schacht16
Estimated H-index: 16
(Anschutz Medical Campus)
Source
Abstract
References15
Newest
#1Tiffany S. Moon (UTSW: University of Texas Southwestern Medical Center)H-Index: 6
#2Taylor J. PakH-Index: 2
Last. Babatunde O. OgunnaikeH-Index: 13
view all 16 authors...
BACKGROUND: Cocaine has a short biological half-life, but inactive urine metabolites may be detectable for a week following use. It is unclear if patients who test positive for cocaine but have a normal electrocardiogram and vital signs have a greater percentage of hemodynamic events intraoperatively. METHODS: A total of 328 patients with a history of cocaine use who were scheduled for elective noncardiac surgery under general anesthesia were enrolled. Patients were categorized into cocaine-posi...
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#1Susanna Calling (Lund University)H-Index: 13
#2Henrik Ohlsson (Lund University)H-Index: 28
Last. Kenneth S. Kendler (VCU: Virginia Commonwealth University)H-Index: 204
view all 5 authors...
OBJECTIVES: Alcohol use disorders (AUD) is well known to aggregate in families and is associated with socioeconomic status (SES). The objective was to study the effect of education, income and neighborhood SES in adulthood on AUD, and to explore whether the potential associations were confounded by shared familial factors, by using a co-relative control design. METHODS: Data on AUD was drawn from the Swedish inpatient and outpatient care registers; prescription drug register; and crime data. Thr...
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#1Tiffany S. Moon (UTSW: University of Texas Southwestern Medical Center)H-Index: 6
#2Michael X. Gonzales (UTSW: University of Texas Southwestern Medical Center)H-Index: 4
Last. Babatunde O. Ogunnaike (UTSW: University of Texas Southwestern Medical Center)H-Index: 13
view all 8 authors...
Abstract Study objective To evaluate the intraoperative hemodynamics and medication requirements of cocaine-positive patients compared to matched cocaine-negative controls. Design Retrospective cohort study. Setting Public county hospital. Patients 821 patients undergoing general anesthesia. Measurements Incidence of hemodynamic events, defined by a mean arterial pressure of 105 mmHg or a heart rate of 100 beats per minute. Main results Cocaine-positive patients did not experience a higher incid...
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#1Julie W. M. Egholm (University of Southern Denmark)H-Index: 2
#2Bolette Sandford Pedersen (UCPH: University of Copenhagen)H-Index: 9
Last. Hanne Tønnesen (UCPH: University of Copenhagen)H-Index: 37
view all 6 authors...
Background: Risky consumption of alcohol is a global problem. More than 3.3 million deaths annually are associated with risky use of alcohol, and global alcohol consumption continues to increase. People who have high alcohol consumption often require planned and emergency surgical procedures. Risky drinking is associated with increased postoperative complications such as infections, cardiopulmonary complications, and bleeding episodes. Alcohol causes disorders of the liver, pancreas, and nervous...
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#1D.J.N. Wong (UCL: University College London)H-Index: 1
#2S.K. Harris (UCL: University College London)H-Index: 1
Last. Sharon DrakeH-Index: 7
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Abstract Background Cancellation of planned surgery impacts substantially on patients and health systems. This study describes the incidence and reasons for cancellation of inpatient surgery in the UK NHS. Methods We conducted a prospective observational cohort study over 7 consecutive days in March 2017 in 245 NHS hospitals. Occurrences and reasons for previous surgical cancellations were recorded. Using multilevel logistic regression, we identified patient- and hospital-level factors associate...
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#1Bridget F. Grant (NIH: National Institutes of Health)H-Index: 140
#2Tulshi D. Saha (NIH: National Institutes of Health)H-Index: 46
Last. Deborah S. Hasin (Columbia University)H-Index: 125
view all 11 authors...
Importance Current information on the prevalence and sociodemographic and clinical profiles of individuals in the general population with DSM-5 drug use disorder (DUD) is limited. Given the present societal and economic context in the United States and the new diagnostic system, up-to-date national information is needed from a single uniform data source. Objective To present nationally representative findings on the prevalence, correlates, psychiatric comorbidity, disability, and treatment of DS...
Source
#1Bridget F. Grant (NIH: National Institutes of Health)H-Index: 140
#2Risë B. Goldstein (NIH: National Institutes of Health)H-Index: 63
Last. Deborah S. Hasin (Columbia University)H-Index: 125
view all 11 authors...
Importance National epidemiologic information from recently collected data on the newDSM-5classification of alcohol use disorder (AUD) using a reliable, valid, and uniform data source is needed. Objective To present nationally representative findings on the prevalence, correlates, psychiatric comorbidity, associated disability, and treatment ofDSM-5AUD diagnoses overall and according to severity level (mild, moderate, or severe). Design, Setting, and Participants We conducted face-to-face interv...
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#1Susan M. Lee (UWO: University of Western Ontario)H-Index: 5
#2Jennifer LandryH-Index: 2
Last. Patricia Morley-ForsterH-Index: 22
view all 5 authors...
BACKGROUND:While surgery and perioperative smoking cessation interventions may motivate patients to quit smoking in the short term, it is unknown how often this translates into permanent cessation. In this study, we sought to determine the rates of long-term smoking cessation after a perioperative s
Source
#1Karsten BartelsH-Index: 19
#2Jörn Karhausen (Duke University)H-Index: 21
Last. Holger K. Eltzschig (University of Colorado Denver)H-Index: 90
view all 5 authors...
Despite the fact that a surgical procedure may have been performed for the appropriate indication and in a technically perfect manner, patients are threatened by perioperative organ injury. For example, stroke, myocardial infarction, acute respiratory distress syndrome, acute kidney injury, or acute gut injury are among the most common causes for morbidity and mortality in surgical patients. In the current review, the authors discuss the pathogenesis of perioperative organ injury, and provide se...
Source
AANA Journal  August 2012  Vol. 80, No. 4  Special Research Edition S33 Cocaine has been associated with acute hemodynamic changes, causing anesthesia providers to be concerned about adverse hemodynamic events during general anesthesia. We sought to determine if there were differences in the prevalence of adverse hemodynamic events, and if hemodynamic instability could be predicted in cocaine-positive patients undergoing general anesthesia for elective surgery. A retrospective cohort study wa...
Cited By1
Newest
#1Jessica K. Goeller (Boston Children's Hospital)H-Index: 4
#2Karsten Bartels (Outcomes Research Consortium)
Summary null In this editorial, we examine how the STRoke After Surgery (STRAS) screening tool and similar risk scoring systems can be used to identify high-risk patients for postoperative stroke. Specific challenges to develop and implement preventative measures aimed at improving postoperative outcomes are discussed. Finally, we suggest potential future areas of research in this field.
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