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Srinivasan Y, Briano J, Czaja S, Lachs MS, Rosen AE, Stewart MG, Rameau A. Elective Surgery Trends and Outcomes of Nonagenarians and Centenarians in Otolaryngology-Head and Neck Surgery: A NSQIP Study. Laryngoscope 2024; 134:3989-3996. [PMID: 38587164 PMCID: PMC11305954 DOI: 10.1002/lary.31446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/11/2024] [Accepted: 03/29/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE To describe types and outcomes of elective otolaryngological surgeries undergone by patients ≥90 years of age and to assess whether very old age is an independent risk factor for postsurgical complications and death. METHODS The National Surgical Quality Improvement Program, a validated national prospective surgical outcomes database, was used to identify all patients aged 65 years and older who underwent elective otolaryngological procedures from 2011 to 2020. Study outcomes included minor complications, major life-threatening complications, and 30-day mortality. Predictors of outcomes, including frailty, were identified using univariable analyses and age was added into the final logistic regression models with stepwise selection. RESULTS A total of 40,723 patients met inclusion criteria; 629 (1.5%) patients were ≥90 years of age. Of the 63,389 procedures, head and neck (67.6%) and facial plastics and reconstructive (15.0%) procedures were most common. The overall incidence of major life-threatening complications, minor complications, and death was 2.0%, 3.5%, and 0.4%, respectively. Age ≥90 was significantly associated with an increased risk for 30-day mortality, but not with major or minor postoperative complications. A high modified frailty index was significantly associated with an increased risk for major postoperative complications and death amongst patients ≥90 years. CONCLUSIONS Elective otolaryngological surgery can be safe in relatively healthy nonagenarians and centenarians, though there is a small increased risk of 30-day mortality. Although older age can predispose patients to other comorbidities, age alone should not deter surgeons and patients from considering elective otolaryngological procedures. Frailty may be a better predictor for surgical outcomes. LEVEL OF EVIDENCE IV Laryngoscope, 134:3989-3996, 2024.
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Affiliation(s)
- Yashes Srinivasan
- Sean Parker Institute for the Voice, Department of
Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, NY 10022,
United States
| | - Juan Briano
- Sean Parker Institute for the Voice, Department of
Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, NY 10022,
United States
| | - Sara Czaja
- Division of Geriatrics and Palliative Medicine, Weill
Cornell Medicine, New York, NY 10022, United States
| | - Mark S. Lachs
- Division of Geriatrics and Palliative Medicine, Weill
Cornell Medicine, New York, NY 10022, United States
| | - Anthony E. Rosen
- Department of Emergency Medicine, Weill Cornell Medicine,
New York, NY 10022, United States
| | - Michael G. Stewart
- Sean Parker Institute for the Voice, Department of
Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, NY 10022,
United States
| | - Anaïs Rameau
- Sean Parker Institute for the Voice, Department of
Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, NY 10022,
United States
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2
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Kok XLF, Gwilliam J, Sayers M, Jones EM, Cunningham SJ. A Cross-Sectional Study of Factors Influencing Pre-Operative Anxiety in Orthognathic Patients. J Clin Med 2023; 12:5305. [PMID: 37629347 PMCID: PMC10455953 DOI: 10.3390/jcm12165305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 08/09/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Orthognathic treatment is an important treatment modality to manage severe dentofacial discrepancies. Patients awaiting orthognathic surgery often experience increased anxiety, which may adversely affect post-operative recovery and treatment satisfaction. This study investigated the effects of a number of factors on pre-operative anxiety in orthognathic patients. Seventy patients prospectively recruited from three orthognathic centres in the UK completed a pre-operative questionnaire that included validated scales for measuring anxiety, social support, resilience, and coping styles. Sociodemographic data and satisfaction with the information provided by the clinical team were also elicited from the questionnaire. Univariable analysis showed that social support from a significant other (p = 0.026), resilience (p < 0.001), and satisfaction with the information provided by the clinical team (p = 0.002) were significantly associated with reduced anxiety, whilst avoidance coping (p < 0.001) and coping through seeking social support (p = 0.006) were significantly related to increased anxiety. With the exception of coping by seeking social support, these relationships retained significance in a multivariable regression analysis. Neither gender nor ethnicity moderated the effects of social support on pre-operative anxiety. These findings suggest potential avenues for clinicians to address with future interventions to reduce pre-operative anxiety. Further qualitative research may provide greater clarity on the relationship between these variables and anxiety.
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Affiliation(s)
- Xiu Ling Florence Kok
- Department of Orthodontics, UCL Eastman Dental Institute, 21 University Street, London WC1E 6DE, UK;
| | - Jamie Gwilliam
- Department of Orthodontics, St George’s Hospital, St George’s University Hospitals NHS Foundation Trust, London SW17 0QT, UK;
| | - Mark Sayers
- Department of Orthodontics, Queen Mary’s Hospital Sidcup, King’s College Hospital NHS Foundation Trust, Sidcup DA14 6LT, UK;
| | - Elinor M. Jones
- Department of Statistical Science, University College London, London WC1E 6BT, UK;
| | - Susan J. Cunningham
- Department of Orthodontics, UCL Eastman Dental Institute, 21 University Street, London WC1E 6DE, UK;
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3
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Gundogmus AG, Sezer Katar K, Orsel S, Ozturk G, Yilmaz KB. The relationship of potential biomarkers with psychological resilience and post-traumatic growth in female patients with breast cancer. PLoS One 2022; 17:e0277119. [PMID: 36525411 PMCID: PMC9757578 DOI: 10.1371/journal.pone.0277119] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 10/21/2022] [Indexed: 12/23/2022] Open
Abstract
While investigating psychosocial factors on resilience and post-traumatic growth draws attention, research on biological correlates is limited. We investigated the relationship between post-traumatic growth, resilience, post-traumatic stress, and potential biomarkers in female patients with breast cancer (n = 71) from the general surgery or oncology clinics. They completed the Post-Traumatic Growth Inventory (PTGI), Connor Davidson Psychological Resilience Scale (CD-RISC), Brief Resilience Scale (BRS), PTSD Checklist for DSM-V, and Hospital Anxiety and Depression Scale. Blood samples were collected for NPY, ALLO, DHEA-S, testosterone, cortisol, and hsCRP levels. The relationship between biochemical parameters and the scales was investigated in the whole patient group and in the subgroup of patients who perceived breast cancer as traumatic. When all the patients were evaluated, hsCRP and depression scores were significantly and positively correlated; and hsCRP, BRS score, and PTGI change in self-perception subscale score were significantly and negatively correlated. There was a significant positive correlation between the ALLO level and the psychological resilience (CD-RISC) score in the patient group who perceived breast cancer as traumatic. It was observed that psychological resilience and PTG were positively correlated, and that multiple biomarkers were associated with psychological resilience in female breast cancer patients. Especially findings regarding ALLO levels and psychological resilience could be a new target for future research.
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Affiliation(s)
- Ayse Gokcen Gundogmus
- Department of Psychiatry, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
- * E-mail:
| | - Kubra Sezer Katar
- Department of Psychiatry, Islahiye State Hospital, Gaziantep, Turkey
| | - Sibel Orsel
- Department of Psychiatry, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Gulfer Ozturk
- Department of Biochemistry, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Kerim Bora Yilmaz
- Department of Surgery, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
- Department of Medical and Surgical Research, Institute of Health Sciences, Hacettepe University, Ankara, Turkey
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4
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Josephs CA, Shaffer VO, Kucera WB. Impact of Mental Health on General Surgery Patients and Strategies to Improve Outcomes. Am Surg 2022:31348221109469. [PMID: 35730505 DOI: 10.1177/00031348221109469] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Mental Health Disorders (MHD) are a growing concern nationwide. The significant impact MHD have on surgical outcomes has only recently started to be understood. This literature review investigated how mental health impacts the outcomes of general surgery patients and what can be done to make improvements. Patients with schizophrenia had the poorest surgical outcomes. Mental health disorders increased post-surgical pain, hospital length of stay, complications, readmissions, and mortality. Mental health disorders decreased wound healing and quality of care. Optimizing outcomes will be best accomplished through integrating more effective perioperative screening tools and interventions. Screenings tools can incorporate artificial intelligence, MHD data, resilience and its biomarkers, and patient mental health questionnaires. Interventions include cognitive behavioral therapy, virtual reality, spirituality, pharmacology, and resilience training.
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Affiliation(s)
- Cooper A Josephs
- 364432Campbell University School of Osteopathic Medicine, Lillington, NC, USA
| | - Virginia O Shaffer
- Department of Surgery, 12239Emory University School of Medicine, Atlanta, GA, USA
| | - Walter B Kucera
- Department of Surgery, 12239Emory University School of Medicine, Atlanta, GA, USA
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5
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Hashim CG, Taib NA, Yoon HJ, Larkin D, Yip D, Lopez V. Psychometric Assessment of the Malay Version of the 14-Item Resilience Scale (RS-14) in Women With Breast Cancer. J Nurs Meas 2021; 29:E18-E38. [PMID: 33593987 DOI: 10.1891/jnm-d-19-00068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE There are a lack of documentation on psychometric assessments on the Malay version of 14-item Resilience scale (RS-14) in Malaysia. This study was to empirically assess its reliability and validity. METHOD A prospective test-retest design was employed on Malaysian women with early breast cancer (N = 105). Data were analyzed using SPSS version 24. RESULTS The results showed overall Cronbach alpha values were .92 and .93 for test-retest, respectively. Intraclass correlation coefficient (ICC) values ranged between .62 and .75. This study accepted three factors and two factors for test-retest, respectively. Individual factors showed Cronbach alpha average ranged from .71 to .91. CONCLUSION The Malay version RS-14 tool was found to be statistically valid, reliable, and reproducible. It was able to measure resilience level in those women under study.
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Affiliation(s)
| | | | | | | | - Desmond Yip
- Australian National University, Canberra, Australia
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Borras C, Ingles M, Mas-Bargues C, Dromant M, Sanz-Ros J, Román-Domínguez A, Gimeno-Mallench L, Gambini J, Viña J. Centenarians: An excellent example of resilience for successful ageing. Mech Ageing Dev 2019; 186:111199. [PMID: 31899226 DOI: 10.1016/j.mad.2019.111199] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 12/17/2019] [Accepted: 12/19/2019] [Indexed: 12/13/2022]
Abstract
Centenarians are remarkable not only because of their prolonged life, but also because they compress morbidity until the very last moments of their lives, thus being proposed as a model of successful, extraordinary ageing. From the medical viewpoint, centenarians do not escape the physiological decline or the age-related diseases or syndromes (i.e. frailty), but the rate of such processes is slow enough to be counterbalanced by their increased intrinsic capacity to respond to minor stresses of daily life (i.e. resilience). These new concepts are reviewed in this paper. Allostatic stresses lead to a chronic low-grade inflammation that has led to the proposal of the "inflammaging" theory of ageing and frailty. The biology of centenarians, described in this review, provides us with clues for intervention to promote healthy ageing in the general population. One of the major reasons for this healthy ageing has to do with the genetic signature that is specific for centenarians and certainly different from octogenarians who do not enjoy the extraordinary qualities of centenarians.
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Affiliation(s)
- C Borras
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain.
| | - M Ingles
- Freshage Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
| | - C Mas-Bargues
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
| | - M Dromant
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
| | - J Sanz-Ros
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
| | - A Román-Domínguez
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
| | - L Gimeno-Mallench
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
| | - J Gambini
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
| | - J Viña
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
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7
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Simon CB, Valencia C, Coronado RA, Wu SS, Li Z, Dai Y, Farmer KW, Moser MM, Wright TW, Fillingim RB, George SZ. Biopsychosocial Influences on Shoulder Pain: Analyzing the Temporal Ordering of Postoperative Recovery. THE JOURNAL OF PAIN 2019; 21:808-819. [PMID: 31891763 DOI: 10.1016/j.jpain.2019.11.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 10/03/2019] [Accepted: 11/19/2019] [Indexed: 01/16/2023]
Abstract
Shoulder surgery is a primary intervention for shoulder pain, yet many individuals experience persistent postoperative pain. Previously, we found individuals categorized as having a high-risk phenotype (comprised of COMT variation and pain catastrophizing) had approximately double the chance of not reaching a 12-month pain recovery criterion. As a means to better understand the development of persistent postoperative shoulder pain, this study advanced our previous work by examining temporal ordering of postoperative shoulder recovery based on potential mediating factors, and expansion of outcomes to include movement-evoked pain and shoulder active range of motion. Before surgery, individuals were categorized as either high-risk (high pain catastrophizing, COMT-genotype linked to low enzyme activity [n = 41]) or low-risk (low pain catastrophizing, COMT-genotype linked to normal enzyme activity [n = 107]). We then compared potential mediating variables at 3, 6, and 12 months postoperatively 1) endogenous pain modulation defined by a conditioned pain modulation paradigm; and 2) and emotion factors such as anxiety, fear of movement, and depressive symptoms. At 3 months, the high-risk subgroup had higher fear and movement-evoked pain, and causal mediation analysis confirmed the direct effect of risk subgroup on 12-month movement evoked pain. However, baseline to 12-month change in depressive symptoms were found to mediate 53% of the total effect of risk subgroup on 12-month movement-evoked pain. This study introduces potential temporal components and relationships to the development of persistent postoperative shoulder pain, which future studies will confirm and assess for potential therapeutic targets. PERSPECTIVE: This study expands upon postoperative shoulder recovery measures to include movement-evoked pain and depressive symptoms, and provides preliminary indication of temporal ordering to postoperative shoulder recovery for a preidentified high-risk subgroup. Future studies will distinguish temporal components of shoulder surgery that may optimize treatment targets of postoperative recovery.
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Affiliation(s)
- Corey B Simon
- Department of Orthopedic Surgery, Duke University, Durham, North Carolina.
| | - Carolina Valencia
- Department of Rehabilitation Sciences, University of Texas at El Paso, El Paso, Texas
| | - Rogelio A Coronado
- Department of Orthopedic Surgery and Rehabilitation, Vanderbilt University, Nashville, Texas
| | - Samuel S Wu
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Zhigang Li
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Yunfeng Dai
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Kevin W Farmer
- Department of Orthopedics and Rehabilitation, University of Florida, Gainesville, Florida
| | - Michael M Moser
- Department of Orthopedics and Rehabilitation, University of Florida, Gainesville, Florida
| | - Thomas W Wright
- Department of Orthopedics and Rehabilitation, University of Florida, Gainesville, Florida
| | - Roger B Fillingim
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, Florida
| | - Steven Z George
- Department of Orthopedic Surgery, Duke University, Durham, North Carolina; Duke Clinical Research Institute, Duke University, Durham, North Carolina
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8
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Bribriesco A, Raja S, Ahmad U. Atlas is not alone: sharing the burden of clinical challenge. J Thorac Dis 2018; 10:S972-S973. [PMID: 29850178 DOI: 10.21037/jtd.2018.03.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Alejandro Bribriesco
- Thoracic Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Siva Raja
- Thoracic Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Usman Ahmad
- Thoracic Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
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9
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Mebarki A. Safety of atmospheric industrial tanks: Fragility, resilience and recovery functions. J Loss Prev Process Ind 2017. [DOI: 10.1016/j.jlp.2017.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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10
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Farinetti A, Manenti A, Melegari G. DHEA as marker of good surgical homeostasis. J Visc Surg 2016; 153:481. [PMID: 27810237 DOI: 10.1016/j.jviscsurg.2016.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- A Farinetti
- Department of Surgery, University of Modena, Policlinic Hospital, v.Pozzo, 41121 Modena, Italy
| | - A Manenti
- Department of Surgery, University of Modena, Policlinic Hospital, v.Pozzo, 41121 Modena, Italy.
| | - G Melegari
- Department of Anaesthesia, University of Modena, Policlinic Hospital, v.Pozzo, 41121 Modena, Italy
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11
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Graham D, Becerril-Martinez G, Tang J. Who is the surgically resilient individual with traumatic spinal cord injury? JOURNAL OF SPINE SURGERY 2016; 2:230-233. [PMID: 27757438 DOI: 10.21037/jss.2016.08.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- David Graham
- Faculty of Medicine, University of Sydney, Sydney, Australia;; TY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, Australia
| | | | - Jonathan Tang
- Faculty of Medicine, University of Sydney, Sydney, Australia
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12
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Francomano D, Fattorini G, Gianfrilli D, Paoli D, Sgrò P, Radicioni A, Romanelli F, Di Luigi L, Gandini L, Lenzi A, Aversa A. Acute endothelial response to testosterone gel administration in men with severe hypogonadism and its relationship to androgen receptor polymorphism: a pilot study. J Endocrinol Invest 2016; 39:265-71. [PMID: 26162521 PMCID: PMC4761016 DOI: 10.1007/s40618-015-0325-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 05/26/2015] [Indexed: 01/01/2023]
Abstract
PURPOSE Testosterone (T) exerts different effects on the cardiovascular system. Despite this knowledge, the acute vascular effect of androgen remains still poorly understood. METHODS We investigated the acute effects of T on vascular function in ten men (18-40 years age) with hypogonadism and severe hypotestosteronemia [serum total testosterone (TT) = 0.6 ± 0.3 ng/mL]. In a 4-day double-blind, randomized, placebo-controlled crossover study, we administered 80 mg daily dose of transdermal-T gel (TG) and evaluated endothelial variations with Endopat2000 (reactive hyperemia index, RHI and the augmentation index, AI); also, CAG repeat polymorphism in exon 1 of the androgen receptor gene was investigated. RESULTS After TG administration, RHI significantly improved at 4 h (p < 0.05), while AI improvement was recorded at 4 and 96 h, also when adjusted for heart rate (AI@75; p < 0.01 and p < 0.001, respectively). Direct relationships between ΔT, ΔDHT and ΔRHI variations (r = 0.37, p < 0.01; r = 0.17, p < 0.05, respectively) as well as between "CAG repeats" length and ΔLnRHI at 96 h (p < 0.03, r (2) = 0.47) were found. An inverse relationship between ΔT and ΔAI (p < 0.01, r = -0.35) and ΔAI@75 (p < 0.01, r = -0.38) were found. CONCLUSION Administration of TG causes an acute vasodilation and improves arterial stiffness probably due to non-genomic actions of T. Endothelial vasodilatory response was more pronounced depending on higher plasma TT and DHT levels attained. Clinical implications in elderly frail populations are discussed.
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Affiliation(s)
- D Francomano
- Department of Experimental Medicine, Endocrinology and Food and Science Section, "Sapienza" University of Rome, 00161, Rome, Italy
| | - G Fattorini
- Department of Experimental Medicine, Endocrinology and Food and Science Section, "Sapienza" University of Rome, 00161, Rome, Italy
| | - D Gianfrilli
- Department of Experimental Medicine, Endocrinology and Food and Science Section, "Sapienza" University of Rome, 00161, Rome, Italy
| | - D Paoli
- Department of Experimental Medicine, Endocrinology and Food and Science Section, "Sapienza" University of Rome, 00161, Rome, Italy
| | - P Sgrò
- Department of Movement, Human and Health Sciences, University "Foro Italico" of Rome, 00135, Rome, Italy.
| | - A Radicioni
- Department of Experimental Medicine, Endocrinology and Food and Science Section, "Sapienza" University of Rome, 00161, Rome, Italy
| | - F Romanelli
- Department of Experimental Medicine, Endocrinology and Food and Science Section, "Sapienza" University of Rome, 00161, Rome, Italy
| | - L Di Luigi
- Department of Movement, Human and Health Sciences, University "Foro Italico" of Rome, 00135, Rome, Italy
| | - L Gandini
- Department of Experimental Medicine, Endocrinology and Food and Science Section, "Sapienza" University of Rome, 00161, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, Endocrinology and Food and Science Section, "Sapienza" University of Rome, 00161, Rome, Italy
| | - A Aversa
- Department of Experimental Medicine, Endocrinology and Food and Science Section, "Sapienza" University of Rome, 00161, Rome, Italy.
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Zhao DF, Becerril-Martinez G, Graham D. Neuropeptide Y: Biomarker and intervention for surgical recovery. Neurobiol Stress 2016; 2:60-1. [PMID: 26844240 PMCID: PMC4721280 DOI: 10.1016/j.ynstr.2015.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 05/18/2015] [Indexed: 11/11/2022] Open
Affiliation(s)
- Dong Fang Zhao
- Sydney Medical School, The University of Sydney, Sydney, Australia
| | | | - David Graham
- Sydney Medical School, The University of Sydney, Sydney, Australia; Department of Surgery, Concord Repatriation General Hospital, Sydney, Australia
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14
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Graham D, Becerril-Martinez G, Quinto L, Zhao DF. Can we measure surgical resilience? Med Hypotheses 2016; 86:76-9. [PMID: 26804602 DOI: 10.1016/j.mehy.2015.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Accepted: 12/03/2015] [Indexed: 11/29/2022]
Abstract
Surgical resilience describes psychological resilience within a surgical setting. Within a surgical setting, psychologically resilient patients have improved recovery and wound-healing. The search for biological correlates in resilient patients has led to the hypothesis that certain endogenous biomarkers (namely neuropeptide Y (NPY), testosterone, and dehydroepiandrosterone (DHEA)) are altered in resilient patients. The concept of surgical resilience raises the question of whether enhanced recovery following surgery can be demonstrated in patients with high titres of resilience biomarkers as compared to patients with low titres of resilience biomarkers. To determine the prognostic value of resilience biomarkers in surgical recovery, a cohort of patients undergoing major surgery should initially be psychometrically tested for their resilience levels before and after surgery so that biomarker levels of NPY, testosterone and DHEA can be compared to a validated psychometric test of resilience. The primary outcome would be length of hospital stay with and without an enhanced recovery program. Secondary outcome measures such as complications, time in rehabilitation and readmission could also be included. If the hypothesis is upheld, resilience biomarkers could be used to support more individualised perioperative management and lead to more efficient and effective allocation of healthcare resources.
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Affiliation(s)
- David Graham
- Faculty of Medicine, The University of Sydney, Australia
| | | | - Lena Quinto
- Faculty of Medicine, The University of Sydney, Australia
| | - Dong Fang Zhao
- Faculty of Medicine, The University of Sydney, Australia
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