Effects of anaesthesia using endotracheal intubation or the laryngeal mask airway, or spinal anaesthesia, on oral mucosal host defences during minor surgery

Hospital readmission after delivery: evidence for an increased incidence of nonurogenital infection in the immediate postpartum period

OBJECTIVE

The purpose of this study was to analyze reasons for postpartum readmission.

STUDY DESIGN

We conducted a database analysis of readmissions within 6 weeks after delivery during 2007, with extended (180 day) analysis for pneumonia, appendicitis, and cholecystitis. Linear regression analysis, survival curve fitting, and Gehan-Breslow statistic with Holm-Sidak all-pairwise analysis for multiple comparisons were used. Probability values of < .05 were considered significant.

RESULTS

Of 222,751 women delivered, 2655 women (1.2%) were readmitted within 6 weeks (0.83% vaginal delivery and 1.8% cesarean section delivery; P < .001). A high percentage of these readmittances occurred within the first 6 weeks: pneumonia (84%), appendicitis (43%), or cholecystitis (46%). Cumulative readmission rates were higher in the first 6 weeks after delivery than in the next 20 weeks (pneumonia curve gradient, 3.7 vs 0.11; appendicitis curve gradient, 1.1 vs 0.36; cholecystitis curve gradient, 6.6 vs 1.7).

CONCLUSION

The cause of postpartum readmission is primarily infectious in origin. A recent pregnancy appears to increase the risk of pneumonia, appendicitis, and cholecystitis.

[Anesthetic considerations in primary immunodeficiencies]

Primary immunodeficiencies are a group of mostly hereditary, or congenital, disorders. Some cases, however, show no hereditary pattern despite an evident familial distribution. The incidence of these cases is variable and the most frequent of them is immunoglobulin A deficiency. Many are pediatric disorders that are occasionally so serious that the patient does not survive the first year of life due to the development of systemic infections. In other cases, survival is much longer and it is possible to find adult carriers in routine clinical practice. These are less aggressive cases that form part of specific clinical syndromes that must be recognized so that appropriate anesthetic management can be planned. We review the clinical characteristics of primary immunodeficiencies that may be relevant to anesthetic management in these patients.