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Norris P, Gow J, Arthur T, Conway A, Fleming FJ, Ralph N. Metabolic syndrome and surgical complications: a systematic review and meta-analysis of 13 million individuals. Int J Surg 2024; 110:541-553. [PMID: 37916943 PMCID: PMC10793842 DOI: 10.1097/js9.0000000000000834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/28/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Metabolic syndrome (MetS) is characterised by the presence of at least three of the five following components: insulin resistance, obesity, chronic hypertension, elevated serum triglycerides, and decreased high-density lipoprotein cholesterol concentrations. It is estimated to affect 1 in 3 people around the globe and is reported to affect 46% of surgical patients. For people with MetS who undergo surgery, an emerging body of literature points to significantly poorer postoperative outcomes compared with nonaffected populations. The aim of this study is to review the current evidence on the risks of surgical complications in patients with MetS compared to those without MetS. METHODS Systematic review and meta-analysis using PRISMA and AMSTAR reporting guidelines. RESULTS The meta-analysis included 63 studies involving 1 919 347 patients with MetS and 11 248 114 patients without MetS. Compared to individuals without the condition, individuals with MetS were at an increased risk of mortality (OR 1.75 95% CI: 1.36-2.24; P <0.01); all surgical site infection types as well as dehiscence (OR 1.64 95% CI: 1.52-1.77; P <0.01); cardiovascular complications (OR 1.56 95% CI: 1.41-1.73; P <0.01) including myocardial infarction, stroke, cardiac arrest, cardiac arrythmias and deep vein thrombosis; increased length of hospital stay (MD 0.65 95% CI: 0.39-0.9; P <0.01); and hospital readmission (OR 1.55 95% CI: 1.41-1.71; P <0.01). CONCLUSION MetS is associated with a significantly increased risk of surgical complications including mortality, surgical site infection, cardiovascular complications, increased length of stay, and hospital readmission. Despite these risks and the high prevalence of MetS in surgical populations there is a lack of evidence on interventions for reducing surgical complications in patients with MetS. The authors suggest prioritising interventions across the surgical continuum that include (1) preoperative screening for MetS; (2) surgical prehabilitation; (3) intraoperative monitoring and management; and (4) postoperative rehabilitation and follow-up.
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Affiliation(s)
- Philip Norris
- School of Nursing and Midwifery, University of Southern Queensland, Australia
| | - Jeff Gow
- School of Commerce, University of Southern Queensland, Toowoomba, Australia
- Senior Research Associate, School of Accounting, Economics and Finance, University of KwaZulu- Natal, Durban, South Africa
| | - Thomas Arthur
- Department of Surgery and Adjunct Professor, Toowoomba Hospital, Centre for Health Research, University of Southern Queensland, Toowoomba, Australia
| | - Aaron Conway
- Peter Munk Cardiac Centre, University Health Network, Toronto, Canada, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
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Wang Z, Mou Y, Li H, Yang R, Jia Y. Impact of Early Intravenous Haemostatic Drugs on Brain Haemorrhage Patients and Their Image Segmentation Based on RGB-D Images. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:4608648. [PMID: 35035838 PMCID: PMC8759877 DOI: 10.1155/2022/4608648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/08/2021] [Accepted: 12/11/2021] [Indexed: 11/19/2022]
Abstract
Cerebral haemorrhage is a serious subtype of stroke, with most patients experiencing short-term haematoma enlargement leading to worsening neurological symptoms and death. The main hemostatic agents currently used for cerebral haemorrhage are antifibrinolytics and recombinant coagulation factor VIIa. However, there is no clinical evidence that patients with cerebral haemorrhage can benefit from hemostatic treatment. We provide an overview of the mechanisms of haematoma expansion in cerebral haemorrhage and the progress of research on commonly used hemostatic drugs. To improve the semantic segmentation accuracy of cerebral haemorrhage, a segmentation method based on RGB-D images is proposed. Firstly, the parallax map was obtained based on a semiglobal stereo matching algorithm and fused with RGB images to form a four-channel RGB-D image to build a sample library. Secondly, the networks were trained with 2 different learning rate adjustment strategies for 2 different structures of convolutional neural networks. Finally, the trained networks were tested and compared for analysis. The 146 head CT images from the Chinese intracranial haemorrhage image database were divided into a training set and a test set using the random number table method. The validation set was divided into four methods: manual segmentation, algorithmic segmentation, the exact Tada formula, and the traditional Tada formula to measure the haematoma volume. The manual segmentation was used as the "gold standard," and the other three algorithms were tested for consistency. The results showed that the algorithmic segmentation had the lowest percentage error of 15.54 (8.41, 23.18) % compared to the Tada formula method.
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Affiliation(s)
- Zhenzhen Wang
- Department of Neurology, Gucheng County Hospital, Hengshui 253800, China
| | - Yating Mou
- Department of Neurology, Gucheng County Hospital, Hengshui 253800, China
| | - Hao Li
- Department of Neurology, Gucheng County Hospital, Hengshui 253800, China
| | - Rui Yang
- Department of Neurology, Gucheng County Hospital, Hengshui 253800, China
| | - Yanxun Jia
- Department of Neurology, Gucheng County Hospital, Hengshui 253800, China
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Guofeng C, Chen Y, Rong W, Ruiyu L, Kunzheng W. Patients with metabolic syndrome have a greater rate of complications after arthroplasty: A systematic review and meta-analysis. Bone Joint Res 2020; 9:120-129. [PMID: 32435464 PMCID: PMC7229294 DOI: 10.1302/2046-3758.93.bjr-2019-0138.r1] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Aims Patients with metabolic syndrome (MetS) are known to be at increased risk of postoperative complications, but it is unclear whether MetS is also associated with complications after total hip arthroplasty (THA) or total knee arthroplasty (TKA). Here, we perform a systematic review and meta-analysis linking MetS to postoperative complications in THA and TKA. Methods The PubMed, OVID, and ScienceDirect databases were comprehensively searched and studies were selected and analyzed according to the guidelines of the Meta-analysis of Observational Studies in Epidemiology (MOOSE). We assessed the methodological quality of each study using the Newcastle-Ottawa Scale (NOS), and we evaluated the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Data were extracted and meta-analyzed or qualitatively synthesized for several outcomes. Results Ten cohort studies involving 1,352,685 patients were included. Qualitative analysis suggested that MetS was associated with a higher incidence of cardiovascular events, and meta-analysis showed that MetS increased the risk of all-cause complications (risk ratio (RR) 1.55, 95% confidence interval (CI) 1.28 to 1.89), surgical site infection (SSI; RR 2.99, 95% CI 1.30 to 6.90), urinary tract infection (UTI; RR 2.58, 95% CI 1.03 to 6.43), and 30-day readmission (RR 1.45, 95% CI 1.33 to 1.59). There was insufficient evidence for assessing an association between MetS and venous thromboembolism events, pulmonary or gastrointestinal complications, or mortality. Conclusion Patients with MetS undergoing THA and TKA are at increased risk of all-cause complications, cardiovascular complications, SSI, UTI, and 30-day readmission. Surgeons should be aware of the increased risk of these complications in MetS, and presurgical protocols for these complications should give special consideration to MetS patients. Cite this article:Bone Joint Res. 2020;9(3):120–129.
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Affiliation(s)
- Cui Guofeng
- Department of Orthopedics, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, China; Department of Orthopedics, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yue Chen
- Department of Orthopedic Surgery, Luoyang Orthopedic Hospital of Henan Province, Luoyang, China
| | - Wei Rong
- Department of Orthopedics, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, China
| | - Liu Ruiyu
- Department of Orthopedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wang Kunzheng
- Department of Orthopedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Zapata D, Halkos M, Binongo J, Puskas J, Guyton R, Lattouf O. Effects and outcomes of cardiac surgery in patients with cardiometabolic syndrome. J Card Surg 2020; 35:794-800. [DOI: 10.1111/jocs.14470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- David Zapata
- Clinical Research Unit, Division of Cardiothoracic SurgeryEmory University Atlanta Georgia
- Department of Biostatistics and Bioinformatics, Rollins School of Public HealthEmory University Atlanta Georgia
| | - Michael Halkos
- Clinical Research Unit, Division of Cardiothoracic SurgeryEmory University Atlanta Georgia
- Department of Biostatistics and Bioinformatics, Rollins School of Public HealthEmory University Atlanta Georgia
| | - Jose Binongo
- Clinical Research Unit, Division of Cardiothoracic SurgeryEmory University Atlanta Georgia
- Department of Biostatistics and Bioinformatics, Rollins School of Public HealthEmory University Atlanta Georgia
| | - John Puskas
- Clinical Research Unit, Division of Cardiothoracic SurgeryEmory University Atlanta Georgia
- Department of Biostatistics and Bioinformatics, Rollins School of Public HealthEmory University Atlanta Georgia
| | - Robert Guyton
- Clinical Research Unit, Division of Cardiothoracic SurgeryEmory University Atlanta Georgia
- Department of Biostatistics and Bioinformatics, Rollins School of Public HealthEmory University Atlanta Georgia
| | - Omar Lattouf
- Clinical Research Unit, Division of Cardiothoracic SurgeryEmory University Atlanta Georgia
- Department of Biostatistics and Bioinformatics, Rollins School of Public HealthEmory University Atlanta Georgia
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Chen S, Li J, Li Q, Qiu Z, Wu X, Chen L. Metabolic syndrome increases operative mortality in patients with impaired left ventricular systolic function who undergo coronary artery bypass grafting: a retrospective observational study. BMC Cardiovasc Disord 2019; 19:25. [PMID: 30674287 PMCID: PMC6343347 DOI: 10.1186/s12872-019-1004-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 01/14/2019] [Indexed: 12/04/2022] Open
Abstract
Background Metabolic syndrome (MetS) is a prevalent risk factor for coronary artery disease progression. Past studies have shown that MetS and its components tends to increase mortality after coronary artery bypass grafting (CABG), but data on the impact of MetS on postoperative outcome in patients with a left ventricular (LV) ejection fraction (EF) < 50% are still lacking. Methods Out of 2300 patients who underwent CABG between 2008 and 2018 in our center, 190 patients were identified as having impaired LV systolic function (EF < 50%). The patients were divided into two groups: those with MetS (n = 87, 45.8%) and those without MetS (n = 103, 54.2%). The influence of MetS on postoperative mortality and major complications was investigated. Results Postoperative mortality occurred in 12.6% of patients with MetS and in 3.9% of patients without MetS (p < 0.05). Multivariate analysis showed that patients with MetS had a significantly greater risk of mortality compared with patients without MetS (relative risk 7.23, p < 0.05). After adjustment for other risk factors, the risk of mortality was increased 6.47-fold [95% confidence interval (CI):1.25–33.6; p < 0.05] in patients with MetS and diabetes and 5.4-fold (95% CI: 1.12–29.7; p < 0.05) in patients with MetS and without diabetes, whereas it was not significantly increased in patients with diabetes and without MetS. Conclusions MetS is an important predictor of increased mortality in patients with LVEF<50% who undergo CABG. The components of MetS have synergistic effect in postoperative mortality. Multifactorial intervention in MetS is required to improve surgical efficacy in these patients.
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Affiliation(s)
- Shuangkun Chen
- Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350001, Fujian, China
| | - Jiahui Li
- Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350001, Fujian, China
| | - Qianzhen Li
- Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350001, Fujian, China
| | - Zhihuang Qiu
- Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350001, Fujian, China
| | - Xijie Wu
- Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350001, Fujian, China
| | - Liangwan Chen
- Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350001, Fujian, China.
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Norris P, Ralph N, Moloney C. Does metabolic syndrome predict surgical complications? A protocol for a systematic review and meta-analysis. Syst Rev 2017; 6:115. [PMID: 28623943 PMCID: PMC5474054 DOI: 10.1186/s13643-017-0515-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is defined by an accumulation of risk factors that include cardiovascular disease, diabetes, chronic high blood pressure, obesity, and hypercholesterolaemia which results in an increased risk of developing serious chronic diseases. MetS is widespread as it is estimated to affect up to 30% of the global population. For people with MetS who undergo surgery, an emerging body of literature points to significantly poorer postoperative outcomes compared with non-affected populations. Surgical patients with MetS are at significantly higher risk of a range of adverse outcomes including death, morbid cardiovascular events, coma, stroke, renal failure, myocardial infarction, and surgical site infections. Increased complication rates result in prolonged hospital stays, a greater need for post-hospitalisation care, and reduced effectiveness of surgical interventions. METHODS/DESIGN We will search the following electronic bibliographic databases: MEDLINE, EMBASE, ScienceDirect, and CINAHL, and the reference lists of included articles. We will also search for unpublished literature. Two authors will screen titles and abstract information independently and select studies according to established inclusion and exclusion criteria. Data will be extracted by the study investigators using Review Manager 5 and will include information on demographics, incidence, prevalence, and outcome variables. Subgroup analysis and sensitivity analysis will be performed to assess the heterogeneity of included studies. Meta-analysis will also be carried out if appropriate study groups are identified. A descriptive narrative for statistical data will also be provided to highlight findings of the systematic review and meta-analysis. DISCUSSION This study will report and summarise adverse outcomes among adult patients with MetS undergoing surgery across a range of surgical specialties. Developing insights into outcomes of this population of interest is necessary to develop guidelines towards better management of surgical patients with metabolic syndrome. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016051071.
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Affiliation(s)
- Philip Norris
- School of Nursing & Midwifery, University of Southern Queensland, Toowoomba, Australia
| | - Nicholas Ralph
- School of Nursing & Midwifery, University of Southern Queensland, Toowoomba, Australia. .,Institute of Resilient Regions, University of Southern Queensland, Toowoomba, QLD, 4370, Australia.
| | - Clint Moloney
- School of Nursing & Midwifery, University of Southern Queensland, Toowoomba, Australia
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Özkan S, Özdemir F, Uğur O, Demirtunç R, Balci AY, Kizilay M, Vural Ü, Kaplan M, Yekeler I. The effects of the metabolic syndrome on coronary artery bypass grafting surgery. Cardiovasc J Afr 2016; 28:48-53. [PMID: 27701481 PMCID: PMC5423427 DOI: 10.5830/cvja-2016-056] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 05/05/2016] [Indexed: 11/06/2022] Open
Abstract
Background The metabolic syndrome (MS) is a clustering of factors that are associated with increased cardiovascular risk. A low-grade inflammatory process acts as the underlying pathophysiology, which suggests that the MS may have a detrimental effect on coronary interventions, including coronary artery bypass grafting (CABG) surgery performed with cardiopulmonary bypass (CPB). We aimed to evaluate the effect of the MS on morbidity and mortality rates in the early postoperative period in patients undergoing CABG. Methods We prospectively included 152 patients (109 males and 43 females; mean age 60.1 ± 8.6 years) who underwent elective CABG on CPB between January and September 2011. Early postoperative morbidity and mortality rates were compared between subjects with and without the MS. Diagnosis of the MS was based on the American National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Results Of the study group, 64 patients (42%) had the MS. The two groups were similar in age and gender. In the postoperative period, rates of atrial fibrillation, wound infection, pulmonary complications, and lengths of intubation, hospitalisation and intensive care unit stay were significantly higher in MS patients (p < 0.01). The MS was significantly associated with wound infection (OR 6.64, 95% CI: 1.72–25.75), pulmonary complications (OR 6.44, 95% CI: 1.58–26.33), arrhythmia (OR 5.47, 95% CI: 1.50–19.97) and prolonged intubation (OR 1.17, 95% CI: 1.05–1.32). The mortality rate was 3.1% in the MS group and 1.1% in the non-MS group, with no significant difference (p > 0.05). Conclusion The MS was associated with a higher rate of early postoperative morbidity following CABG, without having a significant effect on the mortality rate.
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Affiliation(s)
- Sevil Özkan
- Department of Internal Medicine, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
| | - Fatih Özdemir
- Department of Cardiovascular Surgery, Dr Siyami Ersek Training and Research Hospital on Thoracic and Cardiovascular Surgery, Istanbul, Turkey
| | - Oğuz Uğur
- Department of Cardiovascular Surgery, Dr Siyami Ersek Training and Research Hospital on Thoracic and Cardiovascular Surgery, Istanbul, Turkey
| | - Refik Demirtunç
- Department of Internal Medicine, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Yavuz Balci
- Department of Cardiovascular Surgery, Dr Siyami Ersek Training and Research Hospital on Thoracic and Cardiovascular Surgery, Istanbul, Turkey
| | - Mehmet Kizilay
- Department of Cardiovascular Surgery, Dr Siyami Ersek Training and Research Hospital on Thoracic and Cardiovascular Surgery, Istanbul, Turkey
| | - Ünsal Vural
- Department of Cardiovascular Surgery, Dr Siyami Ersek Training and Research Hospital on Thoracic and Cardiovascular Surgery, Istanbul, Turkey
| | - Mehmet Kaplan
- Department of Cardiovascular Surgery, Dr Siyami Ersek Training and Research Hospital on Thoracic and Cardiovascular Surgery, Istanbul, Turkey
| | - Ibrahim Yekeler
- Department of Cardiovascular Surgery, Dr Siyami Ersek Training and Research Hospital on Thoracic and Cardiovascular Surgery, Istanbul, Turkey
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Tzimas P, Petrou A, Laou E, Milionis H, Mikhailidis D, Papadopoulos G. Impact of metabolic syndrome in surgical patients: should we bother? Br J Anaesth 2015; 115:194-202. [DOI: 10.1093/bja/aev199] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Ardeshiri M, Faritus Z, Ojaghi-Haghighi Z, Bakhshandeh H, Kargar F, Aghili R. Impact of metabolic syndrome on mortality and morbidity after coronary artery bypass grafting surgery. Res Cardiovasc Med 2014; 3:e20270. [PMID: 25478548 PMCID: PMC4253799 DOI: 10.5812/cardiovascmed.20270] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 06/10/2014] [Accepted: 06/27/2014] [Indexed: 11/16/2022] Open
Abstract
Background: The prevalence of Metabolic syndrome (MetS) has been increased in Asian countries. It represents a cluster of cardiovascular risk factors including obesity, insulin resistance, lipid abnormality and hypertension. Objectives: The purpose of this study was to assess the association between MetS and outcome in patients undergoing coronary artery bypass grafting surgery (CABG). Patients and Methods: This prospective study was performed on patients scheduled for coronary artery bypass grafting surgery (CABG). All the patients were followed up in hospital and three months afterward. Patients were excluded if they were younger than 18 years or had severe comorbidities, a history of valvular heart disease, and low ejection fraction. Results: A total of 235 patients (135 women) with a mean age of 59 ± 9.3 years were included. MetS was more prevalent in women (P < 0.001). The most prevalent complications were bleeding [20 (8.5%)] and dysrhythmia [18 (7.7%)]. At three months follow-up, the frequency rates of readmission [24 (10.2%)] and mediastinitis [9 (3.8%)] were higher than other complications. Diabetes and MetS were risk factors for a long ICU stay (> 5 days) and atelectasia (P < 0.05). Significant associations were observed between diabetes and pulmonary embolism (P = 0.025) and mediastinitis (P = 0.051). Conclusions: Identification of MetS before CABG can predict the surgery outcome. Patients with MetS have increased risks for longer ICU stay and atelectasia.
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Affiliation(s)
- Maryam Ardeshiri
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Zahra Faritus
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Zahra Faritus, Rajaie Cardiovascular Medical and Research Center, Vali-Asr St., Niayesh Blvd, Tehran, Iran. Tel: +98-2123922159, Fax: +98-2122663293, E-mail:
| | - Zahra Ojaghi-Haghighi
- Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Hooman Bakhshandeh
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Faranak Kargar
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Rokhsareh Aghili
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, IR Iran
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Ounhasuttiyanon A, Lohsiriwat V. Metabolic syndrome and outcome after breast reconstruction. Gland Surg 2014; 3:85-7. [PMID: 25083501 DOI: 10.3978/j.issn.2227-684x.2014.02.07] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 02/27/2014] [Indexed: 12/11/2022]
Abstract
Metabolic syndrome with its core components including obesity, insulin resistance, dyslipidemia and hypertension; is has been proven as a multiplex risk factor for cardiovascular disease. It is also recently shown by meta-analysis for its association with increased risk of common cancers including breast cancer. Multiple studies have shown metabolic syndrome prone to have poor perioperative outcome and complications for multiple type of surgery including vascular and flap surgery due to compromising microvascular circulation in this group of patient. However, lack of data on consequences of metabolic syndrome on breast cancer surgery as well as in breast reconstructive surgery indicate the need of further study in this area for the improvement of outcome of breast cancer and reconstructive surgery.
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Affiliation(s)
- Areerat Ounhasuttiyanon
- Division of Head, Neck and Breast Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital Mahidol University, Bangkok 10700, Thailand
| | - Visnu Lohsiriwat
- Division of Head, Neck and Breast Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital Mahidol University, Bangkok 10700, Thailand
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Angeloni E, Melina G, Benedetto U, Refice S, Capuano F, Roscitano A, Comito C, Sinatra R. Metabolic Syndrome Affects Midterm Outcome After Coronary Artery Bypass Grafting. Ann Thorac Surg 2012; 93:537-44. [DOI: 10.1016/j.athoracsur.2011.10.066] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Revised: 10/22/2011] [Accepted: 10/25/2011] [Indexed: 10/14/2022]
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