scholarly journals 429 Preoperative Risk Assessment In Elective Colorectal Patients

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
C Cernei ◽  
R Grossman ◽  
O Bodger ◽  
J Williams ◽  
C Pritchard ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Cardiopulmonary Exercise Testing ◽  
Final Analysis ◽  
Assessment Model ◽  
Operative Risk ◽  
Risk Assessment Model ◽  
Combined Model ◽  
Possum Score ◽  
Operative Severity Score ◽  
Severity Scores

Abstract Introduction Cardiopulmonary Exercise Testing (CPET) and the Colorectal Physiology and Operative Severity Score (CR-POSSUM) are increasingly used in colorectal surgical practice to risk-stratify patients preoperatively and for planning level 2 HDU or ITU admission. This study aims to generate a simple, objective pre-operative risk assessment model to complement clinical judgement, and to determine objectively for whom CPET is necessary in colorectal pre-assessment. Method A retrospective cohort study was conducted. Demographic and perioperative data were gathered, and CR-POSSUM score was determined retrospectively. Mortality at 12 months was considered the primary outcome with readmissions up to 12 months as secondary outcomes. Statistical analysis used Binary Logistic Regression, and odds ratios were reported with confidence intervals. A new combined pre-operative risk assessment model with the most significant individual predictors was constructed. Results Some 167 elective patients were included in the final analysis. Half of patients had planned HDU admissions. The all-cause mortality at 90 days was 3.5% and at 12 months was 11%. Readmission rate at 30 days was 10%, with a further 11.3% at 90 days postoperatively. The ASA, Physiology Score and Operative Severity Scores correlated with mortality rates (p < 0.05). Current diagnostic performance using CPET vs. the combined model identified 48% and 35% ‘high risk’ patients with 83.3% and 56.5% vs 94.4% and 76.1% sensitivity and specificity, respectively. The model draws its predictive power mainly from the CR-POSSUM. Conclusions Current practice at the study centre produces outcomes above the national average. The process can be improved whilst focusing resources further using the combined model.

Risk assessment model for venous thromboembolism in hospitalized surgical and non-surgical patients in the 4th Hungarian Antithrombotic Guidelines entitled “Diminution and Treatment of Venous Thromboembolism”

2010 ◽  
Vol 151 (34) ◽  
pp. 1365-1374 ◽  
Author(s):  
Marianna Dávid ◽  
Hajna Losonczy ◽  
Miklós Udvardy ◽  
Zoltán Boda ◽  
György Blaskó ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Venous Thromboembolism ◽  
Assessment Model ◽  
Surgical Patients ◽  
Risk Assessment Model

A kórházban kezelt sebészeti és belgyógyászati betegekben jelentős a vénásthromboembolia-rizikó. Profilaxis nélkül, a műtét típusától függően, a sebészeti beavatkozások kapcsán a betegek 15–60%-ában alakul ki mélyvénás trombózis vagy tüdőembólia, és az utóbbi ma is vezető kórházi halálok. Bár a vénás thromboemboliát leggyakrabban a közelmúltban végzett műtéttel vagy traumával hozzák kapcsolatba, a szimptómás thromboemboliás események 50–70%-a és a fatális tüdőembóliák 70–80%-a nem a sebészeti betegekben alakul ki. Nemzetközi és hazai felmérések alapján a nagy kockázattal rendelkező sebészeti betegek többsége megkapja a szükséges trombózisprofilaxist. Azonban profilaxis nélkül marad a rizikóval rendelkező belgyógyászati betegek jelentős része, a konszenzuson alapuló nemzetközi és hazai irányelvi ajánlások ellenére. A belgyógyászati betegek körében növelni kell a profilaxisban részesülők arányát és el kell érni, hogy trombózisrizikó esetén a betegek megkapják a hatásos megelőzést. A beteg trombóziskockázatának felmérése fontos eszköze a vénás thromboembolia által veszélyeztetett betegek felderítésének, megkönnyíti a döntést a profilaxis elrendeléséről és javítja az irányelvi ajánlások betartását. A trombózisveszély megállapításakor, ha nem ellenjavallt, profilaxist kell alkalmazni. „A thromboemboliák kockázatának csökkentése és kezelése” című, 4. magyar antithromboticus irányelv felhívja a figyelmet a vénástrombózis-rizikó felmérésének szükségességére, és elsőként tartalmazza a kórházban fekvő belgyógyászati és sebészeti betegek kockázati kérdőívét. Ismertetjük a kockázatbecslő kérdőíveket és áttekintjük a kérdőívekben szereplő rizikófaktorokra vonatkozó bizonyítékokon alapuló adatokat.

Signature Analysis: Statistical Models and Their Application to FA

1996 ◽  
Author(s):  
C.K. Lakshminarayan ◽  
S. Pabbisetty ◽  
O. Adams ◽  
F. Pires ◽  
M. Thomas ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Failure Analysis ◽  
Statistical Models ◽  
Essential Elements ◽  
Assessment Model ◽  
Signature Analysis ◽  
Risk Assessment Model ◽  
Sample Sizes ◽  
Reliability Engineering ◽  
Semiconductor Chips

Abstract This paper deals with the basic concepts of Signature Analysis and the application of statistical models for its implementation. It develops a scheme for computing sample sizes when the failures are random. It also introduces statistical models that comprehend correlations among failures that fail due to the same failure mechanism. The idea of correlation is important because semiconductor chips are processed in batches. Also any risk assessment model should comprehend correlations over time. The statistical models developed will provide the required sample sizes for the Failure Analysis lab to state "We are A% confident that B% of future parts will fail due to the same signature." The paper provides tables and graphs for the evaluation of such a risk assessment. The implementation of Signature Analysis will achieve the dual objective of improved customer satisfaction and reduced cycle time. This paper will also highlight it's applicability as well as the essential elements that need to be in place for it to be effective. Different examples have been illustrated of how the concept is being used by Failure Analysis Operations (FA) and Customer Quality and Reliability Engineering groups.

A semi-quantitative risk assessment model for the outbreak of grass carp hemorrhage

2013 ◽  
Vol 19 (3) ◽  
pp. 521-527 ◽  
Author(s):  
Song YANG ◽  
Shuqin WU ◽  
Ningqiu LI ◽  
Cunbin SHI ◽  
Guocheng DENG ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Grass Carp ◽  
Assessment Model ◽  
Quantitative Risk Assessment ◽  
Risk Assessment Model

scholarly journals An Alternative Risk Assessment Model of Urban Waterlogging: A Case Study of Ningbo City

2021 ◽  
Vol 13 (2) ◽  
pp. 826
Author(s):  
Meiling Zhou ◽  
Xiuli Feng ◽  
Kaikai Liu ◽  
Chi Zhang ◽  
Lijian Xie ◽  
...  
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Assessment Model ◽  
Risk Assessments ◽  
Risk Assessment Model ◽  
Risk Area ◽  
The North ◽  
Coastal Cities ◽  
Risk Areas ◽  
The City

Influenced by climate change, extreme weather events occur frequently, and bring huge impacts to urban areas, including urban waterlogging. Conducting risk assessments of urban waterlogging is a critical step to diagnose problems, improve infrastructure and achieve sustainable development facing extreme weathers. This study takes Ningbo, a typical coastal city in the Yangtze River Delta, as an example to conduct a risk assessment of urban waterlogging with high-resolution remote sensing images and high-precision digital elevation models to further analyze the spatial distribution characteristics of waterlogging risk. Results indicate that waterlogging risk in the city proper of Ningbo is mainly low risk, accounting for 36.9%. The higher-risk and medium-risk areas have the same proportions, accounting for 18.7%. They are followed by the lower-risk and high-risk areas, accounting for 15.5% and 9.6%, respectively. In terms of space, waterlogging risk in the city proper of Ningbo is high in the south and low in the north. The high-risk area is mainly located to the west of Jiangdong district and the middle of Haishu district. The low-risk area is mainly distributed in the north of Jiangbei district. These results are consistent with the historical situation of waterlogging in Ningbo, which prove the effectiveness of the risk assessment model and provide an important reference for the government to prevent and mitigate waterlogging. The optimized risk assessment model is also of importance for waterlogging risk assessments in coastal cities. Based on this model, the waterlogging risk of coastal cities can be quickly assessed, combining with local characteristics, which will help improve the city’s capability of responding to waterlogging disasters and reduce socio-economic loss.

scholarly journals An Integrated Flood Risk Assessment Model for Cities Located in the Transitional Zone between Taihang Mountains and North China Plain: A Case Study in Shijiazhuang, Hebei, China

Atmosphere ◽  
2019 ◽  
Vol 10 (3) ◽  
pp. 104 ◽  
Author(s):  
Qiang Liu ◽  
Hongmao Yang ◽  
Min Liu ◽  
Rui Sun ◽  
Junhai Zhang
Keyword(s):  
Risk Assessment ◽  
Flood Risk ◽  
North China Plain ◽  
North China ◽  
Transitional Zone ◽  
Assessment Model ◽  
Analysis Tool ◽  
Risk Assessment Model ◽  
Flood Risk Assessment ◽  
Risk Map

Cities located in the transitional zone between Taihang Mountains and North China plain run high flood risk in recent years, especially urban waterlogging risk. In this paper, we take Shijiazhuang, which is located in this transitional zone, as the study area and proposed a new flood risk assessment model for this specific geographical environment. Flood risk assessment indicator factors are established by using the digital elevation model (DEM), along with land cover, economic, population, and precipitation data. A min-max normalization method is used to normalize the indices. An analytic hierarchy process (AHP) method is used to determine the weight of each normalized index and the geographic information system (GIS) spatial analysis tool is adopted for calculating the risk map of flood disaster in Shijiazhuang. This risk map is consistent with the reports released by Hebei Provincial Water Conservancy Bureau and can provide reference for flood risk management.

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