scholarly journals Multiple Brain Abscesses due toStreptococcus anginosus: Prediction of Mortality by an Imaging Severity Index Score

2016 ◽  
Vol 2016 ◽  
pp. 1-8
Author(s):  
K. O. Kragha
Keyword(s):  
Elderly Patient ◽  
Prognostic Value ◽  
Severity Index ◽  
Altered Mental Status ◽  
Index Score ◽  
Aggressive Treatment ◽  
Streptococcus Anginosus ◽  
Prediction Of Mortality ◽  
Severity Index Score ◽  
Brain Abscesses

An elderly patient with altered mental status, brain abscesses, ventriculitis, and empyemas died of septic shock and brain abscesses secondary toStreptococcus anginosusdespite aggressive treatment. An imaging severity index score with a better prognostic value than the Glasgow coma scale predicted mortality in this patient.

Le score ISIS (Instability Severity Index Score) revisité

2015 ◽  
Vol 101 (8) ◽  
pp. e15 ◽  
Author(s):  
C. Bessière ◽  
M.-O. Gauci ◽  
F. Balg ◽  
P. Boileau
Keyword(s):  
Severity Index ◽  
Index Score ◽  
Severity Index Score

Factors affecting length of stay in Fournier’s gangrene: a retrospective analysis of 10 years’ data

2020 ◽  
Author(s):  
Mithat Eksi ◽  
Yusuf Arikan ◽  
Abdulmuttalip Simsek ◽  
Osman Ozdemir ◽  
Serdar Karadag ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Severity Index ◽  
Mortality Rates ◽  
Fournier’S Gangrene ◽  
Index Score ◽  
Fournier's Gangrene ◽  
Wound Therapy ◽  
Severity Index Score

Abstract Background We aimed to investigate the parameters that have an effect on the length of stay and mortality rates of patients with Fournier’s gangrene. Material and Methods A retrospective review was performed on 80 patients who presented to the emergency department and underwent emergency debridement with the diagnosis of Fournier’s gangrene between 2008 and 2017. The demographic and clinical characteristics, length of stay, Fournier’s Gangrene Severity Index score, cystostomy and colostomy requirement, additional treatment for wound healing and the mortality rates of the patients were evaluated. Results Of the 80 patients included in the study, 65 (81.2 %) were male and 15 (18.7 %) female. The most common comorbidity was diabetes mellitus. The mean time between onset of complaints and admission to hospital was 4.6 ± 2.5 days. As a result of the statistical analyses, it was found that Fournier’s Gangrene Severity Index score, hyperbaric oxygen therapy, negative pressure wound therapy and the presence of sepsis and colostomy were significantly positively correlated with length of stay. Also it was found that the Fournier’s Gangrene Severity Index score, administration of negative pressure wound therapy and the presence of sepsis were correlated with mortality. Conclusion Fournier’s gangrene is a mortal disease and an emergency condition. With the improvements in Fournier’s gangrene disease management, mortality rates are decreasing, but long-term hospital stay has become a new problem. Knowing the values predicting length of stay and mortality rates can allow for patient-based treatment and may be useful in treatment choice.

scholarly journals The Instability Severity Index Score Revisited: Evaluation of 217 Consecutive Cases of Recurrent Anterior Shoulder Instability

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0026
Author(s):  
Matthew T. Provencher ◽  
George Sanchez ◽  
Andrew S. Bernhardson ◽  
Liam A. Peebles ◽  
Daniel B. Haber ◽  
...  
Keyword(s):  
Bone Loss ◽  
Severity Index ◽  
Index Score ◽  
Glenoid Bone Loss ◽  
Anterior Shoulder Instability ◽  
Arthroscopic Stabilization ◽  
Recurrent Instability ◽  
Severity Index Score ◽  
Recurrent Anterior Shoulder Instability

Objectives: The instability severity index score (ISIS) was designed to predict the risk of recurrence after arthroscopic instability shoulder surgery and to better predict those who would benefit from an open or bone transfer operation. Although this score has been widely disseminated to predict recurrence, there are certain areas in which preoperative assessment is limited, especially in radiographic workup. The objective of this study was to examine the validity of ISIS based on its existing variables, as well as to evaluate additional imaging and patient history variables pertinent to the potential redevelopment of a new score to assess risk of recurrent anterior instability following an arthroscopic Bankart repair. Methods: All consecutive patients were prospectively enrolled with recurrent anterior shoulder instability who subsequently underwent an arthroscopic stabilization with minimum 24 months follow-up. Exclusion criteria included, prior surgery on the shoulder, posterior or multidirectional instability, or a rotator cuff tear. All instability severity index score variables were recorded (age <20, degree and sport type, hyperlaxity, Hill Sachs on AP xray, glenoid loss of contour on AP xray), as well as additional variables: 1. Position of arm at dislocation; 2. Number of instability events; 3. Total time of instability; 4. Glenoid bone loss percent; 5. Amount of attritional glenoid bone loss; 6. Hill Sachs measures (H/W/D and volume), and outcomes (recurrent instability) and scores (WOSI, ASES and SANE). Regression analysis was utilized to determine preoperative variables that predicted outcomes and failures. Results: There were 217 consecutive patients (209 male-96.5%, 8 female-3.5%) who met criteria and were all treated with a primary arthroscopic shoulder stabilization during a 3.5-year period (2007-2011), with mean follow-up of 42 (range, 26-58 mos). The mean age at first instability event was 23.9 (range, 16-48), with 55% right shoulder affected, 60% dominant shoulder. Outcomes were improved from mean scores preoperative (WOSI=1050/2100, ASES=61.0, SANE=52.5) to postoperative (WOSI=305/2100, ASES=93.5, SANE=95.5), and 11.5% (25/217) had evidence or recurrent instability or subluxation. A total of 51/217 were 20 years or under, hyperlaxity in 5, Hill Sachs on internal rotation XR in 77, glenoid contour on AP XR in 41, with an overall mean ISIS score of 3.6. Factors associated with failure were glenoid bone loss greater than 14.5%(p<0.001), total time of instability symptoms >11.5 months(p<0.03), Hill Sachs volume > 1.3 cm3 with H>1.5 cm, W>1.0 cm and D>5 mm(p<0.01), contact sport (p<0.01) and age 20 or under (p<0.01). There was no correlation in outcomes with Hill Sachs on IR or glenoid contour on XR (p>0.45), sports participation, and Instability Severity Score (mean=3.4 success, vs 3.9 failure, p>0.44). Conclusion: At nearly four years of follow-up, there was an 11.5% failure rate of scope stabilization surgery. However, there was no correlation between treatment outcome and the ISIS measure given a mean score of 3.4 with little difference identified in those that failed. However, several important parameters previously unidentified were detected including, glenoid bone loss >14.5%, Hill Sachs volume >1.3 cm3, and time length of instability symptoms. Therefore, the ISIS measure may need to be redesigned in order to incorporate variables that more accurately portray the actual risk of failure following arthroscopic stabilization.

Long-term, Prospective, Multicenter Study of Isolated Bankart Repair for a Patient Selection Method Based on the Instability Severity Index Score

2019 ◽  
Vol 47 (5) ◽  
pp. 1057-1061 ◽  
Author(s):  
Hervé Thomazeau ◽  
Tristan Langlais ◽  
Alexandre Hardy ◽  
Jonathan Curado ◽  
Olivier Herisson ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Severity Index ◽  
Index Score ◽  
Bankart Repair ◽  
Prospective Multicenter Study ◽  
Severity Index Score ◽  
Bony Lesions ◽  
Long Term Recurrence Rate

Background: An isolated arthroscopic Bankart repair carries a high mid- and long-term risk of recurring instability. Preoperative patient selection based on the Instability Severity Index Score should improve outcomes. Purpose: To report the overall long-term recurrence rate for isolated Bankart repair, investigate the predictive factors for recurrence, analyze time to recurrence, and determine a quantitative cutoff point for recurrence in terms of Instability Severity Index Score. Study Design: Cohort study; Level of evidence, 2. Methods: This was a prospective multicenter study. Inclusion criteria were recurring anterior instability and an Instability Severity Index Score of 4 or less. Of the 125 patients included, 20 patients had a score of 0, 31 patients scored 1, 29 patients scored 2, 34 patients scored 3, and 11 patients scored 4. All centers used the same arthroscopic technique and rehabilitation protocol. Follow-up data were collected at 3, 6, 12, and 24 months and 3 and 9 years. The primary endpoint was recurrence of instability (total or partial dislocation). The statistical analysis was performed by use of the software package SAS 9.4. Results: We initially identified 328 patients, of whom 125 patients were prospectively included. The main reason for excluding the 202 patients was the presence of bony lesions, which carry 2 points each in the Instability Severity Index Score (humeral head notch and/or glenoid lesion visible on standard radiographs). Of the 125 eligible patients, 73% were athletes and 22.5% competitors; 16% were lost at the last follow-up. At the endpoint, 23% had experienced a recurrence after a mean interval of 35 months (range, 5.5-103 months). No statistical differences were found between patients with and without bony lesions in the overall group of 125 patients or in the subgroup with an Instability Severity Index Score of 3 or 4 points ( P = .4). According to univariate analysis, the only predictive factor for recurrence was age less than 20 years at the time of surgery, with a 42% rate of recurrence in this group ( P = .03). Multivariate analysis showed that the Instability Severity Index Score was the only predictive factor with a quantitative cutoff point (namely, a score of ≤2 points) that was statistically associated with a decreased long term recurrence rate ( P = .02). The recurrence rate was 10% for a preoperative Instability Severity Index Score of 2 or less compared with 35.6% for a score of 3 or 4. The survival curves demonstrated no new dislocations after year 4 for patients with an Instability Severity Index Score of up to 2 points. Conclusion: In a preselected population, mainly without bony lesions, the Instability Severity Index Score cutoff value that provides an acceptable recurrence rate at 9 years after isolated Bankart repair is 2 out of 10.

Evaluation of the Instability Severity Index score in predicting failure following arthroscopic Bankart surgery in an active military population

2019 ◽  
Vol 28 (5) ◽  
pp. e156-e163 ◽  
Author(s):  
Andrew G. Chan ◽  
Kelly G. Kilcoyne ◽  
Stephen Chan ◽  
Jonathan F. Dickens ◽  
Brian R. Waterman
Keyword(s):  
Severity Index ◽  
Index Score ◽  
Military Population ◽  
Severity Index Score
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