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Article ; Online: Comment on "AI in Healthcare: A Revolutionary Ally or an Ethical Dilemma?"

Ntalouka, Maria P / Adamantia, Aretha / Bareka, Metaxia / Arnaoutoglou, Eleni

2024

Language	English
Publishing date	2024-04-03
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	2612982-6
ISSN	2146-3131 ; 2146-3131
ISSN (online)	2146-3131
ISSN	2146-3131
DOI	10.4274/balkanmedj.galenos.2024.2024-3-31
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Article ; Online: Clinical guideline on reversal of direct oral anticoagulants in patients with life threatening bleeding.

Grottke, Oliver / Afshari, Arash / Ahmed, Aamer / Arnaoutoglou, Eleni / Bolliger, Daniel / Fenger-Eriksen, Christian / von Heymann, Christian

European journal of anaesthesiology

2024 Volume 41, Issue 5, Page(s) 327–350

Abstract: Background: Anticoagulation is essential for the treatment and prevention of thromboembolic events. Current guidelines recommend direct oral anticoagulants (DOACs) over vitamin K antagonists in DOAC-eligible patients. The major complication of ... ...

Abstract	Background: Anticoagulation is essential for the treatment and prevention of thromboembolic events. Current guidelines recommend direct oral anticoagulants (DOACs) over vitamin K antagonists in DOAC-eligible patients. The major complication of anticoagulation is serious or life-threatening haemorrhage, which may necessitate prompt haemostatic intervention. Reversal of DOACs may also be required for patients in need of urgent invasive procedures. This guideline from the European Society of Anaesthesiology and Intensive Care (ESAIC) aims to provide evidence-based recommendations and suggestions on how to manage patients on DOACs undergoing urgent or emergency procedures including the treatment of DOAC-induced bleeding. Design: A systematic literature search was performed, examining four drug comparators (dabigatran, rivaroxaban, apixaban, edoxaban) and clinical scenarios ranging from planned to emergency surgery with the outcomes of mortality, haematoma growth and thromboembolic complications. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) methodology was used to assess the methodological quality of the included studies. Consensus on the wording of the recommendations was achieved by a Delphi process. Results: So far, no results from prospective randomised trials comparing two active comparators (e.g. a direct reversal agent and an unspecific haemostatic agent such as prothrombin complex concentrate: PCC) have been published yet and the majority of publications were uncontrolled and observational studies. Thus, the certainty of evidence was assessed to be either low or very low (GRADE C). Thirty-five recommendations and clinical practice statements were developed. During the Delphi process, strong consensus (>90% agreement) was achieved in 97.1% of recommendations and consensus (75 to 90% agreement) in 2.9%. Discussion: DOAC-specific coagulation monitoring may help in patients at risk for elevated DOAC levels, whereas global coagulation tests are not recommended to exclude clinically relevant DOAC levels. In urgent clinical situations, haemostatic treatment using either the direct reversal or nonspecific haemostatic agents should be started without waiting for DOAC level monitoring. DOAC levels above 50 ng ml-1 may be considered clinically relevant necessitating haemostatic treatment before urgent or emergency procedures. Before cardiac surgery under activated factor Xa (FXa) inhibitors, the use of andexanet alfa is not recommended because of inhibition of unfractionated heparin, which is needed for extracorporeal circulation. In the situation of DOAC overdose without bleeding, no haemostatic intervention is suggested, instead measures to eliminate the DOACs should be taken. Due to the lack of published results from comparative prospective, randomised studies, the superiority of reversal treatment strategy vs. a nonspecific haemostatic treatment is unclear for most urgent and emergency procedures and bleeding. Due to the paucity of clinical data, no recommendations for the use of recombinant activated factor VII as a nonspecific haemostatic agent can be given. Conclusion: In the clinical scenarios of DOAC intake before urgent procedures and DOAC-induced bleeding, practitioners should evaluate the risk of bleeding of the procedure and the severity of the DOAC-induced bleeding before initiating treatment. Optimal reversal strategy remains to be determined in future trials for most clinical settings.
MeSH term(s)	Humans ; Heparin/therapeutic use ; Prospective Studies ; Hemorrhage/prevention & control ; Anticoagulants ; Hemostatics/therapeutic use ; Administration, Oral
Chemical Substances	Heparin (9005-49-6) ; Anticoagulants ; Hemostatics
Language	English
Publishing date	2024-04-04
Publishing country	England
Document type	Journal Article
ZDB-ID	605770-6
ISSN	1365-2346 ; 0265-0215
ISSN (online)	1365-2346
ISSN	0265-0215
DOI	10.1097/EJA.0000000000001968
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Zs.A 1955: Show issues

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Article: Femoral-Obturator-Sciatic (FOS) Nerve Block as an Anesthetic Triad for Arthroscopic ACL Reconstruction: Is This the Magic Trick We Were Missing?

Bareka, Metaxia / Ntalouka, Maria P / Angelis, Fragkiskos / Mermiri, Maria / Tsiaka, Aikaterini / Hantes, Michael / Arnaoutoglou, Eleni

Journal of clinical medicine

2024 Volume 13, Issue 4

Abstract: Arthroscopic anterior cruciate ligament (ACL) reconstruction with hamstring grafting is a common orthopedic procedure that is associated with moderate-to-severe pain. Peripheral nerve blockade as an anesthetic technique is an appealing option in the era ... ...

Abstract	Arthroscopic anterior cruciate ligament (ACL) reconstruction with hamstring grafting is a common orthopedic procedure that is associated with moderate-to-severe pain. Peripheral nerve blockade as an anesthetic technique is an appealing option in the era of modern anesthesia. The aim of this narrative review is to document the efficacy and safety of the combination of femoral, obturator, and sciatic (FOS) nerve blocks as an exclusive method for anesthesia in patients undergoing ACL reconstruction. An electronic search of the literature published up to October 2023 was conducted in the Medline, Embase, Cochrane, Web of Science, and Google Scholar databases to find studies on ACL reconstruction and peripheral obturator nerve block. Overall, 8 prospective studies-with a total of 315 patients-published between 2007 and 2022 were included in this review. Ultrasound-guided peripheral FOS nerve blockade is an effective anesthetic technique for ACL reconstruction, offering good perioperative pain management, minimal opioid consumption, and an excellent safety profile. Further well-designed prospective studies are needed to determine the best approach for obturator nerve blockade and the appropriate type and dosage of local anesthetic.
Language	English
Publishing date	2024-02-13
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13041054
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Article ; Online: Appraisal of the clinical practice guidelines on thromboprophylaxis in orthopaedic procedures; Do we AGREE (II)?

Ntalouka, Maria P / Koutalos, Antonis / Angelis, Fragkiskos / Bareka, Metaxia / Hantes, Michael / Karachalios, Theofilos / Arnaoutoglou, Eleni

Injury

2024 Volume 55, Issue 6, Page(s) 111517

Abstract: Objective: Optimal thromboprophylaxis in orthopaedic procedures is crucial in an attempt to lower the risk of venous thromboembolism, including deep vein thrombosis and pulmonary embolism. We aim to: 1) identify clinical practice guidelines (CPGs) and ... ...

Abstract	Objective: Optimal thromboprophylaxis in orthopaedic procedures is crucial in an attempt to lower the risk of venous thromboembolism, including deep vein thrombosis and pulmonary embolism. We aim to: 1) identify clinical practice guidelines (CPGs) and recommendations (CPRs) on thromboprophylaxis in adult patients undergoing orthopaedic procedures, and 2) assess the methodological quality and reporting clarity of these guidelines. Methods: The study was conducted following the 2020 PRISMA guidelines for a systematic review and has been registered on the international prospective register of systematic reviews (PROSPERO) under the registration number (CRD42023406988). An electronic search was conducted using Medline, Embase, Cochrane, Web of Science, Google Scholar and medRxiv. The search terms used were ""adults", "orthopedic surgery", "orthopedic surgeries", "orthopedic surgical procedure", "orthopedic surgical procedures" "english language", "venous thromboembolism", in all possible combinations (January 2013 to March 2023). The eligible studies were evaluated by four blind raters, employing the Appraisal of Guidelines for Research & Evaluation II (AGREE-II) analysis tool. Results: The literature research resulted in 931 studies. Finally, a total of 16 sets of guidelines were included in the current analysis. There were 8 national and 8 international CPGs. Eight CPGs made specific recommendations for orthopaedic surgery and referred mostly to joints; one guideline focused on pelvi-acetabular trauma, while the rest were more inclusive and non-specific. Four guidelines, one from the American Society of Hematology (ASH), two from the United Kingdom (UK) and one from India were found to have the highest methodological quality and reporting clarity according to the AGREE-II tool. Inter-rater agreement was very good with a mean Cohens Kappa 0.962 (95 % CI, 0.895-0.986) in the current analysis. So, the reliability of the measurements can be interpreted as good to excellent. Conclusion: Optimal thromboprophylaxis in orthopaedic procedures is crucial. The available guidelines were found to be mostly of high methodological quality and inter-rater agreement was very good, according to our study.
Language	English
Publishing date	2024-04-02
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2024.111517
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Zs.A 778: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Conical Aortic Neck as a Predictor of Outcome after Endovascular Aneurysm Exclusion: Midterm Results.

Nana, Petroula / Spanos, Konstantinos / Kouvelos, George / Arnaoutoglou, Eleni / Giannoukas, Athanasios / Matsagkas, Miltiadis

Annals of vascular surgery

2022 Volume 90, Page(s) 77–84

Abstract: Background: Conical neck may affect endovascular aneurysm repair (EVAR) outcomes. The aim of this study was to present EVAR neck adverse events [endoleak type Ia (ET Ia) and graft migration], in patients with conical neck morphology compared to patients ...

Abstract	Background: Conical neck may affect endovascular aneurysm repair (EVAR) outcomes. The aim of this study was to present EVAR neck adverse events [endoleak type Ia (ET Ia) and graft migration], in patients with conical neck morphology compared to patients with non-conical necks. An additional analysis of the factors that may affect neck adverse events in patients with conical necks, during the first postoperative year, was executed. Methods: A retrospective analysis of prospective data was conducted, including patients that underwent elective EVAR, between 2017 and 2019. All patients completed the clinical and imaging follow-up of the initial 12 months. Regarding imaging, all cases underwent computed tomography angiography (CTA), preoperatively, at the 1st and 12th month of follow-up. Preoperative and postoperative aneurysm anatomic characteristics (supra-renal and infra-renal aortic diameters, aneurysm diameter, neck angle, thrombus, and calcification) were recorded. Proximal neck was defined as the infrarenal aortic segment, with a diameter less than 30 mm. Conical neck was any neck with a diameter increase ≥2 mm per cm of length (from outer-to-outer aortic wall). The proximal 15 mm of the neck length were considered the zone of endograft sealing. Migration was any ≥10 mm caudal movement of the endograft, relative to its position detected at the CTA of the first month. Neck adverse events were defined as the composite event of ET Ia and migration. Results: The cohort included 150 patients; 66 (44%) presented conical neck morphology. No significant difference was detected regarding the preoperative anatomic characteristics between the conical and non-conical groups. Only distal (15 mm) neck diameter was wider in the conical group (P < 0.001). Supra-renal active fixation was used in 63.3% of the total cohort; 59.5% in patients with non-conical necks and 68.2% in patients with conical morphology (P = 0.275). Graft oversizing was 18.2% and 18.7% in the non-conical and conical group, respectively (P = 0.248). Oversizing >20% was equal between groups [37.8% vs. 33.3%% (P = 0.608) while oversizing ≥30% was more common among patients with conical necks (3.5% vs. 10.6%, P < 0.001, 3.2 odds ratio, 95% confidence interval: 0.79, 12.91). Regarding ET Ia and migration, no difference was recorded between the groups. In a subanalysis among patients with conical necks, a lower graft migration rate was detected among patients with higher oversizing rate (P = 0.037). Conclusions: EVAR may offer similarly good midterm outcomes in patients with conical and non-conical neck anatomy. An oversizing to the higher suggested rate may be preventive of graft migration during the first postoperative year in necks with conical morphology. Aggressive oversizing (>20%) do not offer any benefit regarding the prevention of adverse events among patients with conical necks.
MeSH term(s)	Humans ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation/adverse effects ; Aortic Aneurysm, Abdominal/surgery ; Treatment Outcome ; Retrospective Studies ; Prospective Studies ; Endovascular Procedures/adverse effects ; Risk Factors ; Endoleak/etiology
Language	English
Publishing date	2022-11-30
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2022.11.004
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Zs.A 2882: Show issues

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Article ; Online: Risk factors and adverse events related to supra- and infra-renal aortic dilation at twelve months after endovascular abdominal aortic aneurysm repair.

Nana, Petroula / Kouvelos, George / Spanos, Konstantinos / Mpatzalexis, Konstantinos / Arnaoutoglou, Eleni / Giannoukas, Athanasios / Matsagkas, Miltiadis

International angiology : a journal of the International Union of Angiology

2022 Volume 41, Issue 6, Page(s) 483–491

Abstract: Background: Aortic remodeling and its effect on adverse events after endovascular abdominal aneurysm repair (EVAR) remain under investigation. This study aimed to assess aortic diameter alterations after EVAR, related risk factors and consequences to ... ...

Abstract	Background: Aortic remodeling and its effect on adverse events after endovascular abdominal aneurysm repair (EVAR) remain under investigation. This study aimed to assess aortic diameter alterations after EVAR, related risk factors and consequences to proximal sealing at 12 months. Methods: A single-center retrospective analysis of consecutive EVAR patients was undertaken. All patients underwent computed tomography angiography, preoperatively, at 1 Results: A hundred fifty patients were included. At 1 Conclusions: During the 12-month follow-up, aortic dilation may be detected from the supra-renal aorta to the total neck length. Neck dilation may be attributed to large neck diameter, supra-renal fixation, and aggressive oversizing. Neck-related adverse events are more common in patients with aortic dilation at 12 months.
MeSH term(s)	Humans ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation/adverse effects ; Aortic Aneurysm, Abdominal/diagnostic imaging ; Aortic Aneurysm, Abdominal/surgery ; Retrospective Studies ; Dilatation ; Endovascular Procedures/adverse effects ; Treatment Outcome ; Risk Factors ; Stents
Language	English
Publishing date	2022-12-12
Publishing country	Italy
Document type	Journal Article
ZDB-ID	604910-2
ISSN	1827-1839 ; 0392-9590
ISSN (online)	1827-1839
ISSN	0392-9590
DOI	10.23736/S0392-9590.22.04971-9
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Zs.A 1833: Show issues

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Article ; Online: Venous thromboembolism and major adverse cardiovascular events in patients with hip fractures suffering from SARS-CoV-2 infection: a systematic review.

Koutalos, Antonios A / Ntalouka, Maria P / Angelis, Fragkiskos A / Hantes, Michael / Arnaoutoglou, Eleni

Hip international : the journal of clinical and experimental research on hip pathology and therapy

2022 Volume 33, Issue 6, Page(s) 1122–1132

Abstract: Introduction: Hip fractures represent 1 of the most common injuries in older adults. They are associated with increased perioperative morbidity and mortality. Additionally, current research suggests that SARS-COV-2 infection may worsen the prognosis of ... ...

Abstract	Introduction: Hip fractures represent 1 of the most common injuries in older adults. They are associated with increased perioperative morbidity and mortality. Additionally, current research suggests that SARS-COV-2 infection may worsen the prognosis of the hip fracture patients who undergo hip fixation. The aims of the present study were: (1) to determine the rate of specific adverse events including VTE (venous thromboembolism) and major adverse cardiovascular events (MACEs) in patients with hip fracture and concomitant SARS-CoV-2 infection undergoing surgery; and (2) to examine if the aforementioned population is at increased risk for VTE and MACEs, when compared to SARS-CoV-2 free patients with hip fracture. Methods: PubMed, EMBASE, Cochrane, Web of Science, Google scholar and medRxiv were searched from March 2020 to January 2021 for English language studies with patients suffering from hip fractures and SARS-COV-2 -CoV-2. 2 researchers were involved in the data extraction and the quality assessment of the studies respectively. Results: The literature search yielded a total of 1256 articles of which 14 were included in the systematic review and 7 in the meta-analysis respectively. The estimated pooled rate for VTE and MACE were 4.3% and 6.3% respectively. Patients with hip fracture and concomitant SARS-CoV-2 infection who undergo surgery are at increased risk for VTE, when compared to SARS-CoV-2 free patients (odds ratio 2.8 [95% CI, 1.1-7.1]). These patients are also at increased risk for MACE postoperatively as indicated by the odds ratio 2.4 (95% CI, 1.0-5.8). The quality of the studies was moderate. Conclusions: Although there is a lack of high-quality data it seems that patients with hip fractures and concomitant SARS-CoV-2 infection are facing a 2.8 and 2.4 times increased risk for VTE and MACE.
MeSH term(s)	Humans ; Aged ; Venous Thromboembolism/epidemiology ; Venous Thromboembolism/etiology ; COVID-19/complications ; SARS-CoV-2 ; Arthroplasty, Replacement, Hip/adverse effects ; Hip Fractures/complications ; Hip Fractures/surgery
Language	English
Publishing date	2022-10-25
Publishing country	United States
Document type	Systematic Review ; Meta-Analysis ; Journal Article
ZDB-ID	1162513-2
ISSN	1724-6067 ; 1120-7000
ISSN (online)	1724-6067
ISSN	1120-7000
DOI	10.1177/11207000221132489
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Zs.A 3810: Show issues

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Article ; Online: The Impact of Iliac Artery Anatomy on Distal Landing Zone After EVAR During the 12-Month Follow-Up.

Nana, Petroula / Spanos, Konstantinos / Kouvelos, George / Dakis, Konstantinos / Arnaoutoglou, Eleni / Giannoukas, Athanasios / Matsagkas, Miltos

Annals of vascular surgery

2022

Abstract: Background: Proximal sealing zone has been the main interest in endovascular abdominal aortic aneurysm repair (EVAR), although the distal landing zone remodeling may also affect EVAR durability. The aim of this study was to assess iliac anatomy and its ... ...

Abstract	Background: Proximal sealing zone has been the main interest in endovascular abdominal aortic aneurysm repair (EVAR), although the distal landing zone remodeling may also affect EVAR durability. The aim of this study was to assess iliac anatomy and its potential impact on distal landing zone adverse events after EVAR during the 12-month follow-up. Methods: A prospective data collection of patients treated with standard bifurcated EVAR devices for abdominal aortic aneurysm was undertaken between 2017 and 2019. Patients that received extension to the external iliac artery were excluded. Follow-up included computed tomography angiography (CTA) at the 1st and 12th month postoperatively. The common iliac artery (CIA) diameter was assessed in three levels: origin (just below the aortic bifurcation), distally (just above the iliac bifurcation) and the middle of the distance between these two landmarks. Iliac angle, tortuosity indexes, relining and oversizing were also analyzed. Distal landing zone-related adverse events were any limb related re-intervention, endoleak type Ib, graft migration, limb stenosis, or occlusion. Results: In total, 268 iliac limbs (134 patients) were included. In all three levels, the mean iliac artery diameters increased at 12-month follow-up. At the origin of the CIA, the diameter increased from 18.7 ± 10.5 mm to 19.9 ± 9.4 mm (P = 0.04), at the middle portion of the CIA, the diameter changed significantly from 15.5 ± 5.1 mm to 17.4 ± 5.4 mm (P < 0.001) and at the distal CIA, from 14.6 ± 3.3 mm to 15.1 ± 3.9 mm (P = 0.03). The iliac angle remained stable (P = 0.14) while the CIA index decreased significantly from 1.17 ± 0.13 to 1.11 ± 0.09 (P < 0.001). The mean value of oversizing was 21.5 ± 14.5% and affected distal iliac diameter increase (P < 0.001). The composite outcome of distal landing zone adverse events was not associated to diameter changes at any level. In 57 cases, a distal iliac diameter ≥18 mm was recorded. The estimated oversizing was lower (16.3 ± 11.8%) compared to <18 mm arteries (22.5 ± 14.9%, P = 0.01). At 12-month follow-up, iliac diameters remained stable in the ≥18 mm group. Endoleak type Ib was more common in iliac arteries ≥18 mm [3 (5.3%) vs. 1 (0.5%) (P = 0.04)] at 12-months. Conclusions: Post-EVAR iliac artery dilation does not seem to have an impact on distal landing zone adverse events during the 12-month follow-up. Aggressive oversizing may be related to iliac dilation. EVAR patients with iliac arteries ≥18 mm are at higher risk for ET Ib.
Language	English
Publishing date	2022-06-30
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2022.06.011
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Zs.A 2882: Show issues

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Article ; Online: Elements of airway training.

Arnaoutoglou, Eleni

Digestion

2010 Volume 82, Issue 2, Page(s) 118–120

Abstract: Little research has been conducted into the topic of training in sedation for endoscopic procedures. In addition, a review of the literature did not reveal any published studies regarding the elements of airway training for endoscopists. From the ... ...

Abstract	Little research has been conducted into the topic of training in sedation for endoscopic procedures. In addition, a review of the literature did not reveal any published studies regarding the elements of airway training for endoscopists. From the anesthesiology published data, it seems that common methods for airway management training include theoretical instructions and hands-on sessions on anesthetized patients, manikins or simulators. Retraining is necessary in order to maintain knowledge and to refresh and update airway skills and should be conducted on a regular basis with simulation-based practice, practice with validated airway training courses, or even with hands-on training in the anesthetic room. The need for the development of formalized airway training courses carrying the joint approval of the gastrointestinal endoscopy and anesthesiology societies seems to be essential.
MeSH term(s)	Airway Obstruction/chemically induced ; Airway Obstruction/therapy ; Analgesics/adverse effects ; Anesthesiology/education ; Curriculum ; Education, Medical, Graduate ; Endoscopy/education ; Endoscopy, Gastrointestinal ; Humans ; Hypnotics and Sedatives/adverse effects ; Professional Competence ; Respiratory Insufficiency/chemically induced ; Respiratory Insufficiency/therapy
Chemical Substances	Analgesics ; Hypnotics and Sedatives
Language	English
Publishing date	2010
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	1712-7
ISSN	1421-9867 ; 0012-2823
ISSN (online)	1421-9867
ISSN	0012-2823
DOI	10.1159/000285653
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Zs.A 572: Show issues

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Article: Appraisal of the Clinical Practice Guidelines for the Use of Antithrombotic Therapy in Elective Spinal Procedures: Do We AGREE (II)?

Ntalouka, Maria P / Brotis, Alexandros G / Angelis, Fragkiskos A / Peroulis, Michail / Matsagkas, Miltiadis / Fountas, Kostantinos N / Arnaoutoglou, Eleni M

Asian spine journal

2023 Volume 17, Issue 4, Page(s) 790–802

Abstract: The perioperative management of patients medicated with antithrombotic agents who require elective spinal surgery is extremely challenging because of the increased risk of surgical bleeding and the concurrent need to minimize the thromboembolic risk. The ...

Abstract	The perioperative management of patients medicated with antithrombotic agents who require elective spinal surgery is extremely challenging because of the increased risk of surgical bleeding and the concurrent need to minimize the thromboembolic risk. The aims of the present systematic review are to: (1) identify clinical practice guidelines (CPGs) and recommendations (CPRs) on this topic and (2) assess their methodological quality and reporting clarity. An electronic systematic search of the English Medical Literature up to January 31, 2021 was conducted using PubMed, Google Scholar, and Scopus. Two raters assessed the methodological quality and reporting clarity of the gathered CPGs and CPRs using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. The agreement between the two raters was assessed using Cohen's kappa. Of the initially gathered 38 CPGs and CPRs, 16 fulfilled our eligibility criteria and were evaluated using the AGREE II instrument. The reports published by "Narouze 2018" and "Fleisher 2014" were scored as being of "high-quality" and having an adequate interrater agreement (Cohen's kappa ≥0.60). Overall, the AGREE II domains of "clarity of presentation" and "scope and purpose" yielded the highest scores (100%), whereas the domain "stakeholder involvement" scored the lowest score (48.5%). The perioperative management of antiplatelet and anticoagulant agents in elective spine surgery may be challenging. Because of the lack of high-quality data in this field, uncertainty remains regarding the optimal practices to balance the risk of thromboembolism against that of bleeding.
Language	English
Publishing date	2023-05-25
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2559763-2
ISSN	1976-7846 ; 1976-1902
ISSN (online)	1976-7846
ISSN	1976-1902
DOI	10.31616/asj.2022.0277
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In stock of ZB MED Cologne/Königswinter

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More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito