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Article ; Online: Third-trimester development of left-side abdominal wall defect.

Hubbard, N / Madey, K / Rochon, M / Browne, M / Quiñones, J N

Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology

2024

Language	English
Publishing date	2024-01-19
Publishing country	England
Document type	Letter
ZDB-ID	1073183-0
ISSN	1469-0705 ; 0960-7692
ISSN (online)	1469-0705
ISSN	0960-7692
DOI	10.1002/uog.27588
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Article ; Online: Image-based digital post-discharge surveillance in England: measuring patient enrolment, engagement, clinician response times, surgical site infection, and carbon footprint.

Rochon, M / Jawarchan, A / Fagan, F / Otter, J A / Tanner, J

The Journal of hospital infection

2023 Volume 133, Page(s) 15–22

Abstract: Background: Surgical site infections (SSIs) can have a significant impact on patients, their families and healthcare providers. With shortening inpatient periods, the post-discharge element of surveillance is becoming increasingly important. Proactive ... ...

Abstract	Background: Surgical site infections (SSIs) can have a significant impact on patients, their families and healthcare providers. With shortening inpatient periods, the post-discharge element of surveillance is becoming increasingly important. Proactive surveillance, including digital wound images using patient smartphones, may be an efficient alternative to traditional methods for collecting post-discharge surveillance (PDS). Aim: To determine success in patient enrolment and engagement including reasons for non-response, the time for clinicians to respond to patients, SSI rates, and carbon emissions when conducting PDS using patient smartphones. Methods: An evaluation was undertaken for a one-month period (June 2022) in two adult cardiac surgery services which routinely used patient smartphones for PDS, using the secure Islacare (Isla) system. Findings: The initial patient response rate for Isla was 87.3%, and the majority of patients (73%) remained engaged throughout the 30-day period. There was no significant difference in age, gender, operation type or distance to hospital between Isla responders or non-responders, or if the hospital provided a photo at discharge or not. Patients using Isla had a shorter post-discharge stay (P = 0.03), although this was not attributed to the platform. Patients not owning a smartphone and a technical issue were the main barriers to participation. Overall, nine SSIs were recorded, eight through the Isla surveillance and one through a hospital transfer readmission. The carbon emission associated with the SSI ranged from 5 to 2615 kg CO2e. Conclusion: In a real-world setting, using patient smartphones is an effective method to collect PDS, including wound images.
MeSH term(s)	Adult ; Humans ; Surgical Wound Infection/epidemiology ; Patient Discharge ; Carbon Footprint ; Aftercare ; Reaction Time ; Risk Factors ; England
Language	English
Publishing date	2023-01-13
Publishing country	England
Document type	Journal Article
ZDB-ID	779366-2
ISSN	1532-2939 ; 0195-6701
ISSN (online)	1532-2939
ISSN	0195-6701
DOI	10.1016/j.jhin.2023.01.001
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Article ; Online: Sex differences in surgical site infections following coronary artery bypass grafting: a retrospective observational study.

Boyle, M / Vaja, R / Rochon, M / Luhana, S / Gopalaswamy, M / Bhudia, S / Raja, S / Petrou, M / Quarto, C

The Journal of hospital infection

2024 Volume 146, Page(s) 52–58

Abstract: Background: Surgical site infection (SSI) following cardiac surgery poses a significant challenge for healthcare providers. Despite advances in surgical techniques and infection control measures, SSI remains a leading cause of morbidity and mortality, ... ...

Abstract	Background: Surgical site infection (SSI) following cardiac surgery poses a significant challenge for healthcare providers. Despite advances in surgical techniques and infection control measures, SSI remains a leading cause of morbidity and mortality, in addition to being a significant economic burden on healthcare services. Current literature suggests there is a reproducible difference in the incidence of SSI following cardiac surgery between sexes. We aim to assess the sex-specific predictive risk factors for sternal SSI following coronary artery bypass grafting (CABG) in addition to identifying any differences in the causative organisms between groups. Methods: Adult patients undergoing isolated CABG between January 2012 and December 2022 in one UK hospital organization were included. In this 10-year, retrospective observational study, a total of 10,208 patients met the inclusion criteria. Pre-operative risk factors were identified using univariate analysis. To assess dependence between sex and organism or Gram stain, a Pearson Chi-squared test with Yates correction for continuity was performed. Results: In total there were 8457 males of which 181 developed a sternal SSI (2.14%) and 1751 females, 128 of whom had a sternal SSI (7.31%). Male patients were found to be significantly more likely to develop an SSI secondary to a Gram-positive organism, whereas female patients were more likely to have a Gram-negative causative organism (P<0.00001). Staphylococcus was statistically more likely to be the causative organism genus in male patients. Pseudomonas aeruginosa was found to be twice as common in the female cohort compared with the male group. Conclusion: In our study, we found a statistically significant difference in the causative organisms and Gram stain for post-CABG sternal SSIs between males and females. Male patients predominately have Gram-positive associated SSIs, whereas female SSI pathogens are more likely to be Gram negative. The preoperative risk profiles of both cohorts are similar, including being an insulin-dependent diabetic and triple vessel coronary artery disease. Given these findings, it prompts the question, should we be tailoring our SSI treatment strategies according to sex and associated risk profiles?
MeSH term(s)	Adult ; Humans ; Male ; Female ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/etiology ; Sex Characteristics ; Coronary Artery Bypass/adverse effects ; Risk Factors ; Cardiac Surgical Procedures/adverse effects ; Retrospective Studies
Language	English
Publishing date	2024-02-01
Publishing country	England
Document type	Observational Study ; Journal Article
ZDB-ID	779366-2
ISSN	1532-2939 ; 0195-6701
ISSN (online)	1532-2939
ISSN	0195-6701
DOI	10.1016/j.jhin.2024.01.013
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Article ; Online: Prevention of deep sternal wound infections in cardiac surgery - reply to Vos et al.

Satta, G / Rochon, M / Shukla, S / Leaper, D

The Journal of hospital infection

2019 Volume 102, Issue 3, Page(s) 295–296

MeSH term(s)	Cardiac Surgical Procedures ; Humans ; Sternum ; Wound Infection
Language	English
Publishing date	2019-02-23
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	779366-2
ISSN	1532-2939 ; 0195-6701
ISSN (online)	1532-2939
ISSN	0195-6701
DOI	10.1016/j.jhin.2019.02.016
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Article: Impact of COVID-19 on the travel and tourism industry.

Škare, Marinko / Soriano, Domingo Riberio / Porada-Rochoń, Małgorzata

Technological forecasting and social change

2020 Volume 163, Page(s) 120469

Abstract: Our paper is among the first to measure the potential effects of the COVID-19 pandemic on the tourism industry. Using panel structural vector auto-regression (PSVAR) (Pedroni, 2013) on data from 1995 to 2019 in 185 countries and system dynamic modeling ( ... ...

Abstract	Our paper is among the first to measure the potential effects of the COVID-19 pandemic on the tourism industry. Using panel structural vector auto-regression (PSVAR) (Pedroni, 2013) on data from 1995 to 2019 in 185 countries and system dynamic modeling (real-time data parameters connected to COVID-19), we estimate the impact of the pandemic crisis on the tourism industry worldwide. Past pandemic crises operated mostly through idiosyncratic shocks' channels, exposing domestic tourism sectors to large adverse shocks. Once domestic shocks perished (zero infection cases), inbound arrivals revived immediately. The COVID-19 pandemic, however, is different; and recovery of the tourism industry worldwide will take more time than the average expected recovery period of 10 months. Private and public policy support must be coordinated to assure capacity building and operational sustainability of the travel tourism sector during 2020-2021. COVID-19 proves that pandemic outbreaks have a much larger destructive impact on the travel and tourism industry than previous studies indicate. Tourism managers must carefully assess the effects of epidemics on business and develop new risk management methods to deal with the crisis. Furthermore, during 2020-2021, private and public policy support must be coordinated to sustain pre-COVID-19 operational levels of the tourism and travel sector.
Language	English
Publishing date	2020-11-16
Publishing country	United States
Document type	Journal Article
ISSN	0040-1625
ISSN	0040-1625
DOI	10.1016/j.techfore.2020.120469
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Article ; Online: Predictive models of surgical site infections after coronary surgery: insights from a validation study on 7090 consecutive patients.

Gatti, G / Rochon, M / Raja, S G / Luzzati, R / Dreas, L / Pappalardo, A

The Journal of hospital infection

2019 Volume 102, Issue 3, Page(s) 277–286

Abstract: Background: The role of specific scoring systems in predicting risk of surgical site infections (SSIs) after coronary artery bypass grafting (CABG) has not been established.: Aim: To validate the most relevant predictive systems for SSIs after CABG.!# ...

Abstract	Background: The role of specific scoring systems in predicting risk of surgical site infections (SSIs) after coronary artery bypass grafting (CABG) has not been established. Aim: To validate the most relevant predictive systems for SSIs after CABG. Methods: Five predictive systems (eight models) for SSIs after CABG were evaluated retrospectively in 7090 consecutive patients undergoing isolated (73.9%) or combined (26.1%) CABG. For each model, accuracy of prediction, calibration, and predictive power were assessed with area under receiver-operating characteristic curve (aROC), the Hosmer-Lemeshow test, and the Goodman-Kruskal γ-coefficient, respectively. Six predictive scoring systems for 30-day in-hospital mortality after cardiac operations were evaluated as to prediction of SSIs. The models were compared one-to-one using the Hanley-McNeil method. Findings: There were 724 (10.2%) SSIs. Whereas all models showed satisfactory calibration (P = 0.176-0.656), accuracy of prediction was low (aROC: 0.609-0.650). Predictive power was moderate (γ: 0.315-0.386) for every model but one (γ: 0.272). When compared one-to-one, the Northern New England Cardiovascular Disease Study Group mediastinitis score had a higher discriminatory power both in overall series (aROC: 0.634) and combined CABG patients (aROC: 0.648); in isolated CABG patients, both models of the Fowler score showed a higher discriminatory power (aROC: 0.651 and 0.660). Accuracy of prediction for SSIs was low (aROC: 0.564-0.636) even for six scoring systems devised to predict mortality after cardiac surgery. Conclusion: In this validation study, current predictive models for SSIs after CABG showed low accuracy of prediction despite satisfactory calibration and moderate predictive power.
MeSH term(s)	Aged ; Aged, 80 and over ; Cardiovascular Surgical Procedures/adverse effects ; Epidemiologic Methods ; Female ; Humans ; Male ; Models, Statistical ; New England/epidemiology ; ROC Curve ; Risk Assessment ; Surgical Wound Infection/epidemiology
Language	English
Publishing date	2019-01-15
Publishing country	England
Document type	Comparative Study ; Journal Article ; Validation Studies
ZDB-ID	779366-2
ISSN	1532-2939 ; 0195-6701
ISSN (online)	1532-2939
ISSN	0195-6701
DOI	10.1016/j.jhin.2019.01.009
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Zs.A 1586: Show issues

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Article ; Online: Enhanced recovery protocol after cesarean delivery: impact on opioid use and pain perception.

Ubom, Ememobong O / Wang, Carrie / Klocksieben, Farina / Flicker, Amanda B / Diven, Liany / Rochon, Meredith / Quiñones, Joanne N

AJOG global reports

2023 Volume 3, Issue 3, Page(s) 100220

Abstract: Background: Opioids are routinely prescribed to patients postoperatively after cesarean delivery. With rates of cesarean deliveries increasing globally and the opioid epidemic continuing to have deleterious effects, finding methods to achieve effective ... ...

Abstract	Background: Opioids are routinely prescribed to patients postoperatively after cesarean delivery. With rates of cesarean deliveries increasing globally and the opioid epidemic continuing to have deleterious effects, finding methods to achieve effective pain control without opioids is of increasing importance. The ERAS (Enhanced Recovery After Surgery) protocol applied following cesarean delivery engages multimodal perioperative management techniques to encourage early recovery. In the obstetrical surgery setting, these interventions include increasing scheduled nonsteroidal anti-inflammatory drug administration and laxative use to improve postoperative gastrointestinal motility and pain scores. Postcesarean patients are also encouraged to use abdominal binders, incentive spirometry, and early movement as pain modulators. Objective: This quality improvement study aimed to measure whether the introduction of an ERAS protocol following cesarean delivery at a United States-based health network would improve outcomes such as the use of opioid medications for pain and pain control. Study design: This single-center retrospective cohort study compared patients who gave birth via cesarean delivery before (n=1425) and after (n=3478) the implementation of the postsurgical recovery protocol. Outcomes of interest included total postoperative opioid medications used, discharge opioid prescription, average pain score, pain scores by postoperative day, and highest pain score. Patients with a history of opioid use disorder, those who underwent a cesarean hysterectomy, and those who experienced a major surgical complication at delivery were excluded. Data were collected from the electronic medical record. Results: Patients in the postimplementation period used significantly fewer opioid medications than those who gave birth before the protocol was introduced at the institution. The total median opioid use before implementation was 75 morphine milligram equivalents (interquartile range, 45-112.5) vs 30 (interquartile range, 15-52.5) after implementation ( Conclusion: Implementation of multimodal pain regimens following cesarean delivery, such as the ERAS protocol, which incorporate both pharmacologic (nonsteroidal anti-inflammatory drugs, laxatives) and nonpharmacologic methods (abdominal binders, deep breathing, movement) can be effective for pain control and may decrease postoperative opioid prescribing needs, thus mitigating the potential for opioid misuse and dependence.
Language	English
Publishing date	2023-05-06
Publishing country	United States
Document type	Journal Article
ISSN	2666-5778
ISSN (online)	2666-5778
DOI	10.1016/j.xagr.2023.100220
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Article ; Online: Barriers and facilitators for surgical site infection surveillance for adult cardiac surgery in a high-income setting: an in-depth exploration.

Tanner, J / Brierley Jones, L / Rochon, M / Westwood, N / Wloch, C / Vaja, R / Rogers, L / Dearling, J / Wilson, K / Magboo, R / Aujla, H / Page, S / Whiting, P / Murphy, G / Brown, C / Lamagni, T / Harrington, P

The Journal of hospital infection

2023 Volume 141, Page(s) 112–118

Abstract: Background: Surgical site infection (SSI) surveillance aims to facilitate a reduction in SSIs through identifying infection rates, benchmarking, triggering clinical review and instituting infection control measures. Participation in surveillance is, ... ...

Abstract	Background: Surgical site infection (SSI) surveillance aims to facilitate a reduction in SSIs through identifying infection rates, benchmarking, triggering clinical review and instituting infection control measures. Participation in surveillance is, however, variable suggesting opportunities to improve wider adoption. Aim: To gain an in-depth understanding of the barriers and facilitators for SSI surveillance in a high-income European setting. Methods: Key informant interviews with 16 surveillance staff, infection prevention staff, nurses and surgeons from nine cardiac hospitals in England. Data were analysed thematically. Findings: SSI surveillance was reported to be resource intensive. Barriers to surveillance included challenges associated with data collection: data being located in numerous places, multiple SSI data reporting schemes, difficulty in finding denominator data, lack of interface between computerized systems, 'labour intensive' or 'antiquated' methods to collect data (e.g., using postal systems for patient questionnaires). Additional reported concerns included: relevance of definitions, perceived variability in data reporting, lack of surgeon engagement, unsupportive managers, low priority of SSIs among staff, and a 'blame culture' around high SSI rates. Facilitators were increased resources, better use of digital technologies (e.g., remote digital wound monitoring), integrating surveillance within routine clinical work, having champions, mandating surveillance, ensuring a closer relationship between surveillance and improved patient outcomes, increasing the focus on post-discharge surveillance, and integration with primary care data. Conclusion: Using novel interviews with 'front-line' staff, identified opportunities for improving participation in SSI surveillance. Translating these findings into action will increase surveillance activity and bring patient safety benefits to a larger pool of surgical patients.
MeSH term(s)	Humans ; Adult ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/prevention & control ; Aftercare ; Patient Discharge ; Cardiac Surgical Procedures ; Infection Control/methods
Language	English
Publishing date	2023-09-20
Publishing country	England
Document type	Journal Article
ZDB-ID	779366-2
ISSN	1532-2939 ; 0195-6701
ISSN (online)	1532-2939
ISSN	0195-6701
DOI	10.1016/j.jhin.2023.08.023
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Zs.A 1586: Show issues

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Article: Vieillissement demographique et participation des personnes agees au financement des depenses de sante et des depenses sociales.

Rochon, M

Cahiers québécois de démographie / Association des démographes du Québec

1999 Volume 28, Issue 1-2, Page(s) 299–329

Title translation	Demographic aging and participation of the elderly in the financing of health and social expenses.
MeSH term(s)	Adult ; Age Factors ; Aged ; Americas ; Canada ; Delivery of Health Care ; Demography ; Developed Countries ; Economics ; Financial Management ; Financing, Government ; Health ; Health Expenditures ; North America ; Population ; Population Characteristics ; Population Dynamics ; Public Sector ; Social Welfare ; Taxes
Language	French
Publishing date	1999
Publishing country	Andorra, Principality of
Document type	English Abstract ; Journal Article
ISSN	0380-1721
ISSN	0380-1721
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Article ; Online: Do in-hospital outcomes of isolated coronary artery bypass grafting vary between male and female octogenarians?

Attia, Rizwan Q / Katumalla, Eve / Cyclewala, Shabnam / Rochon, Melissa / Marczin, Nandor / Raja, Shahzad G

Interactive cardiovascular and thoracic surgery

2021 Volume 34, Issue 6, Page(s) 958–965

Abstract: Objectives: Female gender and advanced age are regarded as independent risk factors for adverse outcomes after isolated coronary artery bypass grafting (CABG). There is paucity of evidence comparing outcomes of CABG between male and female octogenarians. ...

Abstract	Objectives: Female gender and advanced age are regarded as independent risk factors for adverse outcomes after isolated coronary artery bypass grafting (CABG). There is paucity of evidence comparing outcomes of CABG between male and female octogenarians. We aimed to analyse in-hospital outcomes of isolated CABG in this cohort. Methods: All octogenarians that underwent isolated CABG, from January 2000 to October 2017, were included. A retrospective analysis of a prospectively collected cardiac surgery database (PATS; Dendrite Clinical Systems, Oxford, UK) was performed. A propensity score was generated for each patient from a multivariable logistic regression model based on 25 pre-treatment covariates. A total of 156 matching pairs were derived. Results: Five hundred and sixty-seven octogenarians underwent isolated CABG. This included 156 females (mean age 82.1 [SD: 0.9]) and 411 males (mean age 82.4 [SD: 2.1 years]). More males were current smokers (P = 0.002) with renal impairment (P = 0.041), chronic obstructive pulmonary disease (P = 0.048), history of cerebrovascular accident (P = 0.039) and peripheral vascular disease (P = 0.027) while more females had New York Heart Association class 4 (P = 0.02), left ventricular ejection fraction 30-49% (P = 0.038) and left ventricular ejection fraction <30% (P = 0.049). On-pump, CABG was performed in 140 males and 52 females (P = 0.921). There was no difference in in-hospital mortality (5.4% vs 6.4%; P = 0.840), stroke (0.9% vs 1.3%; P = 0.689), need for renal replacement therapy (17.0% vs 13.5%; P = 0.732), pulmonary complications (9.5% vs 8.3%; P = 0.746) and sternal wound infection (2.7% vs 2.6%; P = 0.882). The outcomes were comparable for the propensity-matched cohorts. Conclusions: No gender difference in outcomes was seen in octogenarians undergoing isolated CABG.
MeSH term(s)	Aged, 80 and over ; Coronary Artery Bypass/adverse effects ; Coronary Artery Disease/complications ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/surgery ; Female ; Hospitals ; Humans ; Male ; Octogenarians ; Postoperative Complications/etiology ; Retrospective Studies ; Risk Factors ; Stroke/etiology ; Stroke Volume ; Treatment Outcome ; Ventricular Function, Left
Language	English
Publishing date	2021-10-30
Publishing country	England
Document type	Journal Article
ZDB-ID	2095298-3
ISSN	1569-9285 ; 1569-9293
ISSN (online)	1569-9285
ISSN	1569-9293
DOI	10.1093/icvts/ivab281
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