Comparison of Clinical Outcomes Between Very Long Stents and Overlapping Stents for the Treatment of Diffuse Coronary Disease in Real Clinical Practice.

BACKGROUND: The stent length as well as the stent overlap for the percutaneous treatment of diffuse coronary disease have been considered predictors of adverse events. However, there are no comparative data on the use of very long stents or overlapping stents in this scenario. OBJECTIVE: To compare the clinical results of very long stents (≥40 mm) or overlapping stents in real clinical practice. METHODS: We included 643 lesions in 628 consecutive patients treated with a single very long stent (≥40 mm) (251 lesions) or ≥2 overlapped stents (392 lesions). We analyzed the procedural characteristics and the presentation of the combined endpoint [cardiovascular death, non-fatal myocardial infarction, need for target lesion revascularization or stent thrombosis] after a follow-up of 20 months. RESULTS: Total stent length was 54 ±â€¯18 mm and minimum diameter was 2.9 ±â€¯1.2 mm. At the end of follow-up, the rate of adverse events was 8.3% (cardiac death: 4.9%, myocardial infarction: 1.7%, target lesion revascularization: 3.1%, stent thrombosis: 0.7%). There were no significant differences between both groups in the presentation of the combined endpoint. Procedures with overlapping stents had more contrast volume (309 ±â€¯115 vs 273 ±â€¯127 ml; p = 0.002), longer duration (47 ±â€¯22 vs 39 ±â€¯18 min; p < 0.0001), higher fluoroscopy time (20 ±â€¯13 vs 16 ±â€¯9 min; p < 0.0001) and higher number of stents to treat the index lesion (2.2 ±â€¯0.5 vs 1; p < 0.0001). CONCLUSIONS: New designs of very long stents allow not only treating increasingly complex lesions, but also simplifying the procedure and decreasing the number of stents with very favorable results similar to those obtained with stent overlap.

Índice O-POSSUM como predictor de morbimortalidad en pacientes intervenidos de fractura de cadera / O-POSSUM score predicts morbidity and mortality in patients undergoing hip fracture surgery

Objetivo: Valorar la capacidad del índice O-POSSUM de predecir la morbimortalidad de los pacientes intervenidos por fractura de la cadera. Material y método: Se revisaron retrospectivamente las historias clínicas de todos los pacientes mayores de 65años intervenidos de fracturas de la cadera entre enero de 2012 y diciembre de 2013. Se incluyó a 229 pacientes, la edad media fue de 82,3años y 170 fueron mujeres. Se recogieron patologías asociadas, tipo de cirugía y valores esperados de morbimortalidad O-POSSUM. Resultados: Tras un seguimiento mínimo de un año se registraron 38 fallecimientos, y 77 pacientes tuvieron alguna complicación. La mortalidad esperada, según el O-POSSUM, fue de 36 pacientes, y la morbilidad, de 132. Conclusión: Comparando los resultados observados con los predichos por el sistema, la escala O-POSSUM aplicada a fracturas de la cadera es más fiable en la predicción de mortalidad y sobreestima la morbilidad

Purpose: The aim of this study is to evaluate the O-POSSUM score capacity to predict the morbidity and mortality of patients undergoing hip fracture surgery. Material and methods: We retrospectively reviewed the clinical records of patients older than 65years old, operated on for hip fractures between January 2012 and December 2013. Of 229 patients, the mean age was 82.3years and 170 were women. We collected comorbidities, type of surgery, and expected morbidity and mortality O-POSSUM values. Results: After a minimum follow up of one year, 38 deaths were reported and 77 patients had complications. The expected mortality according to the O-POSSUM was 35 patients and expected morbidity 132. Conclusion: By comparing the observed results with those predicted, the O-POSSUM scale is reliable in predicting mortality and overestimates morbidity

O-POSSUM score predicts morbidity and mortality in patients undergoing hip fracture surgery. / Índice O-POSSUM como predictor de morbimortalidad en pacientes intervenidos de fractura de cadera.

PURPOSE: The aim of this study is to evaluate the O-POSSUM score capacity to predict the morbidity and mortality of patients undergoing hip fracture surgery. MATERIAL AND METHODS: We retrospectively reviewed the clinical records of patients older than 65years old, operated on for hip fractures between January 2012 and December 2013. Of 229 patients, the mean age was 82.3years and 170 were women. We collected comorbidities, type of surgery, and expected morbidity and mortality O-POSSUM values. RESULTS: After a minimum follow up of one year, 38 deaths were reported and 77 patients had complications. The expected mortality according to the O-POSSUM was 35 patients and expected morbidity 132. CONCLUSION: By comparing the observed results with those predicted, the O-POSSUM scale is reliable in predicting mortality and overestimates morbidity.