West Midlands Evidence Repository(WMER)

West Midlands Evidence Repository (WMER)

 

Welcome to the West Midlands Evidence Repository (WMER).

WMER is an online repository that is managed by a consortium of West Midlands NHS Library and Knowledge Services. Our aim is to collate, store and make available research and other non-traditional publications by our NHS organisations.

Please see below for the full list of WMER organisations. If you wish to engage with us as we develop the repository please contact us via email: wmnhskr@gmail.com

Please note deposit of items within WMER does not mean endorsement of the research or any opinions expressed within it by the consortium organisations.

 

  • 30-day Morbidity and Mortality after Cholecystectomy for Benign Gallbladder Disease (AMBROSE): A Prospective, International Collaborative Cohort Study

    Wong, Geoffrey Yuet Mun; Wadhawan, Himanshu; Roth Cardoso, Victor; Bravo Merodio, Laura; Rajeev, Yashasvi; Maldonado, Ricardo David; Martinino, Alessandro; Balasubaramaniam, Vignesh; Ashraf, Aabid; Siddiqui, Adeela; et al. (Lippincott Williams & Wilkins, 2024-02-13)
    Objective: This study aimed to assess 30-day morbidity and mortality rates following cholecystectomy for benign gallbladder disease and identify the factors associated with complications. Summary background data: Although cholecystectomy is common for benign gallbladder disease, there is a gap in the knowledge of the current practice and variations on a global level. Methods: A prospective, international, observational collaborative cohort study of consecutive patients undergoing cholecystectomy for benign gallbladder disease from participating hospitals in 57 countries between January 1 and June 30, 2022, was performed. Univariate and multivariate logistic regression models were used to identify preoperative and operative variables associated with 30-day postoperative outcomes. Results: Data of 21,706 surgical patients from 57 countries were included in the analysis. A total of 10,821 (49.9%), 4,263 (19.7%), and 6,622 (30.5%) cholecystectomies were performed in the elective, emergency, and delayed settings, respectively. Thirty-day postoperative complications were observed in 1,738 patients (8.0%), including mortality in 83 patients (0.4%). Bile leaks (Strasberg grade A) were reported in 278 (1.3%) patients and severe bile duct injuries (Strasberg grades B-E) were reported in 48 (0.2%) patients. Patient age, ASA physical status class, surgical setting, operative approach and Nassar operative difficulty grade were identified as the five predictors demonstrating the highest relative importance in predicting postoperative complications. Conclusion: This multinational observational collaborative cohort study presents a comprehensive report of the current practices and outcomes of cholecystectomy for benign gallbladder disease. Ongoing global collaborative evaluations and initiatives are needed to promote quality assurance and improvement in cholecystectomy.
  • Risk Stratification in Primary Sclerosing Cholangitis: Does Size Matter?

    Hussain, Nasir; Trivedi, Palak J; Hussain, Nasir; Trivedi, Palak J; Liver; Medical and Dental (Springer Science + Business Media, 2024-02-12)
    No abstract available
  • Hot feet! Dancing the chilblains Cha Cha

    Bleem, Ilona; Bleem, Ilona; Medical and Dental; South Warwickshire University NHS Foundation Trust (Elsevier, 2019-10)
    This poster abstract reports a case of chilblains arising during a warm summer holiday.
  • Enhancing glycaemic control with impetus on weight management: Observing for early worsening of diabetic retinopathy

    Jacob, Sarita; Varughese, George I; Jacob, Sarita; Ophthalmology; Medical and Dental (Nature Publishing Group, 2024-02-10)
    No abstract available
  • Pulmonary artery wave intensity analysis in pulmonary hypertension associated with heart failure and reduced left ventricular ejection fraction.

    Yim, Ivan H W; Parker, Kim H; Drury, Nigel E; Lim, Hoong Sern; Yim, Ivan H W; Lim, Hoong Sern; Cardiology; Medical and Dental (Wiley, 2024-02-12)
    Wave intensity analysis (WIA) uses simultaneous changes in pressure and flow velocity to determine wave energy, type, and timing of traveling waves in the circulation. In this study, we characterized wave propagation in the pulmonary artery in patients with pulmonary hypertension associated with left-sided heart disease (PHLHD) and the effects of dobutamine. During right heart catheterization, pressure and velocity data were acquired using a dual-tipped pressure and Doppler flow sensor wire (Combowire; Phillips Volcano), and processed offline using customized Matlab software (MathWorks). Patients with low cardiac output underwent dobutamine challenge. Twenty patients with PHLHD (all heart failure with reduced left ventricular ejection fraction) were studied. Right ventricular systole produced a forward compression wave (FCW), followed by a forward decompression wave (FDW) during diastole. Wave reflection manifesting as backward compression wave (BCW) following the FCW was observed in 14 patients. Compared to patients without BCW, patients with BCW had higher mean pulmonary artery pressure (28.7 ± 6.12 vs. 38.6 ± 6.5 mmHg, p = 0.005), and lower pulmonary arterial capacitance (PAC: 2.88 ± 1.75 vs. 1.73 ± 1.16, p = 0.002). Pulmonary vascular resistance was comparable. Mean pulmonary artery pressure of 34.5 mmHg (area under the curve [AUC]: 0.881) and PAC of 2.29 mL/mmHg (AUC: 0.833) predicted BCW. The magnitude of the FCW increased with dobutamine (n = 11) and correlated with pulmonary artery wedge pressure. Wave reflection in PHLHD is more likely at higher pulmonary artery pressures and lower PAC and the magnitude of reflected waves correlated with pulmonary artery wedge pressure. Dobutamine increased FCW but did not affect wave reflection.

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