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All of the intensive care patients had been triaged directly to the operating theatre to undergo major surgery, including limb amputations, thoracotomy, laparotomy, and craniotomy.
Recent studies confirmed that cognitive impairment is common among older patients undergoing major surgery, including cardiac interventions [ 5, 6, 18, 23].
A variety of recent publications demonstrated conditions without infection that induce PCT (e.g. cardiogenic shock, major surgery including cardiac surgery, accidental trauma, pancreatitis, or burn trauma) [ 8, 10- 16, 16- 19].
3, 4 Esophagectomy is a high-risk procedure with serious postoperative complications and a reported mortality rate ranging from 2 to 6%. 1, 3, 5 Moreover, esophageal cancer patients often have considerable risk factors for major surgery, including obesity and pulmonary and cardiovascular diseases.
This statistically significant decrease of physical quality of life at one month may be related to an ongoing healing processes consecutive to an postoperative acute systemic inflammatory response syndrome after major surgery including the sickness behaviour [ 2], or to incomplete postoperative rehabilitation [ 40].
The VON annual survey does not differentiate between Level IIIC (those that provide major surgical services excluding serious congenital heart anomalies that require cardiopulmonary bypass or extracorporeal membrane oxygenation (ECMO)) and Level IIID hospitals (those that do provide major surgery including surgical repair of serious congenital heart anomalies or ECMO).
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In our study we included patients staying on the surgical ward ≥72 hours because of major general surgery, including central or extensive peripheral vascular surgery, major oncologic surgery, lung surgery, extensive abdominal surgery and trauma.
Venous thromboembolism (VTE) is a serious complication of major orthopedic surgery including total hip arthroplasty (THA) and total knee arthroplasty (TKA) [ 1].
As a universal phenomenon, delirium is frequently identified after major complicated surgery (including cardiac and vascular surgery) but rarely noted after minor ambulatory surgery (such as cataract surgery) [ 5, 14- 16].
Comorbidities and data regarding the causes of major joint surgery, including the type of orthopaedic surgery, the time elapsed after surgery before rehabilitation admission, and the length of stay were collected.
The aim of this study was to undertake a randomized trial between lumbar continuous epidural analgesia and continuous femoral blockade in adults undergoing major knee surgery, including comparison of analgesic efficacy [ 1], side effects, patient satisfaction and rehabilitation indices [ 2].
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