Acknowledgment A sincere thanks to Drs. Brad J. Hymel and Don D. Doussan for their contribution to this chapter in the previous edition of this text. Risk More common in men than in women. Symptoms begin in fifth-seventh decades of…
Risk Incidence of sepsis within USA: Approximately 1 million per year and increasing. Severe sepsis and septic shock are associated with high morbidity and mortality, and septic shock is the most common cause of death among critically ill pts in…
Risk Incidence in USA: 500,000–1,000,000 with recurrent tonic-clonic seizures. 10–20 million at risk to have one tonic-clonic seizure secondary to alcohol withdrawal, febrile convulsions (in children), CNS pathology, and/or metabolic disturbances. Prevalence of epilepsy is 0.5–1% of the population. Perioperative…
Risk Incidence in USA: 600,000 people with epilepsy have uncontrolled seizures. Racial predominance: None. Perioperative Risks Sudden death Status epilepticus Seizure-mediated cardiac dysrhythmias Worry About Liver toxicity from anticonvulsants (on the decline with the new drug generation) Periop trauma from…
Risk Incidence of epilepsy estimated to be 0.5–2.3%. 30–40% of pts with epilepsy will develop intractable seizures (>1/mo refractory to two or more medications). Approx 400,000 people in USA have medically uncontrolled epilepsy. Perioperative Risks Epilepsy has causality with a…
Risk Incidence of absence seizures in USA is 1.9–8 cases per 100,000 population. Seizures are most common in children aged 4–14 y but rare in adults. Perioperative Risks Risk of transition of absence seizures into tonic-clonic seizures or SE is…
Risk Scoliosis is a lateral and rotational deformity of the spine that, when measured by x-ray, has a Cobb angle of >10 degrees. The incidence of this spine deformity is 1–4%. Most cases of scoliosis are idiopathic (70% of cases)…
Risk Incidence: 9:1,000,000 per y. Prevalence: 300,000 Americans have scleroderma. Male:female ratio is 1:4; highest in young African-American women. More severe in Native Americans and African Americans. 10-y survival is 55–60%; presence of pulm Htn is a major prognostic predictor.…
Risk Occurs in 1 to 3–5:100.000 live births. The incidence could be higher because of asymptomatic cases in adult population. Perioperative Risks Significant risk of pulm Htn, respiratory failure, and cardiac failure in the periop period. Worry About Intraop pulm…
Risk Most common psychotic disorder with a lifetime worldwide prevalence of 1% Increased risk of suicide (5–10%) Perioperative Risks Marked by deterioration of function and self-care Exacerbation of psychosis with abrupt discontinuation of medications Worry About Pt being uncooperative, combative,…