Impact of sepsis on risk of postoperative arterial and venous thromboses: large prospective cohort study

OBJECTIVES To evaluate the impact of preoperative sepsis on risk of postoperative arterial and venous thromboses. DESIGN Prospective cohort study using the National Surgical Quality Improvement Program database of the American College of Surgeons (ACS-NSQIP). SETTING Inpatient and outpatient procedures in 374 hospitals of all types across the United States, 2005-12. PARTICIPANTS 2,305,380 adults who underwent surgical procedures. MAIN OUTCOME MEASURES Arterial thrombosis (myocardial infarction or stroke) and venous thrombosis (deep venous thrombosis or pulmonary embolism) in the 30 days after surgery. RESULTS Among all surgical procedures, patients with preoperative systemic inflammatory response syndrome or any sepsis had three times the odds of having an arterial or venous postoperative thrombosis (odds ratio 3.1, 95% confidence interval 3.0 to 3.1). The adjusted odds ratios were 2.7 (2.5 to 2.8) for arterial thrombosis and 3.3 (3.2 to 3.4) for venous thrombosis. The adjusted odds ratios for thrombosis were 2.5 (2.4 to 2.6) in patients with systemic inflammatory response syndrome, 3.3 (3.1 to 3.4) in patients with sepsis, and 5.7 (5.4 to 6.1) in patients with severe sepsis, compared with patients without any systemic inflammation. In patients with preoperative sepsis, both emergency and elective surgical procedures had a twofold increased odds of thrombosis. CONCLUSIONS Preoperative sepsis represents an important independent risk factor for both arterial and venous thromboses. The risk of thrombosis increases with the severity of the inflammatory response and is higher in both emergent and elective surgical procedures. Suspicion of thrombosis should be higher in patients with sepsis who undergo surgery.

Zur Aktualität von Jacques Rancière. Einleitung in sein Werk

Das Buch bietet einen hervorragenden Einstieg in die Arbeiten von Jacques Rancière. Zentrale Theorieannahmen werden dargestellt und deren Bedeutung für die Kultur- und Sozialwissenschaften der Gegenwart aufgezeigt. Ist es notwendig, angesichts der Rezeptionsflut in den letzten Jahren, überhaupt noch Worte bezüglich der Aktualität der Arbeiten Jacques Rancières zu verlieren? Tatsachlich gibt es wahrscheinlich gegenwärtig wenige Philosophen, die in ganz unterschiedlichen Kontexten so stark aufgegriffen und zitiert werden wie der französische Denker Rancière. Dieses Buch führt – mit einem durchaus kritischen Impetus – in das Denken und in die Arbeiten Jacques Rancières ein.