RISK PREVENTION
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A challenge to RAM is regional connectivity. Connectivity issues are predominant in remote and densely populated areas where cellular reception is subjected to available infrastructure.
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Key to the optimal design of future RAM trials is the acquisition of big data through large-scale, prospective, observational studies and adequately powered RCT’s with selective deployment of RAM, incorporation of biomarkers and machine learning.
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Current systems for postoperative monitoring in surgical populations on hospital wards and at home are inadequate, with infrequent vital signs monitoring contributing to thousands of cases of undetected or delayed detection of hemodynamic compromise.
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Remote automated monitoring (RAM), a subcomponent of telemedicine, is improving with technological advances that enable data integration and synthesis, as well as directed frontline nurse response, especially in surgical wards and at home.
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In the aspirin group, there was a significant reduction in the composite outcome of death and MI (HR 0.50) and MI alone (HR 0.44).
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There was no significant difference in the incidence of major bleeding between the two groups.
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This study demonstrated that among patients with prior PCI undergoing noncardiac surgery, perioperative aspirin may be more likely to be beneficial in this subgroup.
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POISE 2 was a blinded factorial randomized controlled trial. A total of 10,010 patients were recruited in 135 centers in 23 countries.
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Participants were ≥45 years old, having non-cardiac surgery, and at risk of cardiovascular complications.
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Participants were randomized to ASA versus placebo and clonidine versus placebo.
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