Wilma M Hopman

Kingston General Hospital, Kingston, Ontario, Canada

Are you Wilma M Hopman?

Claim your profile

Publications (128)306.11 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Adjuvant chemotherapy (AC) improves survival among patients with colon cancer (CC). Two meta-analyses have demonstrated a decrease in survival with increasing time to AC (TTAC). Here, we examine the predominant factors leading to delay in TTAC.
    Journal of oncology practice / American Society of Clinical Oncology. 08/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: To prospectively assess changes in health-related quality of life (HRQOL) over 10 years, by age and sex, and to compare measured within-person change to estimates of change based on cross-sectional data.
    Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation. 06/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Sequence variations in the gene(s) encoding vitamin K epoxide reductase complex subunit 1 (VKORC1), the enzyme target of warfarin, have been associated with increased cardiovascular disease in the general population. Coronary artery calcification (CAC) is a prevalent form of cardiovascular disease in chronic kidney disease. We tested the hypothesis that the VKORC1 rs8050894 CC genotype would be associated with mortality and progression of CAC ≤4 years.
    Arteriosclerosis Thrombosis and Vascular Biology 05/2014; · 6.34 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Chagas cardiomyopathy is an endemic disease in Latin America. A significant proportion of patients develop atrial fibrillation (AF), which may result in stroke and increased morbidity or mortality. Interatrial block (IAB) has been associated with the development of AF in different clinical scenarios. The aim of our study was to determine whether IAB can predict new-onset AF in patients with Chagas cardiomyopathy and implantable cardioverter-defibrillators (ICDs). We conducted a retrospective study of patients with Chagas cardiomyopathy and ICDs from 14 centers in Latin America. Demographics, clinical, and device follow-up were collected. Surface electrocardiograms were scanned at 300 dpi and maximized ×8. Semiautomatic calipers were used to determine P-wave onset and offset. Partial IAB was defined as a P wave of >120 ms and advanced IAB as a P wave of >120 ms with biphasic morphology (±) in inferior leads. AF events and ICD therapies were reviewed during follow-up by 2 independent investigators. A total of 80 patients were analyzed. Mean age was 54.6 ± 10.4 years, and 52 (65%) were male. Mean left ventricular ejection fraction was 40 ± 12%. IAB was detected in 15 patients (18.8%), with 8 (10.0%) partial and 7 (8.8%) advanced. During a follow-up of 33 ± 20 months, 11 patients (13.8%) presented with new AF. IAB (partial + advanced) was strongly associated with new AF (p <0.0001) and inappropriate therapy by the ICD (p = 0.014). In conclusion, IAB (partial + advanced) predicted new-onset AF in patients with Chagas cardiomyopathy and ICDs.
    The American journal of cardiology 03/2014; · 3.58 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Management of atrial fibrillation (AF) is hampered by frequent recurrences after restoration of sinus rhythm. Delayed interatrial conduction has been associated with the development of AF in different clinical settings. The aim of our study was to assess whether advanced interatrial block (aIAB) was associated with AF recurrence after pharmacological cardioversion with two different antiarrhythmic drugs. We included 61 patients with recent onset AF without structural heart disease that underwent successful pharmacological cardioversion. Thirty-one patients received a single oral dose of propafenone and 30 patients received iv vernakalant. A 12-lead ECG (filter 150 Hz, 25 mm/s, 10 mm/mV) after conversion was evaluated for the presence of interatrial block (IAB); partial (pIAB): P-wave duration > 120 ms, and advanced (aIAB): P-wave > 120 ms and biphasic morphology (±) in inferior leads. Clinical follow-up and electrocardiographic recordings were performed for a 12-month period. Age was 58 ± 10.4 years and 50.8% were male. aIAB was present in 11 patients (18%) and pIAB in 10 (16.4%). At 1-year follow up 22 patients (36%) had AF recurrence. The recurrence rate with aIAB was 90.9% versus 70% in those with pIAB and 12.5% in normal P-wave duration (p = 0.001). The presence of aIAB was strongly associated with AF recurrence (Odds Ratio 18.4 in multivariable modeling). Recurrence was not affected by the drug used for cardioversion (p 0.92). Advanced interatrial block is associated with higher risk of AF recurrence at 1 year after pharmacological cardioversion, independent of the drug used. This article is protected by copyright. All rights reserved.
    Cardiovascular Therapeutics 01/2014; · 2.85 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Individuals with chronic leg ulceration may have significantly impaired health-related quality of life (HRQOL) due to pain, impaired mobility, poor sleep, depression, restricted work capacity, and social isolation. The study purpose was to examine the associations among sociodemographic and clinical factors and HRQOL in a large sample of community-dwelling adults being treated for leg ulcers. Data are from the cross-sectional baseline assessment of the Canadian Bandaging Trial, a multi-center, randomized controlled trial conducted to assess time to healing with two forms of high-compression bandaging. All participants received a comprehensive, standardized clinical assessment, and completed the 12-item Short Form (SF-12) and McGill Pain Questionnaire. SF-12 data were compared to age- and sex-adjusted norms, and multivariable logistic regression was used to identify factors associated with whether individuals were below, or at/above their normative values on the physical and mental component summary (PCS, MCS). Of 424 individuals enrolled over a 50-month period, 407 (96 %) completed the SF-12. Mean age was 65 ± 17 years, and 55 % were women. Mean PCS was 39.1 ± 9.9 with 91 (22.4 %) scoring at/above the mean value for their age and sex; equivalent values for the MCS were 51.4 ± 9.9 and 209 (51.4 %). Higher levels of pain, younger age, larger size and longer duration of ulcer, and limited mobility were associated with poorer HRQOL. Findings confirm the considerable burden of illness associated with leg ulcers. Given the chronic and recurring nature of the condition, strategies focused on improving HRQOL and healing are needed for this vulnerable population.
    Quality of Life Research 01/2014; · 2.41 Impact Factor
  • Sarah Ferrara, Wilma M. Hopman, Michael Leveridge
    [Show abstract] [Hide abstract]
    ABSTRACT: Introduction We assess how urologists are rated online by patients and which factors influence these ratings. Methods We created an anonymous database of urologists’ ratings from Ontario, Canada using a popular rating website (RateMDs.com). Comments were assessed for mention of diagnosis, bedside manner and nonlinguistic emphasis devices, and the impact of these variables was analyzed. Results A total of 3,288 ratings were identified for 224 urologists (median 15 ratings per urologist, range 1 to 35), representing 75.4% of practicing urologists in the province. Mean rating was 3.96/5 (median 4.75, range 1 to 5). Overall 2,215 ratings (67.4%) were 4/5 or greater. Comment on good bedside manner was associated with higher ratings (mean 4.74 vs 3.92, p <0.001) and comment on poor bedside manner was associated with lower ratings (mean 2.45 vs 4.01, p <0.001). Patients mentioning surgery rated urologists higher than those who did not (4.28 vs 3.85, p <0.001). A specific diagnosis was mentioned in 1,056 cases (32.1%). Mean rating was highest for kidney cancer (4.67) and lowest for vasectomy (3.77, p <0.001). Comments with at least 1 word in full capital letters and those with a word or phrase in quotation marks were accompanied by lower ratings (mean 3.11 vs 4.03 and 3.13 vs 4.02, respectively, p <0.001). Longer comments were also associated with lower ratings (word count 1 to 50—mean rating 4.24, word count 51 to 100—mean rating 3.88, word count greater than 100—mean rating 3.29; p <0.001). Conclusions Urologists are reviewed favorably online. Patients who note surgery, a cancer diagnosis or good bedside manner rate urologists highly, while longer comments, the use of all caps or quotation marks, or mention of a poor bedside manner are associated with lower ratings.
    Urology Practice. 01/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Main causes of death in chronic Chagas' cardiomyopathy (CChC) are progressive congestive heart failure and sudden cardiac death. Implantable cardioverter defibrillators (ICD) have been proved an effective therapy to prevent sudden death in patients with CChC. Identification of predictors of sudden death remains a challenge. To determine whether surface fragmented ECG (fQRS) helps identifying patients with CChC and ICDs at higher risk of presenting appropriate ICD therapies. Multicenter retrospective study. All patients with CChC and ICDs were analyzed. Clinical demographics, surface ECG, and ICD therapies were collected. A total of 98 patients were analyzed. Another four cases were excluded due to pacing dependency. Mean age was 55.5 ± 10.4 years, male gender 65%, heart failure New York Heart Association class I 47% and II 38%. Mean left ventricular ejection fraction (LVEF) 39.6 ± 11.8%. The indication for ICD was secondary prevention in 70% of patients. fQRS was found in 56 patients (59.6%). Location of fragmentation was inferior (57.1%), lateral (35.7%), and anterior (44.6%). Rsr pattern was the more prevalent (57.1%). Predictors of appropriate therapy in the multivariate model were: increased age (P = 0.01), secondary prevention indication (P = 0.01), ventricular pacing >50% of the time (P = 0.004), and LVEF <30% (P = 0.01). The presence of fQRS did not identify patients at higher risk of presenting appropriate therapies delivered by the ICD (P = 0.87); regardless of QRS interval duration. fQRS is highly prevalent among patients with CChC. It has been found a poor predictor of appropriate therapies delivered by the ICD in this population.
    Annals of Noninvasive Electrocardiology 01/2014; 19(1):43-9. · 1.08 Impact Factor
  • Source
    International journal of cardiology 12/2013; · 6.18 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF) is successful in ∼70-80 % after repeated procedures. This suggests a subgroup of PAF patients where electrical abnormalities outside the pulmonary veins are important. Prolonged P-wave duration (PWD), a marker of atrial remodelling, may identify this subgroup. This study's aim was to assess the association of PWD on standard 12 lead ECG with AF recurrence post PVI. Retrospectively, ECGs were blindly analysed on PVI patients from August 2007-August 2011; patients with persistent AF, mitral valve disease, undergoing redo procedures or no sinus rhythm (SR) ECG within 1 year of PVI were excluded. ECGs were directly uploaded at 300 dpi, amplified ×10, and then PWD measured in all leads. Prolonged PWD was as priori defined as maximum PWD ≥ 140 ms. The selective cohort consisted of 100 patients out of a total of 170 PVI: age 58 ± 11 years, 72 % male, LVEF 62 ± 9 %, 18 % ischaemic heart disease and 13 % diabetic. Thirty-five had prolonged PWD, which was associated with greater AF recurrence rates compared to those without prolonged PWD (63 vs. 38 %, p < 0.05). Similarly, AF recurrence was associated with greater maximum PWD (139 ± 17 vs. 129 ± 14, p < 0.01), P-wave dispersion (58 ± 21 vs. 49 ± 15, p < 0.01), left atrium (LA) dimension (41 ± 6 vs. 38 ± 5, p < 0.05) and LA volumes (40 ± 14 vs. 34 ± 11, p < 0.05) compared to those who remained in SR. None of these variables were independent predictors of AF recurrence by multivariate analysis. The presence of pre-existent prolonged PWD is associated with a higher risk of AF recurrence post PVI for paroxysmal AF.
    Journal of Interventional Cardiac Electrophysiology 12/2013; · 1.39 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives This study aims to determine whether fragmented QRS (fQRS) in the surface electrocardiogram (ECG) at implantable cardioverter defibrillator (ICD) implant can predict arrhythmic events using appropriate therapy delivered by the ICD as a surrogate. Background Hypertrophic obstructive cardiomyopathy (HOCM) is a genetic disorder associated with life-threatening arrhythmias frequently requiring an ICD. Seeking a noninvasive method of risk stratification remains a challenge. Methods This paper is a retrospective, multicenter study of patients with HOCM and ICD. Surface 12-lead ECGs were analyzed. Appropriate therapy was validated by a blinded Core Lab. Univariate and multivariate analyses were performed. A p value of <0.05 was considered significant. Results We included 102 patients from 13 centers. Mean age at implant was 41.16 ± 18.25 years, 52 % were male. Mean left ventricular ejection fraction was 61.56 ± 9.46 % and two thirds had heart failure according to the New York Heart Association class I. Secondary prophylaxis ICD implantation was the indication for implant in 40.2 % of cases. About half received a single-chamber ICD. fQRS was present at the time of diagnosis in 21 and in 54 % at ICD implant. At a mean follow-up of 47.8 ± 39.3 months, 41 patients (40.2 %) presented with appropriate therapy. In a multivariate logistic regression, predictors of appropriate therapy included fQRS at implant (odds ratio [OR], 16.4; 95 % confidence interval [CI], 3.6–74.0; p = 0.0003), history of combined ventricular tachycardia/fibrillation/sudden death (OR, 14.3; 95 % CI, 3.2–69.3; p = 0.001) and history of syncope (OR, 5.5; 95 % CI, 1.5–20.4; p = 0.009). Ten deaths (9.8 %) occurred during the follow-up. fQRS in the lateral location increased the risk of appropriate therapy (p < 0.0001). Conclusions fQRS predicts arrhythmic events in patients with HOCM and should be considered in a model of risk stratification.
    Journal of Interventional Cardiac Electrophysiology 12/2013; 38(3). · 1.39 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Sublobar resection for non-small cell lung cancer (NSCLC) remains controversial owing to concern about local recurrence and long-term survival outcomes. We sought to determine the efficacy of wedge resection as an oncological procedure. We analyzed the outcomes of all patients with NSCLC undergoing surgical resection at the Cancer Centre of Southeastern Ontario between 1998 and 2009. The standard of care for patients with adequate cardiopulmonary reserve was lobectomy. Wedge resection was performed for patients with inadequate reserve to tolerate lobectomy. Predictors of recurrence and survival were assessed. Appropriate statistical analyses involved the χ(2) test, an independent samples t test and Kaplan-Meier estimates of survival. Outcomes were stratified for tumour size and American Joint Committee on Cancer seventh edition TNM stage for non-small cell lung cancer. A total of 423 patients underwent surgical resection during our study period: wedge resection in 71 patients and lobectomy in 352. The mean age of patients was 64 years. Mean follow-up for cancer survivors was 39 months. There was no significant difference between wedge resection and lobectomy for rate of tumour recurrence, mortality or disease-free survival in patients with stage IA tumours less than 2 cm in diameter. Wedge resection with lymph node sampling is an adequate oncological procedure for non-small cell lung cancer in properly selected patients, specifically, those with stage IA tumours less than 2 cm in diameter.
    Canadian journal of surgery. Journal canadien de chirurgie 12/2013; 56(6):E165-E170. · 1.63 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To determine the associations between insulin resistance, fibroblast growth factor 23 (FGF-23), and coronary artery calcification (CAC) in chronic kidney disease (CKD) patients. FGF-23 is associated with atherosclerosis and cardiovascular disease, but its association with insulin resistance in CKD has not been explored. Cross sectional study of 72 stage 3-5 CKD patients receiving care in Ontario, Canada. Insulin resistance was measured by the homeostasis model assessment of insulin resistance (HOMA-IR), FGF-23 was measured by carboxyl terminal enzyme linked immunoassay (ctFGF-23) and CAC was measured by multi-slice computed tomography. Median HOMA-IR was 2.19μU/ml (interquartile range 1.19 to 3.94). Patients with HOMA-IR>2.2 had greater ctFGF-23 (179.7 vs 109.6; P=0.03), and 40% higher log CAC scores (2.09±0.87 vs 1.58±1.26; P=0.049). Multivariable linear regression adjusted for 1,25 dihydroxyvitamin D, kidney function, and parathyroid hormone revealed insulin resistance was a risk factor for greater log ctFGF-23 levels (log HOMA IR β=0.37; 95% confidence interval 0.14 to 0.59; P=0.002). Insulin resistant CKD patients demonstrated higher FGF-23 levels, and increased CAC, while PO4 levels remained normal, suggesting a potential link between insulin resistance and PO4 homeostasis in CKD.
    Journal of diabetes and its complications 10/2013; · 2.11 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To test the Pediatric Bleeding Questionnaire's (PBQ) utility for predicting excessive bleeding during elective surgery, we retrospectively evaluated 60 pediatric patients who had been preoperatively investigated for von Willebrand disease. Of 58 patients with bleeding scores (BS) ≤2 (within normal range), 1 hemorrhaged during surgery. Two had a BS of >2 (positive BS); however, neither bled excessively during surgery. The resulting sensitivity, specificity, positive predictive values, and negative predictive values of the PBQ are 0%, 97%, 0%, and 98%, respectively. On the basis of this small sample, we cannot recommend the PBQ for screening in this setting.
    Journal of Pediatric Hematology/Oncology 06/2013; · 0.97 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Venous leg ulceration is associated with pain and poor health-related quality of life (HRQL). The purpose of this study was to identify demographic and clinical characteristics associated with pain and decreased HRQL in patients with active venous ulcers. Baseline data were combined from two trials that took place between 2001 and 2007 (n = 564). Pain was measured using the Numeric Pain Scale (NPS), and HRQL was measured using the Medical Outcomes Survey 12-item Short Form (SF-12), which generates a Physical (PCS) and Mental Component Summary (MCS). Analyses included logistic and linear regression (for pain and HRQL, respectively). Mean age was 66.5 years; 47% were male. Median NPS score was 2.2 (out of 10) and mean PCS and MCS scores were 38.0 and 50.5, respectively (scores are standardized to a mean of 50 representing average HRQL). Younger age, living with others, and arthritis were associated with pain. Poorer PCS was associated with being female, venous/mixed ulcer etiology, larger ulcers, longer ulcer duration, cardiovascular disease, arthritis and higher pain intensity. Poorer MCS was associated with younger age, longer ulcer duration, comorbidity and higher pain intensity. Research is needed to test strategies to reduce pain and possibly improve HRQL in high risk groups.
    Chronic Diseases and Injuries in Canada 06/2013; 33(3):167-74. · 0.68 Impact Factor
  • Source
    A K Altwairgi, W M Hopman, M Mates
    [Show abstract] [Hide abstract]
    ABSTRACT: Primary prophylaxis with granulocyte colony-stimulating factors (pp-g-csf) is recommended in patients undergoing chemotherapy carrying a febrile neutropenia (fn) risk of 20% or more. In the present study, we examined clinical practice patterns and the impact of pp-g-csf on fn incidence in women with early-stage breast cancer (ebc) treated with modern adjuvant chemotherapy (act). This single-centre retrospective cohort study of women with ebc, who were identified from the pharmacy database and who received at least 1 cycle of modern act from January 2009 to December 2011, was conducted at the Cancer Centre of Southeastern Ontario. Data on patient demographics, pathology, stage distribution, chemotherapy, pp-g-csf use, dose reductions, chemotherapy delays, treatment discontinuation, relative dose intensity, and fn events were collected. Chi-square tests, t-tests, univariate and multivariate logistic regression analyses, and nonparametric Mann-Whitney U-tests were used for data analysis. Of the 239 women eligible for analysis, 145 (61%) received pp-g-csf, and 50 (21%) developed at least 1 episode of fn. Use of pp-g-csf was associated with a significantly lower rate of fn (14% vs. 31%, p = 0.002) and trends to fewer dose delays (17% vs. 27%, p = 0.060) and dose reductions (19% vs. 25%, p = 0.28). Among women receiving pp-g-csf, higher fn rates were associated with an age of 65 years or older, taxane-based chemotherapy, and prophylaxis with filgrastim. Clinical practice patterns at our institution showed that more than 50% of ebc patients treated with modern act received pp-g-csf, which led to fewer fn episodes and increased delivery of planned act. The observed high fn risk despite pp-g-csf was linked to older age, taxane-based chemotherapy, and filgrastim.
    Current Oncology 06/2013; 20(3):e171-9. · 1.63 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Von Willebrand's disease (VWD) patients undergoing major surgery are prophylactically treated to promote haemostasis. There is variability in perioperative clinical practice; however, most guidelines suggest replacing the deficient factor to a level of 1.0 IU mL(-1) (or 100%). A review of the literature reveals a paucity of well constructed descriptive data quantifying the changes in coagulation that occur in response to surgical stress. The aim of this study was to quantify the changes in haemostatic variables occurring in response to elective orthopaedic surgery in normal individuals. Eligible subjects >18 years of age undergoing total hip or knee replacement were recruited. Blood samples were drawn at five time points: baseline, preoperatively, 30 min after surgical incision, 30 min postoperatively, postoperative day (POD) 1. Analyses included t-tests and repeated measures anova. Overall 30 patients, 21 women and 9 men, with a mean age of 65 were included in the final analysis. All von Willebrand factor (VWF) variables were seen to significantly decrease intraoperatively and increase postoperatively. VWF multimers showed a statistically significant decrease in high molecular weight multimers intraoperatively and an increase postoperatively. On subgroup analysis, age, gender and anaesthesia type were significantly correlated with changes in VWF parameters. Data presented in the current study establish a physiological baseline for VWF parameters in the normal population and demonstrate mean VWF/factor VIII levels greater than 1.0 IU mL(-1) intraoperatively. As such, current management in VWD patients does not appear to mimic the normal physiological response to surgery.
    Haemophilia 05/2013; · 3.17 Impact Factor
  • Source
    Katya M Herman, Wilma M Hopman, Mark W Rosenberg
    [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE: Obesity is associated with impaired health-related quality of life (HRQL). As perceived constructs, self-rated health (SRH) and general life satisfaction (LS) might be more strongly related to perceived weight status than actual weight status. The aim was to assess agreement between perceived weight status and self-reported body mass index (BMI), and to investigate their associations with SRH and LS as indicators of HRQL. METHODS: Cross-sectional data included 87,545 adults aged 18-65 years from the 2005 Canadian Community Health Survey. Agreement between perceived weight status and self-reported BMI was assessed. Prevalence of suboptimal SRH and LS was estimated by perceived weight status and BMI, and adjusted logistic regression used to assess the odds of suboptimal outcomes. RESULTS: Overall agreement between perceived weight status and self-reported BMI was only moderate (females: κ = 0.58; males: κ = 0.42). The lowest prevalences of suboptimal SRH and LS were in those who reported both a healthy weight BMI and "about right" weight perception. Discordance between perceived weight status and BMI status, and congruence (i.e. perceived weight status = BMI) around underweight or overweight/obese were associated with poorer SRH and LS. For weight perceptions of "about right", BMI status had minimal influence on suboptimal SRH or LS, while perceptions of underweight or overweight were associated with higher odds of suboptimal SRH and LS, independent of BMI. CONCLUSIONS: Adults' weight status perceptions often do not agree with their actual weight status, even when self-reported. While both perceived and actual weight status influence self-rated health and life satisfaction, perceptions are more strongly associated with these HRQL indicators and should be considered when informing obesity-targeted policies and programmes.
    Quality of Life Research 03/2013; · 2.41 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: STUDY OBJECTIVE: To evaluate the utilization of the surgical step-down unit (SSDU) by a sample of patients who were preoperatively booked for admission to the unit, and to identify those patient characteristics and perioperative variables that are associated with an intervention in the unit. DESIGN: Retrospective chart review. SETTING: Canadian tertiary-care facility. MEASUREMENTS: Data from 133 elective surgery patients with prebooked SSDU beds were recorded, including comorbidities, Surgical Risk Scale (SRS), Surgical Apgar Score (SAS), and number and nature of interventions and events occurring in the SSDU. MAIN RESULTS: Of the 133 patients scheduled for SSDU admission, 60 (45.1%) were actually admitted and the other 73 (54.9%) were admitted directly to the surgical ward or else discharged. Of the patients admitted to the SSDU, 48.3% had an intervention during their stay. In logistic regression, the SRS was a significant predictor (P < 0.001) of SSDU use, while the SAS was a significant predictor (P = 0.034) of the need for an intervention or the likelihood of an event while in the SSDU. CONCLUSIONS: Less than half of patients identified were actually admitted to the SSDU postoperatively; of those, less than half required an intervention. The Surgical Apgar Score, a score based on intraoperative factors, predicted the need for an intervention during SSDU admission. Consideration should be given to the development of a predictive score that emphasizes intraoperative factors and early postoperative factors to optimize allocation of this scarce resource.
    Journal of clinical anesthesia 03/2013; · 1.32 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Describe health-related quality of life (HRQoL) of former Canadian Forces (CF) men and women in uniform (Veterans) after transition to civilian life, and compare to age- and sex-adjusted Canadian norms. The 2010 Survey on Transition to Civilian Life was a national computer-assisted telephone survey of CF Regular Force personnel who released during 1998-2007. HRQoL was assessed using the SF-12 Physical (PCS) and Mental (MCS) Component Summary scores. Descriptive analysis of HRQoL was conducted for socio-demographic, health, disability and determinants of health characteristics. Mean age was 46 years (range 20-67). Compared to age- and sex-adjusted Canadian averages, PCS (47.3) was low and MCS was similar (52.0). PCS and MCS were variably below average for middle age groups and lowest for non-commissioned ranks, widowed/divorced/separated, 10-19 years of service, physical and mental health conditions, disability, dissatisfaction with finances, seeking work/not working, low social support and difficulty adjusting to civilian life. Among Veterans Affairs Canada clients, 83% had below-average physical PCS, 49% had below-average MCS, and mean PCS (38.2) was significantly lower than mean MCS (48.3). HRQoL varied across a range of biopsychosocial factors, suggesting possible protective factors and vulnerable subgroups that may benefit from targeted interventions. These findings will be of interest to agencies supporting Veterans in transition to civilian life and to researchers developing hypotheses to better understand well-being in Canadian Veterans.
    Canadian journal of public health. Revue canadienne de santé publique 02/2013; 104(1):e15-21. · 1.02 Impact Factor

Publication Stats

2k Citations
306.11 Total Impact Points


  • 1996–2014
    • Kingston General Hospital
      Kingston, Ontario, Canada
    • Queen's University
      • • Division of Cardiology
      • • Department of Community Health and Epidemiology
      • • Department of Family Medicine
      • • Department of Medicine
      Kingston, Ontario, Canada
  • 2013
    • University Hospital Of South Manchester NHS Foundation Trust
      • Department of Cardiology
      Manchester, England, United Kingdom
    • Hospital Español de Mendoza
      Мендоса, Mendoza, Argentina