Research Topics
| Duminda N WijeysunderaSummaryAffiliation: University of Toronto Country: Canada Publications
| Collaborators
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Detail Information
Publications
A population-based study of anesthesia consultation before major noncardiac surgeryDuminda N Wijeysundera
Department of Anesthesia, Toronto General Hospital and University of Toronto, ON, Canada
Arch Intern Med 169:595-602. 2009..Nonetheless, the impact of anesthesia consultation on outcomes in the population remains unclear...- Outcomes and processes of care related to preoperative medical consultationDuminda N Wijeysundera
Institute for Clinical Evaluative Sciences, Keenan Research Centre, Li Ka Shing Knowledge Institute of St Michael s Hospital, Department of Anesthesia, Toronto General Hospital and University of Toronto, EN 3 450, 200 Elizabeth St, Toronto, ON M5G 2C4, Canada
Arch Intern Med 170:1365-74. 2010..Nonetheless, the impact of these consultations, which may be performed by general internists or specialists, on outcomes is unclear... - Clinical evidence, practice guidelines, and β-blocker utilization before major noncardiac surgeryDuminda N Wijeysundera
St Michael s Hospital, Toronto, Ontario, Canada
Circ Cardiovasc Qual Outcomes 5:558-65. 2012..However, subsequent studies raised concerns about a widespread use of perioperative β-blockade. Little is known regarding how this changing evidence influenced the use of perioperative β-blockers in clinical practice... - Risk of elective major noncardiac surgery after coronary stent insertion: a population-based studyDuminda N Wijeysundera
Li Ka Shing Knowledge Institute of St Michael s Hospital, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada
Circulation 126:1355-62. 2012..Guidelines recommend that noncardiac surgery be delayed until 30 to 45 days after bare-metal stent implantation and 1 year after drug-eluting stent implantation... - Development of an algorithm to identify preoperative medical consultations using administrative dataDuminda N Wijeysundera
Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
Med Care 47:1258-64. 2009..However, administrative data in many jurisdictions lack specific codes to identify preoperative medical consultations, as opposed to consultations for nonoperative indications... 
Non-invasive cardiac stress testing before elective major non-cardiac surgery: population based cohort studyDuminda N Wijeysundera
Institute for Clinical Evaluative Sciences, Toronto, Ontario M4N 3M5, Canada
BMJ 340:b5526. 2010..To determine the association of non-invasive cardiac stress testing before elective intermediate to high risk non-cardiac surgery with survival and hospital stay...- Bayesian statistical inference enhances the interpretation of contemporary randomized controlled trialsDuminda N Wijeysundera
Department of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
J Clin Epidemiol 62:13-21.e5. 2009..Frequentist methods have limitations that might be overcome, in part, by Bayesian inference. To illustrate these advantages, we re-analyzed randomized trials published in four general medical journals during 2004... - Variation in the practice of preoperative medical consultation for major elective noncardiac surgery: a population-based studyDuminda N Wijeysundera
Li Ka Shing Knowledge Institute, St Michael s Hospital, Toronto, Ontario, Canada
Anesthesiology 116:25-34. 2012..However, the factors that determine whether individuals undergo consultation and the extent of interhospital variation remain unclear... - Preoperative consultations by anesthesiologistsDuminda N Wijeysundera
Keenan Research Centre, Li Ka Shing Knowledge Institute of St Michael s Hospital, and Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada
Curr Opin Anaesthesiol 24:326-30. 2011..The goal of this review is to discuss the implications of recent studies that have evaluated the processes-of-care and outcomes related to preoperative anesthesia consultation... 
Determinants of complications with recombinant factor VIIa for refractory blood loss in cardiac surgeryKeyvan Karkouti
University of Toronto, University Health Network, Department of Anesthesia, 3 Eaton North, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada
Can J Anaesth 53:802-9. 2006..Recombinant factor VIIa (rFVIIa) is being used for refractory, excessive blood loss (EBL) after cardiac surgery, but its safety for this indication is not known...- The risk-benefit profile of aprotinin versus tranexamic acid in cardiac surgeryKeyvan Karkouti
Department of Anesthesia, University of Toronto, and Toronto General Hospital, Toronto, ON, Canada M5G 2C4
Anesth Analg 110:21-9. 2010..It remains unclear whether its risk-benefit profile differs among low-, moderate-, and high-risk cardiac surgical patients... - Acute surgical anemia influences the cardioprotective effects of beta-blockade: a single-center, propensity-matched cohort studyW Scott Beattie
Department of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
Anesthesiology 112:25-33. 2010.... - Acute kidney injury after cardiac surgery: focus on modifiable risk factorsKeyvan Karkouti
Department of Anesthesia and Health Policy, Management, and Evaluation, Toronto General Hospital, University of Toronto, 200 Elizabeth St, EN 3 402, Toronto, Ontario, Canada M5G 2C4
Circulation 119:495-502. 2009..Lacking effective therapies, risk factor modification may offer a means of preventing this complication. The objective of the present study was to identify and determine the prognostic importance of such risk factors... - Factors associated with colonoscopy performed in nonhospital settingsOthman Alharbi
Department of Medicine, Division of Gastroenterology, Sunnybrook Health Services Centre, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
Can J Gastroenterol 24:419-24. 2010..Regulation of these facilities is variable, and concerns regarding the quality of procedures in nonhospital (NH) settings have been raised. Further study is needed to better understand endoscopic practice in these facilities... - Prognostic value of postoperative proteinuria in cardiac surgery: a pilot studyKeyvan Karkouti
University Health Network, Toronto General Hospital, Department of Anesthesia, EN 3 402, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada
Can J Anaesth 53:500-6. 2006..The objective of this pilot study was to determine if postoperative proteinuria is associated with adverse outcomes following cardiac surgery with cardiopulmonary bypass... - Influence of erythrocyte transfusion on the risk of acute kidney injury after cardiac surgery differs in anemic and nonanemic patientsKeyvan Karkouti
Department of Anesthesia, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
Anesthesiology 115:523-30. 2011..Two important risk factors for AKI are preoperative anemia and perioperative erythrocyte transfusion, and elucidating their relationship may help in devising preventive strategies... - The incremental value of thrombelastography for prediction of excessive blood loss after cardiac surgery: an observational studyMarcin Wasowicz
Toronto General Hospital, 200 Elizabeth St, 3EN 402 Toronto, ON, Canada M5G 2C4
Anesth Analg 111:331-8. 2010..Accurate risk stratification may help reduce the burden of excessive blood loss after cardiac surgery. We measured the incremental value of thrombelastography to an existing risk prediction model for excessive blood loss in cardiac surgery... - Improving the identification of patients at risk of postoperative renal failure after cardiac surgeryDuminda N Wijeysundera
Department of Anesthesia, Toronto General Hospital and University of Toronto, Ontario, Canada
Anesthesiology 104:65-72. 2006..Calculated creatinine clearance (CrCl) is an alternative measure of renal function that may allow better estimation of renal reserve... - Derivation of a risk index for the prediction of massive blood transfusion in liver transplantationStuart A McCluskey
Department of Anesthesia and Pain Management, University of Toronto, Toronto, Ontario, Canada
Liver Transpl 12:1584-93. 2006..The ROC for this risk index was 0.79. MBT in liver transplantation surgery can be accurately predicted by 7 readily available preoperative predictors... - Advance targeted transfusion in anemic cardiac surgical patients for kidney protection: an unblinded randomized pilot clinical trialKeyvan Karkouti
Department of Anesthesia and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
Anesthesiology 116:613-21. 2012..Prophylactic erythrocyte transfusion in anemic patients may, therefore, protect against AKI... - Calcium antagonists are associated with reduced mortality after cardiac surgery: a propensity analysisDuminda N Wijeysundera
Department of Anesthesia, University of Toronto, EN 3-453, Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada
J Thorac Cardiovasc Surg 127:755-62. 2004..This benefit also extends to the subgroup that underwent coronary artery bypass grafting. A large randomized controlled trial of perioperative calcium channel blockers is therefore warranted... - Variability and predictability of large-volume red blood cell transfusion in cardiac surgery: a multicenter studyKeyvan Karkouti
University Health Network, Toronto General Hospital, Department of Anesthesia, Ontario, Canada
Transfusion 47:2081-8. 2007..The objectives of this study were to measure the interinstitution variation and predictability of large-volume RBC transfusion... - Association of echocardiography before major elective non-cardiac surgery with postoperative survival and length of hospital stay: population based cohort studyDuminda N Wijeysundera
Keenan Research Centre, Li Ka Shing Knowledge Institute of St Michael s Hospital, 80 Bond Street, Toronto, ON, Canada
BMJ 342:d3695. 2011..To determine the association of resting echocardiography before elective intermediate to high risk non-cardiac surgery with survival and length of hospital stay... - Calcium channel blockers for reducing cardiac morbidity after noncardiac surgery: a meta-analysisDuminda N Wijeysundera
Department of Anesthesia, University of Toronto, ON
Anesth Analg 97:634-41. 2003..The majority of these benefits are attributable to diltiazem, suggesting the need for further evaluation of this drug in a large RCT... - N-acetylcysteine is associated with increased blood loss and blood product utilization during cardiac surgeryDuminda N Wijeysundera
Department of Anesthesia, Toronto General Hospital and University of Toronto, Toronto, Ontario, Canada
Crit Care Med 37:1929-34. 2009..We, therefore, performed a post hoc analysis of a recent randomized controlled trial in cardiac surgery to determine whether N-acetylcysteine was associated with increased blood loss and blood product transfusion... - Risk associated with preoperative anemia in noncardiac surgery: a single-center cohort studyW Scott Beattie
Department of Anesthesia, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada
Anesthesiology 110:574-81. 2009..The objective of this observational study was to measure the prevalence of preoperative anemia and assess the relationship between preoperative anemia and postoperative mortality... - Epidural anaesthesia and survival after intermediate-to-high risk non-cardiac surgery: a population-based cohort studyDuminda N Wijeysundera
Department of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
Lancet 372:562-9. 2008..We therefore undertook a population-based cohort study to determine whether perioperative epidural anaesthesia or analgesia is associated with improved 30-day survival... - Risk associated with preoperative anemia in cardiac surgery: a multicenter cohort studyKeyvan Karkouti
Department of Anesthesia, University Health Network, University of Toronto, Toronto, Ontario, Canada, M5G 2C4
Circulation 117:478-84. 2008..Whether preoperative anemia also is an independent risk factor for adverse outcomes after cardiac surgery, however, has not been fully elucidated... - The independent association of massive blood loss with mortality in cardiac surgeryKeyvan Karkouti
Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada
Transfusion 44:1453-62. 2004..The objective of this cohort study was to quantify the independent association of MBL in cardiac surgery with all-cause in-hospital mortality... - A population-based analysis of outpatient colonoscopy in adults assisted by an anesthesiologistOthman Alharbi
Department of Medicine, Division of Gastroenterology, University of Toronto, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, Ontario, Canada
Anesthesiology 111:734-40. 2009..This study's objective was to identify nonpayor factors (patient, physician, institution) associated with anesthesiologist assistance at colonoscopy... - Platelet transfusions are not associated with increased morbidity or mortality in cardiac surgeryKeyvan Karkouti
Department of Anesthesia, University Health Network, University of Toronto, Toronto, Ontario, Canada
Can J Anaesth 53:279-87. 2006..To determine the independent relationship between leukoreduced platelet transfusions and adverse events in cardiac surgery... - Off-pump coronary artery surgery for reducing mortality and morbidity: meta-analysis of randomized and observational studiesDuminda N Wijeysundera
Department of Anesthesia, Toronto General Hospital, Toronto, Ontario, Canada
J Am Coll Cardiol 46:872-82. 2005..The purpose of this study was to assess the effects of off-pump coronary bypass surgery (OPCAB) on mortality and morbidity... - A propensity score case-control comparison of aprotinin and tranexamic acid in high-transfusion-risk cardiac surgeryKeyvan Karkouti
Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada
Transfusion 46:327-38. 2006..Prophylactic use of the antifibrinolytic drugs aprotinin and tranexamic acid is thought to prevent these hemostatic defects. Their relative clinical utility and safety in high-transfusion-risk cardiac surgery, however, is not known... - Does tight heart rate control improve beta-blocker efficacy? An updated analysis of the noncardiac surgical randomized trialsW Scott Beattie
Department of Anesthesia, Toronto General Hospital and University of Toronto, EN 3 450 200 Elizabeth St, Toronto, Ontario M5G 2C4, Canada
Anesth Analg 106:1039-48, table of contents. 2008..Tight control of heart rate (HR) has been suggested to improve these outcomes. Meta-analyses have not considered the influence of tight HR control on the efficacy of perioperative beta-blockade... - N-acetylcysteine for preventing acute kidney injury in cardiac surgery patients with pre-existing moderate renal insufficiencyDuminda N Wijeysundera
Department of Anesthesia, Toronto General Hospital and University of Toronto, EN 3 450, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada
Can J Anaesth 54:872-81. 2007..To determine if N-acetylcysteine warrants definitive evaluation in a large multicentre trial, we evaluated its effects on a surrogate outcome, estimated glomerular filtration rate (eGFR), in a randomized trial... - The influence of baseline hemoglobin concentration on tolerance of anemia in cardiac surgeryKeyvan Karkouti
Department of Anesthesia, University Health Network, University of Toronto, Toronto, Ontario, Canada
Transfusion 48:666-72. 2008..Nonetheless, "normal" Hb concentrations vary widely in the population, and this variability may influence patients' tolerance of acute anemia. This retrospective cohort study was carried out to test this hypothesis... - Alpha-2 adrenergic agonists to prevent perioperative cardiovascular complications: a meta-analysisDuminda N Wijeysundera
Department of Anesthesia, University Health Network, Ontario, Toronto, Canada
Am J Med 114:742-52. 2003..During cardiac surgery, they reduce ischemia and may also have effects on mortality and myocardial infarction. Large randomized trials are needed to evaluate these agents during cardiac and vascular surgery... - Derivation and validation of a simplified predictive index for renal replacement therapy after cardiac surgeryDuminda N Wijeysundera
Department of Anesthesia, Toronto General Hospital and University of Toronto, Toronto, Ontario, Canada
JAMA 297:1801-9. 2007..A predictive index for renal replacement therapy (RRT; hemodialysis or continuous venovenous hemodiafiltration) after cardiac surgery may improve clinical decision making and research design... - Gender differences in mortality following non-cardiovascular surgery: an observational studyKeerat Grewal
Department of Anesthesia and Pain Management, Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario, Canada
Can J Anaesth 59:255-62. 2012..The objective of the study was to determine whether there are differences in mortality between males and females following non-cardiovascular surgery and to ascertain to what extent preoperative risk factors explain these differences... - Renal dysfunction in high-risk patients after on-pump and off-pump coronary artery bypass surgery: a propensity score analysisAndrew Chukwuemeka
Division of Cardiovascular Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
Ann Thorac Surg 80:2148-53. 2005..Our results suggest that renal function should not be a deciding factor when determining whether or not a patient undergoes off-pump coronary artery bypass grafting surgery... - A meta-analytic comparison of preoperative stress echocardiography and nuclear scintigraphy imagingW Scott Beattie
Department of Anesthesia and Pain Management University Health Network Toronto General Hospital, University of Toronto, Toronto, Ontario
Anesth Analg 102:8-16. 2006..A moderate-to-large perfusion defect by either SE or TI predicts postoperative MI and death. We conclude the SE is superior to TI in predicting postoperative cardiac events... - Systematic review: prediction of perioperative cardiac complications and mortality by the revised cardiac risk indexMeredith K Ford
Toronto General Hospital and University of Toronto, Toronto, Ontario, Canada
Ann Intern Med 152:26-35. 2010..The Revised Cardiac Risk Index (RCRI) is widely used to predict perioperative cardiac complications... - Use of clinically based troponin underestimates the cardiac injury in non-cardiac surgery: a single-centre cohort study in 51,701 consecutive patientsW Scott Beattie
Department of Anesthesia and Pain Management, University Health Network, Toronto, ON, Canada
Can J Anaesth 59:1013-22. 2012.... - Calcium antagonists reduce cardiovascular complications after cardiac surgery: a meta-analysisDuminda N Wijeysundera
Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada
J Am Coll Cardiol 41:1496-505. 2003..66, 95% CI 0.26 to 1.70, p = 0.4). CONCLUSIONS: Use of CAs during cardiac surgery significantly reduced rates of MI, ischemia, and SVT. Further study using large RCTs is justified... - Evaluating surrogate measures of renal dysfunction after cardiac surgeryDuminda N Wijeysundera
Department of Anaesthesia, University of Toronto, Ontario, Canada
Anesth Analg 96:1265-73, table of contents. 2003..Both measures were correlated with clinical outcomes. Creatinine clearance had the advantage of a distribution suitable for parametric statistical tests... - Relationship of erythrocyte transfusion with short- and long-term mortality in a population-based surgical cohortKeyvan Karkouti
Department of Anesthesia, Toronto General Hospital, University Health Network, Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
Anesthesiology 117:1175-83. 2012..Nonetheless, unmeasured confounding may unduly influence this comparison. This unmeasured risk may have less influence on comparisons of patients undergoing surgery at hospitals with differing transfusion rates... - The prevention of chronic postsurgical pain using gabapentin and pregabalin: a combined systematic review and meta-analysisHance Clarke
Department of Anesthesia and Pain Management, Toronto General Hospital, 200 Elizabeth Street, Eaton North 3 EB 317, Pain Research Unit, Toronto, ON M5G 2C4, Canada
Anesth Analg 115:428-42. 2012..A search of electronic databases (Medline, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, IPA, and CINAHL) for relevant English-language trials to June 2011 was conducted...