Abstract：
BACKGROUND:Few graduating residents seek surgical critical care (SCC) fellowships; fewer than half of positions fill. We hypothesized substantial differences exist in practice patterns and attitudes between SCC surgeons in academic practice (ACs) and in private practice (PVTs). STUDY DESIGN:A survey instrument was sent to 1,544 board-certified SCC intensivists in North America. RESULTS:Of those invited, 489 responded (32% response rate). Respondents were mostly men (88%) and Caucasian (86%), with a mean age of 48 years; 60% were ACs, 28% were PVTs, and 12% reported "other;" 94% currently practiced SCC. PVTs (50%) were more likely than ACs (18%) to provide SCC for only their own patients, less likely (24% versus 74%) to function as an "ICU attending," and less likely to work with residents (36% versus 91%) and fellows (4% versus 60%; all p < 0.001). PVTs (48%) spent more time performing elective operations than ACs (27%; p < 0.001). They were more likely than ACs to relinquish management of SCC patients to medical consultants: infectious disease (34% versus 12%), cardiology (31% versus 12%), and pulmonary (23% versus 3%; all p < 0.001). Conflicts with medical specialists were a bigger problem for PVTs (43%) than for ACs (17%; p < 0.001). CONCLUSIONS:Private practice surgical intensivists are more likely than academic intensivists to provide critical care for only their own patients and to use consultants to avoid conflicts.
journal_name
J Am Coll Surgjournal_title
Journal of the American College of Surgeonsauthors
Cohn SM,Price MA,Stewart RM,Corneille MG,Myers JG,McCarthy J,Jonas RB,Hargis SM,Dent DLdoi
10.1016/j.jamcollsurg.2007.10.004subject
Has Abstractpub_date
2008-03-01 00:00:00pages
419-25issue
3eissn
1072-7515issn
1879-1190pii
S1072-7515(07)01722-Xjournal_volume
206pub_type
杂志文章abstract：BACKGROUND:In response to a Congressional mandate to compare risk-adjusted surgical outcomes from Department of Veterans Affairs (VA) hospitals with those from private-sector hospitals, the National Surgical Quality Improvement Program was initiated in the VA system and then was developed in a select group of universit...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2007.02.066
更新日期：2007-06-01 00:00:00
abstract：:Technical modification of the DSRS by using the end-to-end splenoadrenal anastomosis allows for effective selective decompression of portal hypertension in children, can be accomplished with no perioperative mortality, and has demonstrated longterm patency and minimal morbidity. Clinical encephalopathy was seen in onl...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(98)00244-0
更新日期：1998-12-01 00:00:00
abstract：BACKGROUND:Uninsured patients have poor access to screening colonoscopy and subsequently present with advanced stages of colorectal cancer (CRC) that beget worse outcomes and higher total costs. Providing pro bono colonoscopies to uninsured patients at high risk for CRC can detect early stage disease and be cost-effect...
journal_title：Journal of the American College of Surgeons
pub_type： 临床试验,杂志文章
doi：10.1016/j.jamcollsurg.2016.04.035
更新日期：2016-07-01 00:00:00
abstract：BACKGROUND:Elaboration of a number of bioactive substances, including adenosine, occurs in heart failure (HF). Adenosine, through the adenosine subtype 1 (A1) receptor, can reduce renal perfusion pressure and glomerular filtration rate and increase tubular sodium reabsorption, which can affect natriuresis and aquaresis...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(02)01136-5
更新日期：2002-05-01 00:00:00
abstract：BACKGROUND:Pancreatic resection can be performed to ameliorate the sequelae of chronic pancreatitis in selected patients. The perceived risk of pancreatectomy may limit its use. Using a national database, this study compared mortality after pancreatic resections for chronic pancreatitis with those performed for neoplas...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2009.05.030
更新日期：2009-10-01 00:00:00
abstract：BACKGROUND:Although a risk score estimating postoperative mortality for patients undergoing gastric bypass exists, there is none predicting postoperative morbidity. Our objective was to develop a validated risk calculator for 30-day postoperative morbidity of bariatric surgery patients. STUDY DESIGN:We used the Americ...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2010.11.003
更新日期：2011-03-01 00:00:00
abstract：BACKGROUND:Nonelective colorectal surgery is associated with substantial patient morbidity and mortality. This study sought to describe the practice of emergency colorectal surgery in the United Kingdom during an 11-year period using the Hospital Episode Statistics (HES) database. STUDY DESIGN:All nonelective admissio...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2009.11.017
更新日期：2010-04-01 00:00:00
abstract：BACKGROUND:The incidence of thyroid cancer in patients treated operatively for thyroid disease has been historically low (<5%). Previous series have not specifically addressed cancer rates in both euthyroid and hyperthyroid patients. This study examined cancer frequency in patients referred for removal of benign thyroi...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jamcollsurg.2012.12.022
更新日期：2013-04-01 00:00:00
abstract：BACKGROUND:Isolated free fluid (FF) on abdominal CT in stable blunt trauma patients can indicate the presence of hollow viscus injury. No criteria exist to differentiate treatment by operative exploration vs observation. The goals of this study were to determine the incidence of isolated FF and to identify factors that...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2014.04.020
更新日期：2014-10-01 00:00:00
abstract：BACKGROUND:Since 1968, there have been three published reports in the United States literature of 41, 118, and 145 consecutive patients undergoing pancreaticoduodenectomy without mortality. In all of these series, the pancreatic remnant was anastomosed to the jejunum. STUDY DESIGN:This study was designed to review 152...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/S1072-7515(03)00331-4
更新日期：2003-08-01 00:00:00
abstract：BACKGROUND:Ablation is increasingly used to treat primary and secondary liver cancer. Ablation near portal pedicles and hepatic veins is challenging. Irreversible electroporation (IRE) is a new ablation technique that does not rely on heat and, in animals, appears to be safe and effective when applied near hepatic vein...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2012.04.029
更新日期：2012-09-01 00:00:00
abstract：BACKGROUND:The Cognitive Changes and Retirement among Senior Surgeons (CCRASS) study suggested that although subjective cognitive awareness may play a role in surgeons' retirement decisions, self-perceived cognitive decline did not predict objective cognitive performance. This article summarizes results from all partic...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2009.08.004
更新日期：2009-11-01 00:00:00
abstract：BACKGROUND:Cirrhosis as an independent predictor of poor outcomes in trauma patients was identified in 1990. We hypothesized that the degree of preinjury hepatic dysfunction is, by itself, an independent predictor of mortality. STUDY DESIGN:The trauma registry at our Level I trauma center was queried for all ICD-9 cod...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2006.08.001
更新日期：2006-12-01 00:00:00
abstract：BACKGROUND:There are few reproducible models of blast injury, so it is difficult to evaluate new or existing therapies. We developed a clinically relevant polytrauma model to test the hypothesis that cerebrovascular resuscitation is optimized when intravenous fluid is restricted. STUDY DESIGN:Anesthetized swine (42+/-...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2006.11.014
更新日期：2007-02-01 00:00:00
abstract：BACKGROUND:The association of acute pancreatitis with fulminant hepatic failure (FHF) was first recognized in 1973. Since then, few studies have described the clinical profile of the FHF patient with acute pancreatitis. Identification of the distinguishing attributes of pancreatitis in combination with FHF will provide...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(98)00222-1
更新日期：1998-11-01 00:00:00
abstract：BACKGROUND:Led by the American College of Surgeons Trauma Quality Improvement Program, performance improvement efforts have expanded to regional and national levels. The American College of Surgeons Trauma Quality Improvement Program recommends 5 audit filters to identify records with erroneous data, and the Georgia Co...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2015.11.035
更新日期：2016-03-01 00:00:00
abstract：BACKGROUND:Earlier work suggested that telephone follow-up could be used in lieu of in-person follow-up after surgery, saving patients time and travel and maximizing use of scarce surgeon and facility resources. We report our experience implementing and evaluating telephone postoperative follow-up within an integrated ...
journal_title：Journal of the American College of Surgeons
pub_type： 临床试验,杂志文章
doi：10.1016/j.jamcollsurg.2016.07.010
更新日期：2016-10-01 00:00:00
abstract：BACKGROUND:This study was undertaken to report our experience with major vascular injuries in gynecologic laparoscopy in order to specify the circumstances under which they occurred, the means of diagnosis, the risk factors, and the means for prevention. STUDY DESIGN:Retrospective case review study. RESULTS:Seventeen...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：
更新日期：1997-11-01 00:00:00
abstract：BACKGROUND:Neuroendocrine tumors commonly metastasize to the liver. Although surgical resection is considered a treatment option for patients with localized metastases confined to the liver, the longterm survival benefit of liver resection has not been clearly demonstrated. We examined the survival of patients undergoi...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(98)00099-4
更新日期：1998-07-01 00:00:00
abstract：BACKGROUND:The Flexibility in Surgical Training (FIST) consortium project was designed to evaluate the feasibility and resident outcomes of optional subspecialty-focused training within general surgery residency training. STUDY DESIGN:After approval by the American Board of Surgery, R4 and R5 residents were permitted ...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jamcollsurg.2017.12.024
更新日期：2018-04-01 00:00:00
abstract：BACKGROUND:Comparison of quality outcomes generated from administrative and clinical datasets have shown inconsistencies. Understanding this is important because data designed to drive performance improvement are used for public reporting of performance. We examined administrative and clinical data and 2 clinical data ...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2011.12.037
更新日期：2012-05-01 00:00:00
abstract：BACKGROUND:The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) provides reliable, risk-adjusted outcomes data using standardized definitions and end points. Collection of the data is time consuming, and the surgical clinical nurse reviewers (SCNRs) can sample only a subset of all ...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2008.08.030
更新日期：2009-01-01 00:00:00
abstract：BACKGROUND:Intratumoral ablative therapy is being used increasingly for the treatment of primary and secondary hepatic malignancies. The interstitial point-source photon radiosurgery system (PRS) is a novel ablative technique that uses radiation therapy similar in dosimetry to interstitial brachytherapy. STUDY DESIGN:...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(00)00295-7
更新日期：2000-08-01 00:00:00
abstract：BACKGROUND:The technique of total mesorectal excision (TME) increases the risk of anastomotic leakage. The impact of postoperative morbidity of TME on longterm survival has never been described. We retrospectively analyzed factors that might influence survival after TME for rectal cancer, including postoperative morbid...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2006.07.021
更新日期：2006-11-01 00:00:00
abstract：BACKGROUND:Oxandrolone, an anabolic agent, has been administered for 1 year post burn with beneficial effects in pediatric patients. However, the long-lasting effects of this treatment have not been studied. This single-center prospective trial determined the long-term effects of 1 year of oxandrolone administration in...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamcollsurg.2011.12.038
更新日期：2012-04-01 00:00:00
abstract：BACKGROUND:The role of C-Jun N-terminal Kinase (c-Jun Kinase) in apoptosis is unclear. It is likely that c-Jun Kinase activation is cell type and stimulus dependent. c-Jun Kinase promotes tumor necrosis factor (TNF)-alpha mediated apoptosis in nuclear factor (NF)-KB deficient cells. Minimal NF-KB expression may be enou...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2007.01.029
更新日期：2007-05-01 00:00:00
abstract：BACKGROUND:The current study seeks to determine if the efficacy and safety of laparoscopic donor nephrectomy holds true when performed in patients older than 60 years of age. STUDY DESIGN:Medical records of 42 renal donors older than 60 years were reviewed compared with younger controls carefully matched for gender, r...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2004.02.018
更新日期：2004-06-01 00:00:00
abstract：BACKGROUND:Surgeons in academic medical centers have traditionally taken a siloed approach to reducing postoperative complications. We initiated a project focusing on transparency and sharing of data to engage surgeons in collaborative quality improvement. Its key features were the development of a comprehensive depart...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2018.12.013
更新日期：2019-04-01 00:00:00
abstract：BACKGROUND:Infarction of the optic nerve posterior to the lamina cribrosa, called posterior ischemic optic neuropathy (PION), is a condition that can result in profound bilateral blindness. Cases of PION treated at this institution and those described in the literature were analyzed to identify clinical features that p...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章,评审
doi：10.1016/s1072-7515(02)01210-3
更新日期：2002-06-01 00:00:00
abstract：BACKGROUND:The aim of this study is to investigate patient-centered quality of life (QOL) outcomes in patients undergoing laparoscopic paraesophageal hernia repair. STUDY DESIGN:We prospectively followed patients who underwent laparoscopic paraesophageal hernia repair between 2009 and 2016. The QOL outcomes were measu...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2017.12.054
更新日期：2018-07-01 00:00:00
