Abstract:
BACKGROUND:The manifestations associated with non-survival after multiple trauma may vary importantly between countries and institutions. The aim of the present study was to assess the quality of performance by comparing actual mortality rates to the literature. METHODS:The study involved evaluation of a prospective consecutive multiple trauma cohort (injury severity score, ISS > 16) primarily admitted to a university hospital. Univariate and multivariate testing of routine parameters and scores, such as the Trauma and Injury Severity Score (TRISS), was used to determine their predictive powers for mortality. RESULTS:The 30-day mortality of 22.8% (n = 54) exactly matched predicted TRISS versions of Champion or the Major Trauma Outcome Study for our 237 multiple trauma patients (42.8 +/- 20.9 years; ISS 29.5 +/- 11.5). Univariate analysis revealed significant differences between survivors and non-survivors when compared for age, ISS, Glasgow coma scale (GCS), pulse oximeter saturation (SapO2), hemoglobin, prothrombin time, and lactate. In multivariate analysis, age, ISS, and GCS (P < 0.001 each) functioned as major independent prognostic parameters of both 24 h and 30-day mortality. Various TRISS versions hardly differed in their precision (area under the curve [AUC] 0.83-0.84), but they did differ considerably in their level of requirement, with the TRISS using newer National Trauma Data Bank coefficients (NTDB-TRISS) offering the highest target benchmark (predicted mortality 13%, Z value -5.7) in the prediction of 30-day mortality. CONCLUSIONS:Because of the current lack of a single, internationally accepted scoring system for the prediction of mortality after multiple trauma, the comparison of outcomes between medical centers remains unreliable. To achieve effective quality control, a practical benchmarking model, such as the TRISS-NTDB, should be used worldwide.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Füglistaler-Montali I,Attenberger C,Füglistaler P,Jacob AL,Amsler F,Gross Tdoi
10.1007/s00268-009-0193-1subject
Has Abstractpub_date
2009-11-01 00:00:00pages
2477-89issue
11eissn
0364-2313issn
1432-2323journal_volume
33pub_type
杂志文章abstract:BACKGROUND:This study was intended to compare the prognostic power of the number of positive lymph nodes with that of the lymph node ratio in patients with ampullary carcinoma. METHODS:A retrospective analysis was conducted of the medical records of 71 consecutive patients with ampullary carcinoma who underwent pancre...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1175-7
更新日期:2011-09-01 00:00:00
abstract::The novel trend toward focused parathyroidectomy requires precise preoperative localization of the parathyroid adenoma in patients with primary hyperparathyroidism (PHPT). The present study evaluated the impact of hybrid single photon emission computed tomography/computed tomography (SPECT/CT), using 99mTc-sestamibi (...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-7849-2
更新日期:2006-01-01 00:00:00
abstract::Hepatectomy with concomitant resection of the inferior vena cava (IVC) has become common for hepatic malignancies involving the IVC. However, diagnosing IVC invasion and the procedure of choice have yet to be standardized. Medical records of nine patients with liver cancer (five metastatic tumors from colorectal cance...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-6908-9
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Appendiceal neuroendocrine tumors (aNET) are a common entity in routine medical care, with a rate per appendectomy as high as 0.3-0.9 %. Considering the relatively young age at diagnosis for these patients, exact information about the long-term prognosis of aNET is required. Survival rates vary substantially...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3164-8
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Medullary thyroid cancer (MTC) disseminates early to lymph nodes (LN). There is no pre- or intraoperative marker to exclude LN involvement and thereby avoid lateral neck dissection in LN-negative patients. MATERIALS AND METHODS:This study was intended to verify the observation that patients with MTC lacking...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0391-4
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:Esophagorespiratory fistula (ERF) caused by esophageal carcinoma is a fatal complication. In our institution, esophageal bypass surgery has been indicated when possible. We herein retrospectively describe the clinical results of esophageal bypass surgery for ERF. PATIENTS AND METHODS:Between April 2001 and ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3391-z
更新日期:2016-05-01 00:00:00
abstract::Surgery is the most effective therapeutic intervention available for the treatment of breast cancer. It has been responsible for obtaining local control and long-term disease-free intervals in more patients over the past century than any other treatment modality. Trends toward earlier stage at diagnosis are likely to ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-001-0010-y
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:Closure of loop ileostomy can be safely performed using sutures or staplers. The aim of the present study was to compare the cost effectiveness of three different techniques. METHODS:A total of 128 consecutive patients who underwent closure of loop ileostomy between January 2002 and December 2008 were analy...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0787-7
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:This study was designed to asses the predictive factors of postoperative complications in patients who underwent a laparoscopic elective approach for recurrent diverticulitis and to determine the relationship between the number of acute episodes and surgical morbidity. METHODS:A retrospective analysis was p...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0162-8
更新日期:2009-11-01 00:00:00
abstract::This study was conducted retrospectively to examine the efficacy of Traverso reconstruction compared with Billroth I reconstruction after pylorus-preserving pancreaticoduodenectomy, in the prevention of several complications. Pylorus-preserving pancreaticoduodenectomy is an aggressive surgery, and insufficiency of the...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-7697-0
更新日期:2005-07-01 00:00:00
abstract::Endoscopic ultrasonography (EUS) and computed tomography (CT) should be used as complementary methods for TNM staging of esophageal cancer. EUS is the most accurate modality for staging primary tumor and mediastinal lymph node metastases. CT should be used to detect infiltration of other mediastinal organs and distant...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF00316809
更新日期:1994-05-01 00:00:00
abstract::Transsphenoidal pituitary surgery has radically modified the management of pituitary-dependent hypercortisolism (Cushing's disease). Bilateral adrenalectomy may, however, represent the ultimate treatment in some cases of hypercortisolism. In the present study we report our experience of bilateral adrenalectomy in 82 p...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900118
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:Stenosis of esophago-jejuno anastomosis is one of the postoperative complications of gastric surgery. This complication usually manifests with the symptom of dysphagia and is treated by endoscopic dilatation. No large-scale studies have been conducted to determine the incidence of this complication after sur...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0609-y
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Papillary thyroid carcinoma (PTC) frequently recurs to the lymph nodes, which may not be fatal immediately but is a stressor for physicians and patients. Recurrence to the distant organs, although less frequent, is often life-threatening, and the lung and bone are organs to which PTC is likely to recur. In t...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1423-5
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:The number of lymph nodes retrieved and examined from a resected colon cancer specimen may be crucial for correct staging. We examined if efforts to increase the lymph node harvest to more than 12 lymph nodes per specimen would upstage some patients from TNM stage II to III. METHODS:Three hospitals compared...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1007/s00268-011-1248-7
更新日期:2011-12-01 00:00:00
abstract::Lower esophageal sphincter pressure has been assessed pre-operatively, intra-operatively,and more than 6 months postoperatively in 34 patients having antireflux surgery for gastro-esophageal reflux disease. The sphincter pressures associated with the outcome in relation to pH measured reflux and the symptoms of recurr...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02071543
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:We describe a new technique of segment-based liver resection by inserting a 6 French balloon catheter into the portal vein via a branch of the superior mesenteric vein. MATERIALS AND METHODS:The catheter was guided into the relevant portal branch supplying the liver segment that contained the tumor. Injecti...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9043-1
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Uncomplicated acute appendicitis has been managed traditionally by early appendicectomy. However, recently, there has been increasing interest in the potential for primary treatment with antibiotics, with studies finding this to be associated with fewer complications than appendicectomy. The aim of this stud...
journal_title:World journal of surgery
pub_type: 杂志文章,meta分析
doi:10.1007/s00268-016-3561-7
更新日期:2016-10-01 00:00:00
abstract::Primary hyperparathyroidism was investigated using the presence of basic fibroblast growth factor (bFGF) from the immunohistochemical viewpoint with an anti-bFGF antibody in hyperplastic parathyroid glands of patients with multiple endocrine neoplasia type I (MEN-I) and of patients with non-MEN. The results correspond...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00299109
更新日期:1994-11-01 00:00:00
abstract:BACKGROUND:We reported phonatory recovery in the majority of 88 patients after recurrent laryngeal nerve (RLN) reconstruction. Here we analyzed factors that might influence the recovery, in a larger patient series. METHODS:At Kuma Hospital, 449 patients (354 females and 95 males) underwent RLN reconstruction with dire...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3634-7
更新日期:2016-12-01 00:00:00
abstract::Idiopathic portal hypertension (IPH) requires invasive measures to prevent rupture and bleeding of esophagogastric varices. However, the long-term results of shunt surgery for IPH have not been reported. In particular, the pros and cons of surgery that preserves the spleen and its long-term hematologic effects have no...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-7656-9
更新日期:2005-08-01 00:00:00
abstract::Neoadjuvant therapy for locally advanced breast cancer improves disease control, but the complications of treatment are not well established. The aim of this study was to assess the operative morbidity in 20 consecutive patients with locally advanced, noninflammatory breast cancer treated with preoperative chemotherap...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658934
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:Medullary thyroid cancer (MTC) represents the third most common type of thyroid cancer, and the prognosis depends on the stage of the disease at diagnosis and completeness of tumor resection. In 2009, the American Thyroid Association (ATA) published guidelines with evidence-based recommendations for the trea...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3643-6
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Utilization of breast reconstruction (BR) is low in many jurisdictions. We studied the geographical and surgical workforce factors that contribute to access and use of BR using a small area analysis approach with a geographical unit of analysis. METHODS:We linked administrative data from Ontario Canada to c...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3060-2
更新日期:2015-08-01 00:00:00
abstract::Factors influencing postoperative hospital mortality and long-term survival after radical resection of stage IV gallbladder carcinoma remain unclear. The objective of this study was to identify characteristics of patients who are good candidates in terms of surgical risk and long-term survival for radical resection of...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-002-6654-4
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND:The use of the Harmonic Scalpel (HS) for cystic duct ligation began with little data about its efficacy or safety. On the other hand, there is not any literature available about the use of PlasmaKinetic Sealer (PK) for closing the cystic duct in laparoscopic cholecystectomy (LC). Therefore, this study was de...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0819-3
更新日期:2011-04-01 00:00:00
abstract::The aim of this study was to investigate the epidemiologic characteristics and changing patterns of gallstone disease in Korea over a recent 20-year period. A total of 4020 gallstone patients who had undergone surgery at Seoul National University Hospital during 1981-2000 were analyzed according to periods: period I (...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-6879-x
更新日期:2004-02-01 00:00:00
abstract::Technetium 99m ((99m)Tc)-methoxyisobutylisonitrile (MIBI) scintigraphy has been reported to be a useful method for visualizing the parathyroid glands for the diagnosis of hyperparathyroidism. Some drug metabolism transporters, such as p-glycoprotein (P-GP) or multidrug resistance-associated protein (MRP), are believed...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0177-2
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Accurate presurgical assessment is important to anticipate postoperative complications, especially in the growing proportion of elderly cancer patients. We designed a study to define which comorbid conditions at the time of diagnosis predict complications after surgery for colorectal cancer. PATIENTS:A rand...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0711-8
更新日期:2007-01-01 00:00:00
abstract::We have evaluated survival and tumor-related symptoms in the presence of mesenteric lymph node and liver metastases in relation to surgical procedures in 314 patients (148 women, mean age at diagnosis 61 years; 249 with liver metastases) treated for midgut carcinoid tumors. Of the operated patients, 46% presented with...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-002-6630-z
更新日期:2002-08-01 00:00:00