Abstract:
BACKGROUND:Preoperative assessment of geriatric-specific determinants of health may enhance perioperative risk stratification among elderly patients. This study examines effects of geriatric-specific variables on postoperative outcomes in patients undergoing elective major abdominal operations. METHODS:Patients included in the ACS NSQIP pilot Geriatric Surgery Research File program who underwent elective pancreatic, liver, and colorectal operations between 2014 and 2016 were examined. Multivariable analyses were performed to evaluate associations between patient-specific geriatric variables and risk of death, morbidity, readmission, and discharge destination. RESULTS:A total of 4165 patients were included. Patients ≥85 years were more likely to die, experience postoperative morbidity, and be discharged to a facility (all p ≤ 0.039) than younger patients. Preoperatively, patients ≥85 years were more likely to use a mobility aid, have a prior fall, have consent signed by a surrogate, and to live alone at home prior to operation (all p < 0.001). After adjustment for ACS NSQIP-estimated probabilities of morbidity or mortality, no geriatric-specific preoperative risk factors were significantly associated with increased risk of death or complications in any age group (all p > 0.055). Patients 75-84 and ≥85 years were more likely to be discharged to facility (OR 2.33 and 4.75, respectively, both p < 0.001) compared to patients 65-74 years. All geriatric-specific variables: use of mobility aid, living alone, consent signed by a surrogate, and fall history, were significantly associated with discharge to a facility (all p ≤ 0.001). CONCLUSIONS:After adjusting for comorbid conditions, geriatric-specific variables are not associated with postoperative mortality and morbidity among elderly patients; however, geriatric-specific variables are significantly associated with discharge to a facility.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Martin AN,Hoagland DL,Turrentine FE,Jones RS,Zaydfudim VMdoi
10.1007/s00268-020-05515-0subject
Has Abstractpub_date
2020-08-01 00:00:00pages
2592-2600issue
8eissn
0364-2313issn
1432-2323pii
10.1007/s00268-020-05515-0journal_volume
44pub_type
杂志文章abstract:BACKGROUND:Donor variational arteries often require complex reconstruction. METHODS:We analysed the incidence of different variations, types of arterial reconstructions and their impact on post-operative results from 409 patients undergoing liver transplantation at Karolinska Institute between 2007 and 2015. RESULTS:...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05406-4
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Our aim was to evaluate the advantages and limitations of delayed laparoscopic cholecystectomy (LC) in a tertiary center. MATERIALS AND METHODS:A retrospective analysis of all patients admitted to our institution with acute calculous cholecystitis (ACC) between January 2003 and December of 2012 was performe...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-3928-4
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:The Lancet recently sponsored a commission examining the role of surgery in global health. There is a paucity of published information on the cost-effectiveness of surgery in low- and middle-income countries, a key metric in the prioritisation of limited resources. METHODS:All patients undergoing emergency ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3271-6
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Scarce data are available on the characteristics of postoperative organ failure (POF) and mortality after gastrectomy. We aimed to describe the causes of organ failure and mortality related to gastrectomy for gastric cancer and to identify patients with POF who are at a risk of failure to rescue (FTR). METH...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05382-9
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Typhoid fever incidence and complications, including intestinal perforation, have declined significantly in high-income countries, with mortality rates <1%. However, an estimated 10.9 million cases still occur annually, most in low- and middle-income countries. With the availability of a new typhoid conjugat...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05567-2
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVES:We set out to clarify the clinicopathologic characteristics of colorectal liver metastases with macroscopic intrabiliary tumor growth and to determine optimal surgical management. METHODS:Over 15 years, 6 of 103 patients undergoing hepatectomy for colorectal liver metastases had macroscopic intrabiliary tum...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-006-0205-3
更新日期:2006-10-01 00:00:00
abstract::The hypervascular nature of carcinoid tumors and their metastases allows a more aggressive role by the radiologist in diagnosis and interventional management. Double-contrast gastrointestinal studies still best define the primary neoplasms. Appendiceal tumors, the most frequent site of carcinoids, frequently escape ra...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689900023
更新日期:1996-02-01 00:00:00
abstract:BACKGROUND:Differentiated thyroid cancer (DTC) with distant metastases at presentation is uncommon; the prognosis of patients with this condition is more favorable than for other cancers. Demographic, clinical, and pathologic characteristics are described at a population level; factors associated with long-term disease...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2006-9
更新日期:2013-07-01 00:00:00
abstract::In 1947, a patient with metastatic islet cell tumor was treated for intractable ulcer disease at the University of Chicago Medical Center. Eight years later, in retrospect, it was recognized that he and another patient had the Zollinger-Ellison syndrome (ZE). From 1947 until the present, 30 patients with the ZE syndro...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658530
更新日期:1990-05-01 00:00:00
abstract::Because of the rarity of adrenocortical carcinoma, survival rates and the prognosis for patients who have undergone operation are not well known. The purpose of the French Association of Endocrine Surgery was to evaluate these factors over an 18-year period. A trend study was associated to assess changes in the clinic...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0047-y
更新日期:2001-07-01 00:00:00
abstract:PURPOSE:The prognosis for stage III melanoma patients is mixed, and there is need for new prognostic factors to be incorporated into a revision of melanoma TNM staging. We analyzed the possible role of the timing of lymph node involvement as an important prognostic factor. METHODS:Among 249 melanoma patients who under...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9895-z
更新日期:2009-03-01 00:00:00
abstract::In a prospective multicenter study, 186 patients with squamous cell esophageal carcinoma, who after evaluation were considered suitable for surgery, were randomized to 4 treatment groups: Group 1, surgery alone; Group 2, pre-operative chemotherapy (cisplatin and bleomycin) and surgery; Group 3, pre-operative irradiati...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1007/BF02067069
更新日期:1992-11-01 00:00:00
abstract::This study aims to examine the frequency of the pheochromocytoma (pheo), defined as a "benign, intra-adrenal, hypertensive, sporadic, unilateral tumor." Three large series amounting to 310 subphrenic chromaffin tumors operated over periods of 17, 23, and 41 years, respectively, have been reviewed. Among those combined...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00353738
更新日期:1994-07-01 00:00:00
abstract::Squamous cell carcinoma of the anus (SCCA) is a rare disease in the average population but is an increasing concern among immunocompromised individuals, such as the HIV-seropositive. Coinfection with human papillomavirus (HPV) in this population is common. HPV infection is difficult to clear with a compromised immune ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-008-9835-y
更新日期:2009-04-01 00:00:00
abstract:INTRODUCTION TO THE PROBLEM:Though declining in the recent decades, high-energy musculoskeletal trauma remains a major contributor to the burden of disease in high-income countries (HICs). However, due to limitations in the available body of the literature, evaluation of this burden is challenging. The purpose of this ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-018-4742-3
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Esophageal achalasia is characterized by the absence of esophageal peristalsis and by a dysfunctional lower esophageal sphincter (LES). Descriptions of clinical, radiological, and manometric findings in patients with achalasia usually have been based on small numbers of patients. This study was designed to d...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9656-z
更新日期:2008-09-01 00:00:00
abstract:INTRODUCTION:The past 25 years have been witness to a revolution in how vascular care is delivered. The majority of arterial and venous interventions have converted from open surgery to minimally invasive percutaneous endovascular procedures. METHODS:This surgical innovations symposium article reviews current endovasc...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05875-7
更新日期:2020-11-22 00:00:00
abstract:BACKGROUND:Acute appendicitis is the most common reason for abdominal surgery in young adults and children. Open appendectomy is still the treatment often chosen because it is simple, safe, and effective. Our aim was to study whether cosmetic results of appendectomy wounds are better after using continuous absorbable i...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-013-2396-8
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:The role of circular staplers in gastroduodenostomy during subtotal gastrectomy for gastric cancer has not been defined clearly. METHODS:A randomized clinical trial included patients with gastric cancer who underwent subtotal gastrectomy with either stapled (99 patients) or handsewn gastroduodenostomy (98 p...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-011-1038-2
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Treatment of peripherally located liver tumors with diaphragmatic invasion is technically demanding but does not preclude resection for cure. The aim of the present study was to compare patients undergoing combined liver and diaphragmatic resection with those submitted to hepatectomy alone so as to evaluate ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2083-9
更新日期:2013-09-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7058-9
更新日期:2003-09-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-6893-z
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:Although laparoscopic appendectomy (LA) is widely performed in many countries, LA for complicated appendicitis, which includes perforated or gangrenous appendicitis with or without localized or disseminated peritonitis, has not become a common practice yet. METHODS:We retrospectively analyzed the clinical r...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9843-y
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Although mortality after liver resection has declined, posthepatectomy liver failure (PHLF) remains a major cause of operative mortality. To date there is not consensus on a definition for PHLF. However, there have been many efforts to define PHLF causing operative mortality. In the present study we sought t...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-1959-z
更新日期:2013-05-01 00:00:00
abstract::Despite careful selection of cirrhotic patients with hepatocellular carcinoma (HCC), liver resection remains associated with a greater risk than in patients without underlying liver disease. In this study we assessed by multivariate analysis parameters associated with in-hospital mortality and morbidity in a selected ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/pl00012259
更新日期:1997-05-01 00:00:00
abstract:INTRODUCTION:Rectus sheath hematoma is rare. It can present to physicians in many specialties, but invariably the surgeon is contacted regarding management. It is frequently difficult to diagnose, which can result in delay of treatment or unnecessary surgery. Its incidence is on the rise. METHODS:We present a series o...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-005-0702-9
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Only few studies have compared laparoscopic total mesorectal excision (LTME) and open total mesorectal excision (OTME) for rectal cancer with follow-up longer than 5 years. The aim of this study was to compare 10-year oncologic outcomes after LTME and OTME for nonmetastatic rectal cancer. METHODS:We conduct...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3631-x
更新日期:2016-12-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3147-9
更新日期:2015-11-01 00:00:00
abstract::The geographic distribution of duodenal ulcer and its characteristics in rural areas of high incidence in developing countries are reviewed. The choice of surgical procedures is discussed in light of the bulky diet and nutritional problems of these countries. A vagotomy procedure is advised for duodenal ulcer and a B...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01654731
更新日期:1977-01-01 00:00:00
abstract::Pepsinogen C is a proteolytic enzyme involved in the digestion of proteins in the stomach; it is also synthesized by a significant percentage of female breast carcinomas. In addition, it has been demonstrated that pepsinogen C is one of the few proteins induced by androgens in breast carcinoma cells. Here we evaluate ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/pl00012325
更新日期:1999-05-01 00:00:00