Abstract:
OBJECTIVE:Venous thromboembolic events (VTE) are potentially preventable causes of morbidity and mortality after injury. We hypothesized that the current clinical incidence of VTE is relatively low and that VTE risk factors could be identified. METHODS:We queried the ACS National Trauma Data Bank for episodes of deep venous thrombosis (DVT) and/or pulmonary embolism (PE). We examined demographic data, VTE risk factors, outcomes, and VTE prophylaxis measures in patients admitted to the 131 contributing trauma centers. RESULTS:From a total of 450,375 patients, 1602 (0.36%) had a VTE (998 DVT, 522 PE, 82 both), for an incidence of 0.36%. Ninety percent of patients with VTE had 1 of the 9 risk factors commonly associated with VTE. Six risk factors found to be independently significant in multivariate logistic regression for VTE were age > or = 40 years (odds ratio [OR] 2.01; 95% confidence interval [CI] 1.74 to 2.32), lower extremity fracture with AIS > or = 3 (OR 1.92; 95% CI 1.64 to 2.26), head injury with AIS > or = 3 (OR 1.24; 95% CI 1.05 to 1.46), ventilator days >3 (OR 8.08; 95% CI 6.86 to 9.52), venous injury (OR 3.56; 95% CI 2.22 to 5.72), and a major operative procedure (OR 1.53; 95% CI 1.30 to 1.80). Vena cava filters were placed in 3,883 patients, 86% as PE prophylaxis, including in 410 patients without an identifiable risk factor for VTE. CONCLUSIONS:Patients who need VTE prophylaxis after trauma can be identified based on risk factors. The use of prophylactic vena cava filters should be re-examined.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Knudson MM,Ikossi DG,Khaw L,Morabito D,Speetzen LSdoi
10.1097/01.sla.0000137138.40116.6csubject
Has Abstractpub_date
2004-09-01 00:00:00pages
490-6; discussion 496-8issue
3eissn
0003-4932issn
1528-1140pii
00000658-200409000-00010journal_volume
240pub_type
杂志文章abstract:OBJECTIVE:To evaluate both institutional and individual learning curves with focused abdominal ultrasound for trauma (FAST) by analyzing the incidence of diagnostic inaccuracies as a function of examiner experience for a group of trauma surgeons performing the study in the setting of an urban level I trauma center. SU...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200005000-00009
更新日期:2000-05-01 00:00:00
abstract::The clinical, pathological, surgical, postoperative findings and survivorship of 58 patients younger and 513 patients older than 21 years at the time of diagnosis with thyroid neoplasms are reported. The younger patients have a predominance of well differentiated carcinomas which are more likely to be follicular. The ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197505000-00018
更新日期:1975-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to create a technical skills assessment toolbox for 35 basic and advanced skills/procedures that comprise the American College of Surgeons (ACS)/Association of Program Directors in Surgery (APDS) surgical skills curriculum and to provide a critical appraisal of the included tools...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0000000000000520
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate the incidence of parastomal hernias (PSHs) after end-colostomy formation using a polypropylene mesh in a randomized controlled trial versus conventional colostomy formation. BACKGROUND:A PSH is the most frequent complication after stoma formation. Symptoms may range f...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000001903
更新日期:2017-04-01 00:00:00
abstract::One-hundred and forty eight patients operated upon for chronic pancreatitis were reviewed retrospectively in 5-20 year followup. Treatment was by drainage of the duct of Wirsung to adefunctionalized jejunal loop, distal pancreatectomy, pancreato-duodenectomy, splanchnicectomy with an operative mortality of 5%. Influen...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197408000-00010
更新日期:1974-08-01 00:00:00
abstract::Seventeen patients with femoral arteriovenous bovine shunts (FAVBS) were evaluated to delineate the cardiovascular consequences of the procedure. The resting cardiac index (CI), as estimated by echocardiography, was increased in 8 patients (47%). Twelve of the 17 patients (71%) had more than a 20% reduction in CI afte...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197607000-00017
更新日期:1976-07-01 00:00:00
abstract::Analysis of experience with chronic bleeding peptic ulcer in 504 patients, admitted from 1960 to 1971, shows a hospital mortality of 12%. This retrospective review suggested that early endoscopic diagnosis, adequate resuscitation and a policy of early selective surgery was necessary if mortality was to be reduced. Wit...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198401000-00008
更新日期:1984-01-01 00:00:00
abstract:OBJECTIVE:To evaluate (1) levels of the host-defense/antimicrobial peptide LL-37 in patients with trauma and hemorrhagic shock (HS) and (2) the effects of a synthetic host-defense peptide; Pep19-4LF on multiple organ failure (MOF) associated with HS. BACKGROUND:HS is a common cause of death in severely injured patient...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002186
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To compare the clinical presentation and results of treatment of postcholecystectomy bile duct injuries in patients with and without arterial injuries. SUMMARY BACKGROUND DATA:Incidence and impact of arterial injuries in patients with a postcholecystectomy biliary injury are unknown, although they are claime...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000074983.39297.c5
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVES:To determine pathologic features associated with recurrence and survival in patients with lymph node-negative gastric adenocarcinoma. STUDY DESIGN:Multi-institutional retrospective analysis. BACKGROUND:Lymph node status is among the most important predictors of recurrence after gastrectomy for gastric aden...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000001084
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVE:To analyze the feasibility and safety of Natural Orifice Transluminal Endoscopic Surgery (NOTES) appendectomy, and to analyze separately the transvaginal appendectomy (TVAE) and the transgastric appendectomy (TGAE) procedures. BACKGROUND:Laparoscopic appendectomy has rare but relevant complications, namely i...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000001742
更新日期:2017-03-01 00:00:00
abstract::All cases of penetrating cardiac trauma in 1985 and 1986 in Jefferson County, Alabama, where patients dying of penetrating trauma received autopsies, were retrospectively reviewed. All hospitals in the county plus the single coroner's office provided the records of the 72 patients comprising this study. Incidents occu...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198906000-00004
更新日期:1989-06-01 00:00:00
abstract::Of 531 patients admitted to the Duke Coronary Care Unit with unstable angina (UA) from June 1981 to September 1982, 100 had persistent angina despite optimal medical therapy of nitrates, propranolol, and nifedipine. At catheterization, 70% of the refractory patients had left main (LM) or three-vessel disease (TVD), 68...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198410000-00007
更新日期:1984-10-01 00:00:00
abstract:OBJECTIVES:Individualized risk assessment in patients with UICC stage II colon cancer based on a panel of molecular genetic alterations. BACKGROUND:Risk assessment in patients with colon cancer and localized disease (UICC stage II) is not sufficiently reliable. Development of metachronous metastasis is assumed to be g...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318272de87
更新日期:2012-11-01 00:00:00
abstract::Thrombosis of the portal vein with or without patency of its tributaries used to be a contraindication to orthotopic liver transplantation (OLTX) until quite recently. Rapid progress in the surgical technique of OLTX in the last few years has demonstrated that most patients with portal vein thrombosis can be safely an...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199103000-00003
更新日期:1991-03-01 00:00:00
abstract:OBJECTIVE:To determine whether F-fluorodeoxyglucose (F-FDG) micro-positron emission tomography (micro-PET) can predict abdominal aortic aneurysm (AAA) rupture. BACKGROUND:An infrarenal AAA model is needed to study inflammatory mechanisms that drive rupture. F-FDG PET can detect vascular inflammation in animal models a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000602
更新日期:2015-02-01 00:00:00
abstract::Two experimental models were utilized to study the efficacy of intraperitoneal povidone-iodine in an established peritonitis. In both models, there was a 100% mortality in the povidone-iodine treated group. In laboratories which have reported favorable results, the animals were treated before peritonitis was allowed t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197806000-00005
更新日期:1978-06-01 00:00:00
abstract::Desmoid tumors are locally invasive, nonmetastasizing fibrous tumors most frequently seen in patients with familial polyposis coli (FPC). Of 325 patients with FPC treated at the Cleveland Clinic, 29 (8.9%) were found to have a total of 36 desmoid tumors. These tumors occur in young patients (mean age: 29.8 years), par...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198607000-00014
更新日期:1986-07-01 00:00:00
abstract:OBJECTIVE:On November 23, 1992, the first endovascular stent graft (ESG) repair of an aortic aneurysm was performed in North America. Following the treatment of this patient, we have continued to evaluate ESG over the past 10 years in the treatment of 817 patients. SUMMARY AND BACKGROUND DATA:Abdominal (AAA) or thorac...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/01.sla.0000090473.63393.e9
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:To assess the immediate and long-term clinical results of 2 different surgical procedures for the treatment of asymmetrical multinodular goiter (AMG). BACKGROUND:Half of the patients presenting with a single benign thyroid nodule have contralateral subclinical disease. There is a controversy whether these pa...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0b013e318272df62
更新日期:2012-11-01 00:00:00
abstract::The management of penetrating colon injury has been frequently debated in the literature, yet few reports have evaluated primary closure versus diverting colostomy in similarly injured patients. Diverting colostomy is the standard of care when mucosal penetration is present, but primary closure in civilian practice ha...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198904000-00009
更新日期:1989-04-01 00:00:00
abstract:OBJECTIVE:To achieve consensus on the best practices in the management of ventral hernias (VH). BACKGROUND:Management patterns for VH are heterogeneous, often with little supporting evidence or correlation with existing evidence. METHODS:A systematic review identified the highest level of evidence available for each ...
journal_title:Annals of surgery
pub_type: 共识发展会议,杂志文章
doi:10.1097/SLA.0000000000001701
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to assess the impact of pouch reconstruction on perioperative outcomes, postprandial symptoms, nutritional and anthropometric parameters, and overall quality of life after total gastrectomy for gastric malignancy. SUMMARY BACKGROUND DATA:The short-term perioperative risks and longer ...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析
doi:10.1097/SLA.0000000000003082
更新日期:2019-06-01 00:00:00
abstract:SUMMARY BACKGROUND DATA:The role of early endoscopic retrograde cholangiopancreatography (ERCP) in acute biliary pancreatitis (ABP) remains controversial. Previous studies have included only a relatively small number of patients with predicted severe ABP. We investigated the clinical effects of early ERCP in these pati...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0b013e3181a77bb4
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:To compare, in a prospective, randomized, single-institution trial laparoscopic adjustable silicone gastric banding (LASGB) with laparoscopic vertical banded gastroplasty (LVBG) in morbidly obese patients. SUMMARY BACKGROUND DATA:LASGB is a simple and safe procedure, but some reports have suggested disappoin...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.sla.0000098627.18574.72
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to assess the reduction in the incidence of parastomal hernia (PH) after placement of prophylactic synthetic mesh using a modified Sugarbaker technique when a permanent end-colostomy is needed. SUMMARY OF BACKGROUND DATA:Prevention of PH formation is crucial given the high prevalenc...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0000000000001684
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:Compare emergency general surgery (EGS) patient outcomes following index and non-index hospital readmissions, and explore predictive factors for non-index readmission. BACKGROUND:Readmission to a different hospital leads to fragmentation of care. The impact of non-index readmsision on patient outcomes follow...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004628
更新日期:2020-11-17 00:00:00
abstract:OBJECTIVE:To evaluate the long-term outcome of patients with esophageal cancer after resection of the extraesophageal component of the neoplastic process en bloc with the esophageal tube. SUMMARY BACKGROUND DATA:Opinions are conflicting about the addition of extended resection of locoregional lymph nodes and soft tiss...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200107000-00005
更新日期:2001-07-01 00:00:00
abstract::Emergency portacaval shunt for variceal bleeding is associated with a high operative mortality, particularly if used as a last resort. Because of this, a strong case has been made against emergency shunt. This report describes an experience with emergency portacaval shunt for the treatment of variceal bleeding when us...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198707000-00007
更新日期:1987-07-01 00:00:00
abstract::This prospective study evaluated host resistance in a surgical population who walked into the hospital for elective surgery. Patients were stratified into Hospital Reactive (HR, n = 19) if they reacted to two or more of five recall skin test antigens and Walk-in Anergic (WA, n = 26) if they did not react to the antige...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198404000-00011
更新日期:1984-04-01 00:00:00