Abstract：
BACKGROUND:We performed an evaluation of antimicrobial guidelines for patients with surgical sepsis. METHODS:The purpose of this study was to validate current empiric antibiotic recommendations in our sepsis protocol based on the suspected site of infection. The primary objective was to assess the appropriateness of empiric antibiotic recommendations and to determine if initial empiric antibiotics provided adequate coverage compared with sensitivity data (accuracy). Secondary end points included antibiotic protocol compliance, intensive care unit (ICU)-free days, and mortality. RESULTS:Appropriate antibiotics were prescribed in 82% of patients. Of the culture-positive patients, 72% received accurate antibiotics. ICU-free days were greater for patients in the compliant group (14.5 vs 8.4; P = .014). Hospital mortality was greater in patients who were noncompliant with protocol recommendations (22% vs 17%; P = .44). CONCLUSIONS:Our current antibiotic guidelines provide appropriate and accurate antimicrobial coverage. Noncompliance with the antibiotic protocol resulted in fewer ICU-free days and increased hospital mortality in surgical sepsis patients.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Fitousis K,Moore LJ,Hall J,Moore FA,Pass Sdoi
10.1016/j.amjsurg.2010.09.001subject
Has Abstractpub_date
2010-12-01 00:00:00pages
776-82; discussion 782issue
6eissn
0002-9610issn
1879-1883pii
S0002-9610(10)00573-8journal_volume
200pub_type
杂志文章abstract：:Forty-one patients with significant pulmonary emboli were reviewed. The presence of heart disease and obesity was found with relatively constant frequency throughout the groups presented. Postoperative infections (wounds or abscess) were frequently associated with fatal or significant pulmonary embolism, particularly ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90067-9
更新日期：1979-03-01 00:00:00
abstract：BACKGROUND:The use of biologic markers to aid in individualizing wound treatment may help improve outcomes. A biologic marker that has been demonstrated to be predictive of healing in both chronic and acute wounds is wound tissue bacterial level. The objective of this study was to determine whether tissue bacterial lev...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.09.009
更新日期：2011-08-01 00:00:00
abstract：:Seven pairs of rats were simultaneously infused with a chemically formulated nutritionally complete amino acid-glucose diet which was delivered, at the same rate, into a central vein or into a feeding gastrostomy. The intragastrically infused rats showed greater weight gain than did the intravenously infused rats. Thi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90092-2
更新日期：1978-02-01 00:00:00
abstract：:In this study, we sought to identify changes in the picture of a selected surgical condition during an interval of time that has brought about radical departures from previously established policies and programs. As a direct consequence, the patients take a more circuitous route to the surgeon. A significant number of...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90549-7
更新日期：1989-03-01 00:00:00
abstract：:Two cases of hepatoma are presented in which the clinical manifestations of biliary obstruction resulted from growth of hepatoma into the extrahepatic bile duct. Recognition of such a manifestation of the hepatoma may allow for surgical extirpation of the tumor combined with radiation therapy, which may result in long...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90088-5
更新日期：1977-02-01 00:00:00
abstract：BACKGROUND:The efficacy of carotid endarterectomy (CEA) in octogenarians is controversial. Recent reports have examined this question in the general population, but little data exist on veterans. With the emergence of carotid artery stenting, we need to evaluate the role of CEA in treating elderly veterans with carotid...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.07.022
更新日期：2005-11-01 00:00:00
abstract：BACKGROUND:The aim of this study was to calculate and analyze the cost of treatment for stage IV pressure ulcers. METHODS:A retrospective chart analysis of patients with stage IV pressure ulcers was conducted. Hospital records and treatment outcomes of these patients were followed up for a maximum of 29 months and ana...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.12.021
更新日期：2010-10-01 00:00:00
abstract：:Fistula-in-ano is a common surgical problem. Various materials have been used to perform the seton technique in the treatment of fistula-in-ano. In this study, a novel material, a self-locking cable tie, was used regardless of the fistula type. Seventeen consecutive patients with anal fistula underwent surgery with th...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.06.048
更新日期：2007-06-01 00:00:00
abstract：BACKGROUND:The role of stereotactic fine-needle aspiration cytology (SFNAC) in the diagnosis of nonpalpable breast lesions is poorly defined. PATIENTS AND METHODS:Data were prospectively collected from 225 consecutive patients with nonpalpable breast lesions who had aspiration cytology followed by immediate surgical e...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-9610(05)80116-3
更新日期：1994-12-01 00:00:00
abstract：BACKGROUND:Because the abdominal insufflation and desufflation associated with laparoscopic procedures may adversely effect a compromised myocardium, patients with significant cardiopulmonary disease should be closely monitored during these procedures. The utility of intraoperative pulmonary artery catheter (PAC) and t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80137-8
更新日期：1995-02-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to determine the indications and outcome of surgery in patients with Hashimoto's thyroiditis (HT). METHODS:All patients who underwent thyroidectomy from 1990 to 2009 with pathologically confirmed HT were identified. Patients whose principle diagnosis was HT were evaluated for s...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.08.021
更新日期：2011-03-01 00:00:00
abstract：BACKGROUND:Portal hypertension is frequently associated with secondary hypersplenism, two common clinical manifestations of which are leukopenia and thrombocytopenia. Surgical portosystemic shunts alleviate portal hypertension but their effect on hypersplenism remains unpredictable. Transjugular intrahepatic portosyste...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00006-8
更新日期：1997-03-01 00:00:00
abstract：:A discussion of congenital arteriovenous malformation of the head and neck based on five patients followed from three to twenty years is presented. Definition of the lesion and its progression as followed by angiography is described. The poor response to surgery is ascribed to the ischemic nature of the area of involv...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90255-6
更新日期：1978-10-01 00:00:00
abstract：:We performed a large single-center prospective randomized controlled study to assess the role of peritoneal drainage in simple elective cholecystectomy. In 248 patients, drains were omitted; 122 patients had closed suction drains and 124 had Penrose drains. There were no deaths, and no patient required reoperation or ...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验,评审
doi：10.1016/s0002-9610(05)80271-5
更新日期：1990-02-01 00:00:00
abstract：:Ten laryngectomees underwent esophageal motility studies to assess the effect of laryngectomy on esophageal function. When these patients are compared with controls, marked derangements in esophageal motility were noted in the upper esophageal sphincter (UES) and in the body of the esophagus. Lower esophageal sphincte...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90416-5
更新日期：1976-01-01 00:00:00
abstract：BACKGROUND:Intestinal failure-associated liver disease (IFALD) can be treated with parenteral fish oil (FO) monotherapy, but practitioners have raised concerns about a potential bleeding risk. This study aims to describe the incidence of clinically significant post-procedural bleeding (CSPPB) in children receiving FO m...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.10.026
更新日期：2017-10-01 00:00:00
abstract：:1. A well defined group of patients have been studied. 2. Composite operation resulted in a 56 per cent five year disease-free survival rate. 3. Treatment of recurrent disease with irradiation increased the five year survival to 61 per cent. 4. Preoperative irradiation for squamous cell carcinoma of the intraoral cavi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90490-0
更新日期：1975-10-01 00:00:00
abstract：BACKGROUND:We previously reported that a particular type of visual-spatial ability, mental rotation of visual forms, correlates with surgical performance in residents. In the current study, we used functional magnetic resonance imaging (fMRI) to identify patterns of cortical activation associated with mental rotation a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.11.011
更新日期：2007-04-01 00:00:00
abstract：:Over a 5-year period, iliopsoas abscesses were found in 11 patients. Although the most common underlying condition was Crohn's disease (3 of 11 patients), 5 abscesses resulted from hematogenous spread from a distant site. Each of these five patients was elderly, severely malnourished, or had an underlying chronic dise...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(92)90043-q
更新日期：1992-04-01 00:00:00
abstract：:The wire introducer method is a satisfactory technique for management of central venous catheters if bacteriologic monitoring of the removed catheter is used to determine whether the introduced catheter should be allowed to remain. The data indicate that when central venous catheters become infected, they do so throug...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90327-5
更新日期：1981-12-01 00:00:00
abstract：INTRODUCTION:Medical students applying for general surgery residencies often require a letter of recommendation (LOR) from the Surgical Chair. However, LORs may reveal gender and ethnic bias. This study examines the presence of implicit bias in general surgery resident selection by evaluating chair LORs. METHODS:A ret...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.08.010
更新日期：2020-08-15 00:00:00
abstract：:The therapeutic significance of noncurative gastrectomy for gastric cancer with liver metastasis was evaluated and the histologic characteristics of such cancer examined. The mean postoperative survival time of patients with liver metastasis limited to one lobe or a few scattered metastases to both lobes without perit...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90167-1
更新日期：1980-09-01 00:00:00
abstract：:The accuracy of operative cholangiograms can be increased by radiomanometry. This study identified 17 patients among 198 studied whose choledocholiths would have likely been missed by routine cholangiography. These are almost invariably small stones the fate of which would be conjectural if left behind. In the present...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90305-1
更新日期：1977-12-01 00:00:00
abstract：BACKGROUND:There are currently between 1 and 2 million breast cancer survivors in the United States. Is the advocated, early intervention the key to successful treatment, or are there other, more important factors? METHODS:Responses to combined decongestive therapy (CDT) for 69 women were analyzed with regard to durat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)00185-3
更新日期：1999-10-01 00:00:00
abstract：:Fifty-four patients receiving peripheral parenteral nutrition consisting of 3.5 percent amino acids in a 5 percent dextrose solution were randomly assigned in a double-blind fashion to receive this solution with or without an antiphlebitic mixture (1000 IU heparin, 5 mg hydrocortisone, and 1.8 mEq sodium hydroxide as ...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0002-9610(86)90022-x
更新日期：1986-01-01 00:00:00
abstract：BACKGROUND:Recently, limited abdominal computed tomography (CT) scans have been reported (Rao, New England Journal of Medicine, 1998) to have accuracy as high as 98%. We compare our hospital's CT accuracy ordered by emergency room (ER) physicians with that of experienced surgeons provided only with the ER history and p...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(02)00850-4
更新日期：2002-05-01 00:00:00
abstract：:It has been shown that truncal vagotomy with pyloroplasty (TVP), but not highly selective vagotomy (HSV), delays the onset, decreases the extent, and changes the pattern of gallbladder emptying. The aim of the present study was to investigate any alterations in gallbladder emptying after a variety of antiulcer gastric...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-9610(05)80160-6
更新日期：1994-10-01 00:00:00
abstract：:Over a 10 year period, 54 patients presented with pancreatic trauma. During the first 5 years of the study, when pancreatography was not utilized for the assessment of pancreatic duct injury, 55 percent of the patients had major pancreatic complications. During the subsequent 5 years, suspected proximal duct injury wa...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90173-8
更新日期：1982-05-01 00:00:00
abstract：:Surgical extirpation of the primary tumor has traditionally been utilized as initial treatment for sarcomas in children. The present report, however, demonstrates that sarcomas are optimally treated by means of a coordianted multidisciplinary approach. The latter offers the potential for achieving improved survival an...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90123-4
更新日期：1977-04-01 00:00:00
abstract：:We found that the mortality rate was no greater in patients with necrotizing enterocolitis complicated by perforation compared with the rate in those with other causes of perforation in similar weight classes. Iatrogenic injuries had a 50 percent mortality rate in all gestational age and birth weight categories and, t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80111-9
更新日期：1988-03-01 00:00:00
