Abstract:
BACKGROUND:The management of surgical sepsis is challenging because of the complexity of interventions. The authors therefore created a computerized clinical decision support program to facilitate this process, with the goal of improving abdominal sepsis mortality. METHODS:The authors evaluated a prospective database for all patients requiring surgery for abdominal sepsis. Patient demographics, Acute Physiology and Chronic Health Evaluation II score, sepsis source, and hospital mortality data were obtained. Observed mortality was compared with predicted mortality using Fisher's exact test. RESULTS:Eighty-seven patients met the inclusion criteria. The average age was 59 ± 17.0 years, and 39% were men. The most common source of infection was the colon (45%). The average Acute Physiology and Chronic Health Evaluation II score was 27.6 ± 9.72. The overall actual mortality rate for the cohort was 24% compared with a predicted Acute Physiology and Chronic Health Evaluation II mortality of 62.5% (P < .0001). CONCLUSION:The use of computerized clinical decision support results in significantly improved survival in patients with intra-abdominal surgical sepsis.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Moore LJ,Turner KL,Todd SR,McKinley B,Moore FAdoi
10.1016/j.amjsurg.2010.07.036subject
Has Abstractpub_date
2010-12-01 00:00:00pages
839-43; discussion 843-4issue
6eissn
0002-9610issn
1879-1883pii
S0002-9610(10)00569-6journal_volume
200pub_type
杂志文章abstract::Desmoid tumors of the head and neck are uncommon and associated with a posttreatment recurrence rate as high as 70 percent. This study was undertaken to determine cure rates achievable by surgery and radiotherapy and the factors influencing failure. A chart review of all patients at our institution with desmoid tumors...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80305-2
更新日期:1988-10-01 00:00:00
abstract::Of 101 patients originally operated on, the status of 98 is known. Given the mortality and reanastomosis rates, the operation must be considered an absolute failure in 28 percent of the patients. Given the other complications that appear (or persist) late postoperatively, only 18 percent of the entire series of patien...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90165-8
更新日期:1980-09-01 00:00:00
abstract::A seven day old dehydrated male infant was found to have acute ischemia of the leg due to acute thrombotic occlusion of an external iliac, common and superficial femoral, and popliteal arteries. Early thrombectomy and arterioplasty resulted in complete remission of ischemia. Our success with direct vascular surgery pr...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90254-8
更新日期:1975-03-01 00:00:00
abstract:BACKGROUND:Trauma in pregnancy remains an important but understudied public health issue. We aimed to determine the prevalence of interpersonal violence in our pregnant trauma population (including pediatric) over the last 20 years, from our Level I trauma center. METHODS:We conducted a descriptive, retrospective char...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.07.003
更新日期:2017-10-01 00:00:00
abstract::We studied 76 patients with symptoms of heartburn, regurgitation, or both and 38 asymptomatic control subjects by measuring the gastric emptying of technetium-99m-labeled oatmeal. In addition, we performed 24-hour esophageal pH monitoring and manometric studies of the esophagus on all study participants. Endoscopy was...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90422-4
更新日期:1989-01-01 00:00:00
abstract::A retrospective study of 316 patients with a diagnosis of intestinal obstruction admitted to the University of Benin Teaching Hospital over a 5 year period is presented. The overall mortality was 10.6 percent. Attention is called to the unacceptably high morbidity and mortality associated with volvulus in this and oth...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90300-1
更新日期:1980-03-01 00:00:00
abstract:BACKGROUND:Following appendectomy, management is often guided by surgeon determination of whether the appendicitis is uncomplicated or complicated. Our objectives were to determine the incidence of discordance between intraoperative and pathological findings and determine effect on outcomes. METHODS:We performed a ret...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.05.004
更新日期:2020-01-01 00:00:00
abstract::The p53 tumor suppressor gene has been implicated in human esophageal tumorigenesis, and mutations are reported in primary esophageal adenocarcinomas and associated Barrett's epithelium. To evaluate the potential clinical significance of this molecular genetic marker in the progression of Barrett's epithelium to invas...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(94)90053-1
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Gastroesophageal reflux is frequently associated with abnormal motility in the body of the esophagus. Concern for dysphagia has led surgeons to perform less competent procedures in this group, or to avoid surgery altogether. The current study was undertaken to evaluate our experience with the laparoscopic Hi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(96)00062-1
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to examine the outcomes of checklist-driven preoperative briefings and postoperative debriefings during the Veterans Health Administration (VHA) medical team training program. METHODS:A briefing score (1, never started; 2, started then discontinued; 3, maintained on original ta...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.07.011
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Established methods for assessing surgical performance face limitations. Global rating scales and procedure-specific checklists are resource intensive and rely on expert opinions. Alternatives that use technology to track hand movements, such as magnetic and optical tracking systems, are generally expensive ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.08.008
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:This study defines the entity of the hypertensive lower esophageal sphincter (HLES) and its treatment, including surgical implications. METHODS:Esophageal manometry was performed on 1,300 patients. Of these, 53 (4%) had HLES with resting pressure > 26.5 mm Hg, defined as the upper limit of normal resting LE...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/S0002-9610(96)00219-X
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:This study evaluated the outcomes of the first 5 years of sentinel node biopsy (SNB) in British Columbia (BC), Canada, 1996 to 2001. METHODS:There were 547 SNB procedures for breast cancer performed by 29 surgeons at 12 hospitals in BC between October 1996 and July 2001. Identification, accuracy, and false-...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)01215-1
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:The adipocyte hormone leptin has been shown to increase migration and angiogenesis in epithelial cells. Therefore, we hypothesized that leptin would induce prostate cancer cell migration and growth factor expression in vitro. METHODS:Prostate cancer cell lines DU145 and PC-3 (androgen-resistant) were treate...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.07.031
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Current recommendations using Hounsfield units (HU) ≤ 10 to identify adrenal adenomas on unenhanced computed tomography (CT) miss 10-40% of benign adenomas. We sought to determine if changing HU threshold and adding absolute percent contrast washout (APW) criteria would identify adrenal adenomas better than ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.04.021
更新日期:2020-10-01 00:00:00
abstract::A 2.5 kg thoracopagus (Siamese) twin and a 0.73 kg premature newborn developed systemic candidiasis and were treated with intravenous miconazole. The conjoined twin was in a state of severe metabolic acidosis, respiratory distress, jaundice, anuria, abdominal distension, and shock. The 0.73 kg premature infant was als...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90349-0
更新日期:1979-11-01 00:00:00
abstract::A case of unicystic ameloblastoma of the mandible in a 10-year-old child is described. In addition to the mandibular swelling the patient also had a proliferative lesion over the alveolus that masqueraded as a neoplastic lesion. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.07.036
更新日期:2008-09-01 00:00:00
abstract::One hundred seventeen patients with threatened limb loss were evaluated. Seventy-three of these patients underwent vascular reconstruction. Diabetics had a significantly higher incidence of ischemic ulceration and gangrene when compared with nondiabetics. Nondiabetics typically presented with rest pain. The outcome of...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80534-8
更新日期:1988-12-01 00:00:00
abstract:BACKGROUND:We hypothesized that the method of breast cancer margin assessment may be associated with different rates of positive margins and residual carcinoma. METHODS:A total of 178 breast cancer specimens were divided into 2 groups (A and B) based on the margin assessment method used. Rates of positive margins, re-...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.06.009
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine whether differing neoadjuvant chemotherapy (NAC) regimens for HER2 positive breast cancer (HER2+ BC) are associated with differing surgical complications. Our goal was to evaluate postoperative complications in HER2+ BC patients receiving NAC with Herceptin (trastuzumab...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.06.053
更新日期:2020-11-01 00:00:00
abstract:INTRODUCTION:The integrity of the medical literature about robotic surgery remains unclear despite wide-spread adoption. We sought to determine if payment from Intuitive Surgical Incorporated (ISI) affected quality of the research produced by surgeons. METHODS:Publicly available financial data from the CMS website reg...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2017.08.017
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:The increased utilization of expanded criteria kidney donors has necessitated the reevaluation of multiple donor risk factors to insure the best outcome from this valuable resource. Reports of decreased graft survival in recipients of kidneys from donors with > or =20% glomerular sclerosis (GS) have led many...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00502-x
更新日期:2000-12-01 00:00:00
abstract::The clinical course of 39 patients on HPN for 5.5 years at The Cleveland Clinic Foundation were reviewed. Rehospitalization and mortality rates were relatively low in this group of patients who had significant disease processes. Rehospitalization and mortality were usually due to the primary underlying disease process...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90174-5
更新日期:1983-01-01 00:00:00
abstract::During a 2 year period, 83 patients with gastric motility problems were evaluated using radionuclide imaging. The patients presented with epigastric distress, postprandial fullness, pain, nausea, vomiting, and diarrhea; signs and symptoms suggestive of either gastroparesis or gastric outlet obstruction. Upper gastroin...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90351-3
更新日期:1983-12-01 00:00:00
abstract:BACKGROUND:To evaluate the clinical and laboratory characteristics of patients submitted to subtotal splenectomy during the immediate and late postoperative period. METHODS:The study was conducted on 34 patients, 25 of whom were submitted to subtotal splenectomy (group I), and 9 to total splenectomy without preservati...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)01407-1
更新日期:2003-04-01 00:00:00
abstract::A retrospective analysis of 176 patients with squamous cell carcinoma of the tongue has been reported. The tongue base and mobile tongue, believed to behave as two clinically distinct anatomic areas, have been compared and contrasted. Women comprised 25 percent of the patients with tumors of the base of the tongue and...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90230-1
更新日期:1983-10-01 00:00:00
abstract:BACKGROUND:Fibroadenomas commonly found by palpation and routine mammography account for approximately 20% of open surgical breast biopsies. Alternatives to open surgery include tumor removal using an automated coring device and tumor ablation using heating or cooling elements. We report our initial experience with cry...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)01010-3
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:Among patients with adhesive small bowel obstruction (ASBO) initially managed with a conservative strategy, predicting risk of operation is difficult. METHODS:We investigated ASBO patients at 2 different periods to derive and validate a clinical prediction model for risk of operation. RESULTS:One hundred f...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.07.045
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Mental skills training refers to the implementation of cognitive performance-enhancing strategies to promote optimal performance. We aimed to develop a surgery-specific mental skills curriculum (MSC) and obtain initial evidence of efficacy. METHODS:The developed MSC consisted of 8 proven performance-enhanci...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.06.027
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Lymphoepithelial cyst of the pancreas is a rare but distinctive cystic lesion lined by a mature, keratinizing squamous epithelium and surrounded by lymphoid tissue. METHODS:To gain more insights into this entity, we describe 5 examples of lymphoepithelial cyst of the pancreas (2 of which were briefly descri...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80247-5
更新日期:1995-07-01 00:00:00