Abstract:
BACKGROUND:Surgical length of stay (LOS) has been correlated with quality of care, with shorter stays implying better care. The relationship between LOS and postdischarge complications (PDCs) has not been evaluated effectively. METHODS:The 2005 to 2007 National Surgical Quality Improvement Program data were queried for patients undergoing elective colectomies. The outcome of interest was the development of a PDC. Multivariate analysis was then performed adjusting for demographics, surgical approach, and comorbidities. RESULTS:A total of 12,956 colectomies were analyzed with an overall PDC of 8.7%. LOS was not associated with increased odds of developing a PDC. The laparoscopic approach reduced the risk of PDCs by 30% (odds ratio = .70, 95% confidence interval, 0.61-0.81). Body mass index, female sex, the presence of diabetes mellitus, and prolonged operative time increased the odds of developing a PDC. CONCLUSIONS:A shorter LOS did not correlate with a reduction in the likelihood of PDCs. Further investigation into the role of LOS as a measure of quality care is needed.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Oyetunji TA,Turner PL,Onguti SK,Ehanire ID,Dorsett FO,Fullum TM,Cornwell EE 3rd,Haider AHdoi
10.1016/j.amjsurg.2012.04.006subject
Has Abstractpub_date
2013-01-01 00:00:00pages
71-6issue
1eissn
0002-9610issn
1879-1883pii
S0002-9610(12)00301-7journal_volume
205pub_type
杂志文章abstract::A 5 year retrospective study of the use of cholangioscopy in 153 difficult biliary cases including stones, strictures, tumors, and anomalies has been reported. In the 88 patients (58 percent) who underwent both operative cholangiography and cholangioscopy, the cholangioscope revealed 11 lesions (13 percent) missed by ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90048-5
更新日期:1984-01-01 00:00:00
abstract::Nitric oxide (NO), a paracrine-acting gas enzymatically synthesized from L-arginine, is a unique biologic mediator that has been implicated in a myriad of physiologic and pathophysiologic states. It is an important regulator of vascular tone and may be the mediator of the hemodynamic changes involved in sepsis and cir...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(05)80017-0
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:Patients with cancer who undergo pancreaticoduodenectomy (PD) followed by radiation and 5-fluorouracil (5-FU) therapy have experienced median overall survival from 18 to 24 months and an actuarial 2-year overall survival from 34% to 48%. We previously reported an 84% 2-year survival using a novel adjuvant ch...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(03)00051-5
更新日期:2003-05-01 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::A lethal gastric perforation occurred after a gastric banding procedure, which was complicated with splenectomy. Prompted by this incident, an experimental study was undertaken in which regional blood flow in the stomach was measured in anesthetized cats after gastric banding or splenectomy or both. A fatal course wit...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80106-9
更新日期:1985-03-01 00:00:00
abstract:BACKGROUND:Acute traumatic rupture of the descending thoracic aorta is usually considered a surgical emergency; a conventional surgical approach carries high morbidity and mortality rates in the perioperative period. Endovascular surgery has recently been considered as providing a new therapeutic strategy for these pat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.01.048
更新日期:2006-09-01 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:PURPOSE:To investigate the frequency, presentation, clinical management, and prognosis of appendiceal carcinoid tumors in children. METHOD:A review of our institution's experience over 50 years. RESULTS:Twenty-two patients below the age of 20 presented with appendiceal carcinoid tumor. The mean age at presentation wa...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80025-7
更新日期:1995-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine if the distance from the skin to the seroma cavity, as measured with ultrasound (US) before catheter placement, correlated with the distance from skin to MammoSite balloon catheter as measured on computerized axial tomography (CAT) after catheter placement. METHODS:...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.11.012
更新日期:2008-08-01 00:00:00
abstract::The human papillomavirus (HPV) has been shown to be associated with neoplasms of the human colon using immunohistochemistry and in situ hybridization. We now report our use of the polymerase chain reaction and Southern blotting to investigate that same association. We selected 38 carcinomas, 21 adenomas, and 24 normal...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80690-7
更新日期:1993-12-01 00:00:00
abstract:BACKGROUND:Clostridium difficile infection (CDI) is a common cause of healthcare associated infections contributing to morbidity and mortality. Our objective was to evaluate the impact of the implementation of a CDI bundle along with probiotic utilization. METHODS:A retrospective review of trauma admissions from 2008 ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.01.005
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Despite blood-conservation techniques, hemorrhage during burn excision remains substantial. It is difficult to predict the blood loss that will occur per operation and how many units the patient will require during surgery. This may result in high cross-match-to-transfusion ratios (CMTRs). METHODS:A retrosp...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.11.030
更新日期:2005-03-01 00:00:00
abstract::Thrombocytopenic patients with surgically correctable lesions such as radial clubhands are too often repeatedly transfused with randomly pooled platelets. This is followed by a clinical rejection of the foreign protein and rapid destruction of the platelets. There may be excessive bleeding episodes. Tissue typing tech...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90010-1
更新日期:1977-05-01 00:00:00
abstract:BACKGROUND:Merkel cell carcinoma (MCC) is a cutaneous neuroendocrine tumor that may spread via lymphatics and can therefore be staged with sentinel lymph node biopsy (SLNB). MCC is radiosensitive and chemosensitive, although the role of adjuvant therapy is still unclear. We examined the impact of different treatments o...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.06.013
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:We evaluated the safety and efficacy of angioembolization to control lower gastrointestinal hemorrhage. METHODS:Retrospective chart review of patients undergoing angiography for lower gastrointestinal hemorrhage from January 2000 to December 2002. RESULTS:Seventy-seven patients with lower gastrointestinal ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.11.024
更新日期:2005-03-01 00:00:00
abstract::Ninety-four routine subclavian vein catheterizations in patients with abdominal surgical procedures were performed by the resident surgical staff at the Medical University of South Carolina Hospital over a ten month period. This was done primarily to have ready access to large veins during surgery and to free the pati...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90093-3
更新日期:1976-02-01 00:00:00
abstract::Trovafloxacin, a new fluoronaphthyridone derivative related to fluoroquinolone antimicrobial drugs, has demonstrated the following characteristics: significant gram-positive and gram-negative activity; significant activity against anaerobes and atypical respiratory pathogens; approximately 11-hour elimination half-lif...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(98)00213-x
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND:There are controversial data on the relationship between trauma and body mass index. We investigated this relationship in traumatic hemorrhagic shock. METHODS:The "Glue Grant" database was analyzed, stratifying patients into underweight, normal weight (NW), overweight, Class I obesity, Class II obesity, and...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.12.016
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Accurate assessment is imperative for learning, feedback and progression. The aim of this study was to examine whether surgeons can accurately self-assess their technical and nontechnical skills compared with expert faculty members' assessments. METHODS:Twenty-five surgeons performed a laparoscopic cholecys...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.01.024
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:A left-sided gallbladder in a normally positioned liver is considered to be a very uncommon anomaly. Laparoscopic cholecystectomy can be performed safely, but bile duct injury is not unusual. It is associated with anomalous intrahepatic portal and biliary systems which impacts any form of partial hepatectomy...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.10.035
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Leakage from esophageal anastomoses is higher than that for other gastrointestinal anastomoses. An intrathoracic anastomotic leak is a potentially catastrophic event. METHODS:Patients with and without thoracic anastomotic leakage were compared for predisposing factors. Leak-related mortality was analyzed. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00559-1
更新日期:2001-03-01 00:00:00
abstract::The technique of intraoperative autotransfusion utilizing the Haemonetics Cell Saver is described. This device separates and washes red blood cells removed from the surgical field. Advantages of this unit over others are (1) no systemic anticoagulation is required, (2) circulatory fibrin debris is removed, (3) plasma ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90390-1
更新日期:1981-10-01 00:00:00
abstract:BACKGROUND:The unpredictability of prosthetic vascular access thrombosis precludes the scheduling of elective graft thrombectomy. This results in inconsistent dialysis for patients, as well as logistical challenges for dialysis clinics and surgeons, and increased cost. In an effort to solve this problem a community-wid...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00133-6
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:The feasibility and safety of low-pressure pneumoperitoneum in laparoscopic cholecystectomy remain unclear. METHODS:A meta-analysis of randomized controlled trials comparing low-pressure with standard-pressure pneumoperitoneum was performed. RESULTS:A total of 1,263 patients were included. Low-pressure pne...
journal_title:American journal of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.amjsurg.2013.09.027
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Etiologies contributing to failure to wean from mechanical ventilation (MV) are multiple, resulting in morbid and costly outcomes. Diaphragm pacing (DP) is used in spinal cord injury to replace MV. Temporary DP could be utilized in acute respiratory failure to reduce MV. METHODS:A prospective FDA feasibilit...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.amjsurg.2017.10.054
更新日期:2018-03-01 00:00:00
abstract::Real-time ultrasound scanning was used during operations on the biliary tract and pancreas. The principal application in biliary surgery was to evaluate the common bile duct for presence of calculi. Our initial experience indicates that operative ultrasonography compares favorably with operative cholangiography. In pa...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90017-9
更新日期:1981-01-01 00:00:00
abstract::We have found that the venous pressure slope during minimal exercise is a sensitive measurement of venous disease. This parameter differed greatly in our two study populations. Due to increased venous pressure, venous insufficiency syndrome patients have a greater volume of pooled blood, which results in smaller press...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(85)90120-5
更新日期:1985-08-01 00:00:00
abstract::Millions of people continue to smoke. Recent studies confirm the pioneering epidemiologic data that indicated that, despite the well-established effects on the lung, most of the hundreds of thousands of premature deaths annually result from extrapulmonary toxicity, particularly accelerated cardiac and vascular disease...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90421-5
更新日期:1984-12-01 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:BACKGROUND:This study aimed to determine the role of fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) in the follow-up of patients who underwent total thyroidectomy and iodine-131 ((131)I) ablation therapy for differentiated thyroid cancer and presented increased thyroglobulin levels with negative ...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-9610(00)00381-0
更新日期:2000-06-01 00:00:00