Abstract：
BACKGROUND:The frequency of 90-day, postdischarge deaths and readmissions in Medicare patients undergoing elective surgical procedures has not been well studied. METHODS:The Medicare MedPar database for 2009 to 2010 was used to develop inpatient risk-adjusted, postoperative length-of-stay (RApoLOS) prediction models for live discharges in 21 categories of elective operations. Moving average control charts were used in each category to define RApoLOS outliers (>3σ). The relationships between RApoLOS outliers and all postdischarge deaths and readmissions within 90 days of discharge were assessed. RESULTS:The inpatient mortality rate was .5%. Of 2,054,189 live discharges, 147,292 (7%) were RApoLOS outliers. There were 14,657 postdischarge deaths (.7%) and 187,566 readmissions (9%). RApoLOS outliers had a 3.5% death rate and a 17% rate of readmission, while those found not to be RApoLOS outliers had a .5% death rate and a 9% readmission rate (P < .0001). CONCLUSIONS:RApoLOS outliers have increased rates of postdischarge deaths and readmissions.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Fry DE,Pine M,Pine Gdoi
10.1016/j.amjsurg.2013.09.007subject
Has Abstractpub_date
2014-03-01 00:00:00pages
326-30; discussion 330issue
3eissn
0002-9610issn
1879-1883pii
S0002-9610(13)00684-3journal_volume
207pub_type
杂志文章abstract：:Normal volunteers and patients were studied to determine the relative importance of NMTT and patient risk factors in the production of hypoprothrombinemia. The normal volunteers demonstrated in vivo NMTT production, but the order of magnitude (cefoperazone, moxalactam, and cefotetan in descending order) was different ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80210-1
更新日期：1988-05-31 00:00:00
abstract：BACKGROUND:Changes in surgical training have raised concerns about residents' operative exposure and preparedness for independent practice. One way of addressing this concern is by optimizing teaching and feedback in the operating room (OR). The objective of this study was to perform a systematic review on perioperativ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2016.12.014
更新日期：2017-07-01 00:00:00
abstract：BACKGROUND:This study utilizes the American College of Surgeons National Surgical Quality Improvement Program database to better understand the impact of obesity on perioperative surgical morbidity in abdominal wall reconstruction (AWR). METHODS:We reviewed the 2005 to 2010 American College of Surgeons National Surgic...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2013.08.047
更新日期：2014-04-01 00:00:00
abstract：:A procedure of tape-guided living donor left hepatectomy is described. A tape was placed along the anterior wall of the inferior vena cava for left liver with caudate lobe, and along Arantius' ligament for left liver without caudate lobe. The final step of liver transection was applied by dividing the liver parenchyma...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.09.044
更新日期：2007-07-01 00:00:00
abstract：BACKGROUND:Surgeons who have demonstrated excellence through extensive publication in the medical education literature can provide valuable guidance for new surgeons interested in educational research. METHODS:National databases identified members of the Association for Surgical Education (ASE) who have accumulated th...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00301-9
更新日期：2000-03-01 00:00:00
abstract：:A persistent perineal sinus may develop in patients undergoing proctocolectomy for inflammatory bowel disease. Healing may resist the traditional methods of wound management. Wide excision including coccygectomy, transposition of the vascularized gracilis muscle flap into the rigid cavity, and wound closure have led t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90290-3
更新日期：1984-07-01 00:00:00
abstract：BACKGROUND:This study was designed to compare short-term laparoscopic total gastrectomy (LTG) with open total gastrectomy (OTG) outcomes in gastric cancer. METHODS:Seventy patients who underwent total gastrectomy via LTG or OTG were included. All cases were matched for stage, age, and sex by means of statistically gen...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.11.011
更新日期：2013-09-01 00:00:00
abstract：:Serum transferrin is an important protein used to assess visceral protein status in patients requiring nutritional support. Since serum transferrin assays are not readily available in all institutions and there is a correlation between the serum transferrin level and TIBC, Blackburn's formula to compute the serum tran...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90337-4
更新日期：1984-11-01 00:00:00
abstract：:A survey was made of 112 cases of gallstone ileus reported in the Japanese literature, including 3 of our cases. The ratio of males to females was 1 to 1.1, the age range was 13 to 87 years, and biliary-enteric fistulas were demonstrated in 81 percent of the patients. Although cholecystoduodenal fistula was most commo...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90185-3
更新日期：1980-09-01 00:00:00
abstract：BACKGROUND:This meta-analysis was performed to determine the degree to which improvements in open hernia repair (OHR) in the last decade have altered the relative benefit of laparoscopic hernia repair (LHR). METHODS:Twenty-seven comparative trials including 4,688 randomized patients were evaluated. RESULTS:Within the...
journal_title：American journal of surgery
pub_type： 杂志文章,meta分析
doi：10.1016/s0002-9610(02)00878-4
更新日期：2002-07-01 00:00:00
abstract：:Significant arterial trauma can result from femoral arterial cannulation for cardiopulmonary bypass or intraaortic balloon pumping. Threat of imminent loss of limb or suture line disruption requires prompt surgical intervention. Delayed appearance of claudication, characteristically at 1 to 2 weeks postoperatively, is...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90026-4
更新日期：1980-08-01 00:00:00
abstract：:The determination of surgical risk is a major problem in general surgical practice and many studies have attempted to predict postoperative outcome. Clinical judgment is still a fundamental skill with which the experienced surgeon can estimate the risk of postoperative infectious morbidity. Predictive scores based on ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)81207-3
更新日期：1993-02-01 00:00:00
abstract：BACKGROUND:Saline-linked electric cautery (SLC) is introduced as an effective device to reduce blood loss in liver surgery. The aim of the current study was to evaluate the safety and efficacy of a 2-surgeon technique using SLC and the Cavitron Ultrasonic Surgical Aspirator (CUSA; Valleylab, Boulder, CO) in living dono...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.01.019
更新日期：2009-02-01 00:00:00
abstract：:Axillary node dissection was performed in 212 patients with malignant melanoma. For 212 initial dissections plus 49 repeat procedures (261 operations), wound infection occurred in 25 (10%) and arm edema in 10 (4%), with other complications being infrequent. The arm edema resolved promptly and completely six (2%) patie...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90069-p
更新日期：1991-09-01 00:00:00
abstract：:Extracorporeal shock-wave lithotripsy (ESWL) in combination with adjuvant litholytic therapy using chenodeoxycholic acid and ursodeoxycholic acid (7 to 8 mg/kg body weight/day of each acid) is a safe and effective, novel nonsurgical approach to gallbladder stones, provided the patients are carefully selected. Experien...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/0002-9610(89)90249-3
更新日期：1989-09-01 00:00:00
abstract：BACKGROUND:This study determined the degree to which ward evaluations, the American Board of Surgery In-Training Examination (ABSITE), and an Objective Structured Clinical Examination (OSCE) provide equivalent information about intern performance. METHODS:Twenty-two general surgery interns completed both the ABSITE an...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80187-1
更新日期：1995-04-01 00:00:00
abstract：:This investigation was designed to study the effects of home health care (HHC) on patients who have been hospitalized with peripheral vascular disease. For a patient to have HHC, the patient had to have a defined wound, educational needs, or both. Sixty patients, 30 with HHC and 30 without, were contacted approximatel...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80302-2
更新日期：1990-08-01 00:00:00
abstract：BACKGROUND:The role of laparoscopic surgery in the treatment of various upper and lower gastrointestinal disorders is still under investigation. However, a variety of laparoscopic procedures may be applied in the treatment of inflammatory bowel disease (IBD). PATIENTS AND METHODS:We present our initial results of lapa...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80072-5
更新日期：1996-01-01 00:00:00
abstract：BACKGROUND:Symptomatic hypocalcemia remains the main postoperative complication after total thyroidectomy. The aim of the present study was to evaluate the role of oral supplementation of calcitriol and calcium salts in preventing severe postoperative hypocalcemia after total thyroidectomy. METHODS:A consecutive serie...
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/j.amjsurg.2005.04.017
更新日期：2005-09-01 00:00:00
abstract：:Aortobrachiocephalic reconstruction was studied in 26 patients. Nine had suffered a previous stroke, and seven had residual deficity. A previous carotid endarterectomy or carotid-to-subclavian bypass had been performed in eight patients. The ascending aorta was the proximal anastomotic site in all cases. Bypass grafti...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80364-7
更新日期：1988-08-01 00:00:00
abstract：:From February 1, 1980, to May 1, 1989, 462 patients underwent the Greenville gastric bypass at the East Carolina University School of Medicine. The operation effectively maintained satisfactory weight loss after 9 years (mean weight preoperatively, 293 lbs; at 24 months, 179 lbs; at 96 months, 194 lbs). The gastric by...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90377-p
更新日期：1991-01-01 00:00:00
abstract：:Intracellular growth hormone has been demonstrated in human mammary carcinoma cells by using an unlabeled antibody enzyme technic with horseradish peroxidase and antihorseradish peroxidase complex. Intense reaction was seen in both male and female mammary carcinoma cells. Positive staining was observed in nuclei and c...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90102-2
更新日期：1978-02-01 00:00:00
abstract：:Twenty-one patients presented with pathologic interactions between the gastrointestinal tract and aortic grafts. Seventeen patients were managed by excision of the graft and axillobifemoral bypass. Six patients died. four deaths were due to disruption of the proximal aortic stump after initial therapy that appeared su...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90003-3
更新日期：1980-08-01 00:00:00
abstract：BACKGROUND:Transjugular intrahepatic portosystemic stent shunt (TIPS) has become the modality of choice for complicated portal decompression. This study was undertaken to determine outcomes after TIPS and the usefulness of TIPS as a "bridge" to transplantation. METHODS:Patients undergoing TIPS from 2001 to 2010 at a t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.06.005
更新日期：2013-04-01 00:00:00
abstract：BACKGROUND:The aim of the current study was to identify predictors of pathologic complete response (pCR) following neoadjuvant therapy. METHODS:From 2000 to 2007, 518 breast cancer patients received neoadjuvant therapy. Data were compared using chi(2) and Fisher's exact tests and multivariate analysis of variance, as ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.06.004
更新日期：2009-10-01 00:00:00
abstract：BACKGROUND:To determine the current surgical management of bleeding duodenal ulcers in our program, faculty (FAC) and residents (RES) were surveyed. METHODS:FAC (n = 33) and RES (n = 42) were surveyed regarding their surgery of choice between oversew (OS) or acid-reducing procedures (ARPs) in 4 scenarios. FAC who had ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.08.021
更新日期：2006-11-01 00:00:00
abstract：:Recent developments in protein and genetic engineering methods have allowed the production of antibody-derived molecules that have important potential as therapeutic agents. Although monoclonal antibodies of murine origin have been used for therapeutic purposes, limitations due to anti-antibody responses and suboptima...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(05)80653-1
更新日期：1992-07-01 00:00:00
abstract：BACKGROUND:Primary hyperparathyroidism (HPT) is an undertreated disease. This study's purpose is to determine if the calcium levels correlate with prevalence of symptoms and surgical treatment in patients with primary HPT. METHOD:Patients treated in 2006-2015 with serum calcium≥10.0 mg/dL and PTH>65 pg/mL were identif...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.09.010
更新日期：2019-03-01 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：:The popliteal artery entrapment syndrome is increasingly recognized as a cause of arterial insufficiency in the leg. Diagnosis is based on a clinical history of claudication, which may be atypical, physical examination, noninvasive exercise testing and angiography. Patients with normal ankle pulses and resting ankle/b...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90285-8
更新日期：1980-03-01 00:00:00
