Hospital length of stay after admission for traumatic injury in Canada: a multicenter cohort study.


OBJECTIVE:To describe acute care length of stay (LOS) over all consecutive hospitalizations for the injury and according to level of care [intensive care unit (ICU), intermediate care, general ward], compare observed and expected LOS, and identify predictors of LOS. BACKGROUND:Prolonged LOS has important consequences in terms of costs and outcome, yet detailed information on LOS after trauma is lacking. METHODS:This multicenter retrospective cohort study was based on adults discharged alive from a Canadian trauma system (1999-2010; n = 126,513). Registry data were used to calculate index LOS (LOS in trauma center with highest designation level) and were linked to hospital discharge data to calculate total LOS (all consecutive hospitalizations for the injury). Expected LOS was obtained by matching general provincial discharge statistics to study data by year, age, and sex. Potential predictors of LOS were evaluated using linear regression. RESULTS:Mean index and total LOS were 8.6 and 9.4 days, respectively. ICU, intermediate care unit, and general ward care constituted 8.9%, 2.5%, and 88.6% of total hospital days. Observed mean index and ICU LOS in our trauma patients were 2.9 and 1.3 days longer than expected LOS (P < 0.0001). The strongest determinants of index LOS were discharge destination, age, transfer status, and injury severity. CONCLUSIONS:Results suggest that acute care LOS after injury is underestimated when only information on the index hospitalization is used and that ICU or intermediate care constitute an important part of LOS. This information should be used to inform the development of an informative and actionable quality indicator.


Ann Surg


Annals of surgery


Moore L,Stelfox HT,Turgeon AF,Nathens A,Bourgeois G,Lapointe J,Gagné M,Lavoie A




Has Abstract


2014-07-01 00:00:00












  • Can We Predict Incisional Hernia?: Development of a Surgery-specific Decision-Support Interface.

    abstract:OBJECTIVE:The aim of this study was to identify procedure-specific risk factors independently associated with incisional hernia (IH) and demonstrate the feasibility of preoperative risk stratification through the use of an IH risk calculator app and decision-support interface. SUMMARY BACKGROUND DATA:IH occurs after 1...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Basta MN,Kozak GM,Broach RB,Messa CA 4th,Rhemtulla I,DeMatteo RP,Serletti JM,Fischer JP

    更新日期:2019-09-01 00:00:00

  • Molecules, cancer, and the surgeon. A review of molecular biology and its implications for surgical oncology.

    abstract::Interactions between molecules control intra- and intercellular physiology. Cancer is emerging as a disease in which individual molecules are either overproduced, mutated, expressed at inappropriate stages of development, or lost due to inheritance or aberrant mitotic division. The major players in this contest of cel...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审


    authors: Arbeit JM

    更新日期:1990-07-01 00:00:00

  • Optimizing Surveillance and Re-intervention Strategy Following Elective Endovascular Repair of Abdominal Aortic Aneurysms.

    abstract:BACKGROUND:EVAR for abdominal aortic aneurysm has an initial survival advantage over OR, but more frequent complications increase costs and long-term aneurysm-related mortality. Randomized controlled trials of EVAR versus OR have shown EVAR is not cost-effective over a patient's lifetime. However, in the EVAR-1 trial, ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Kim LG,Sweeting MJ,Epstein D,Venermo M,Rohlffs FEV,Greenhalgh RM

    更新日期:2019-10-07 00:00:00

  • Prognosis in acute organ-system failure.

    abstract::This prospective study describes the current prognosis of patients in acute Organ System Failure (OSF). Objective definitions were developed for five OSFs, and then 5677 ICU admissions from 13 hospitals were monitored. The number and duration of OSF were linked to outcome at hospital discharge for each of the 2719 ICU...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Knaus WA,Draper EA,Wagner DP,Zimmerman JE

    更新日期:1985-12-01 00:00:00

  • Improving the Quality of Ward-based Surgical Care With a Human Factors Intervention Bundle.

    abstract:OBJECTIVE:This study aimed to explore the impact of a human factors intervention bundle on the quality of ward-based surgical care in a UK hospital. SUMMARY OF BACKGROUND DATA:Improving the culture of a surgical team is a difficult task. Engagement with stakeholders before intervention is key. Studies have shown that ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Johnston MJ,Arora S,King D,Darzi A

    更新日期:2018-01-01 00:00:00

  • Toward strategies for cost containment in surgical patients.

    abstract::The University of Rochester, Department of Surgery, in response to an experimental community-wide limit on hospital budgets, studied high-cost general surgical patients as a potential source of leverage for containment of hospital costs. It was found that a small number of patients impact significantly on hospital cos...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Drucker WR,Gavett JW,Kirshner R,Messick WJ,Ingersoll G

    更新日期:1983-09-01 00:00:00

  • Maintenance of cardiodynamics with aspirin during abdominal aortic aneurysmectomy (AAA).

    abstract::The importance of prostacyclin (PGI2) and thromboxane (Tx) medication of depressed cardiac performance during abdominal aortic aneurysm operative surgery was studied by contrasting the effects of 650 mg aspirin administered 12 hours before operation to that of a placebo. In 11 patients who received a placebo, the stab...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章


    authors: Utsunomiya T,Krausz MM,Dunham B,Mannick JA,Allen PD,Shepro D,Hechtman HB

    更新日期:1981-11-01 00:00:00

  • A personal experience with 100 consecutive total colectomies and straight ileoanal endorectal pull-throughs for benign disease of the colon and rectum in children and adults.

    abstract::In 1974 total colectomy and ileoanal straight endorectal pull-through (ERPT) were first used at our institution for the definitive management of total colonic Hirschsprung's disease in infants and children. Early success with this operation encouraged us to use this procedure in children and adults with ulcerative col...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Coran AG

    更新日期:1990-09-01 00:00:00

  • Surgical management of carcinoma of the junction of the main hepatic ducts.

    abstract::Twenty-six patients are reviewed who had primary carcinomas involving the junction of the hepatic ducts. The majority had had an initial procedure of palliative biliary diversion elsewhere and were referred for further treatment. In three cases, en bloc resection of the tumor with total hepatectomy and orthotopic live...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Fortner JG,Kallum BO,Kim DK

    更新日期:1976-07-01 00:00:00

  • Permanent Pancreatic Duct Occlusion With Neoprene-based Glue Injection After Pancreatoduodenectomy at High Risk of Pancreatic Fistula: A Prospective Clinical Study.

    abstract:OBJECTIVE:The aim of this study was to assess safety and efficacy of pancreatic duct occlusion (PDO) with neoprene-based glue in selected patients undergoing pancreatoduodenectomy (PD) at high risk of postoperative pancreatic fistula (POPF). BACKGROUND DATA:PD is the reference standard approach for tumors of the pancr...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章


    authors: Mazzaferro V,Virdis M,Sposito C,Cotsoglou C,Droz Dit Busset M,Bongini M,Flores M,Prinzi N,Coppa J

    更新日期:2019-11-01 00:00:00

  • Classification of pathologic response to neoadjuvant therapy in esophageal and junctional cancer: assessment of existing measures and proposal of a novel 3-point standard.

    abstract:OBJECTIVE:To assess existing measures of pathologic response to neoadjuvant therapy in esophageal and junctional cancer, and to recommend an optimum classification. BACKGROUND:Multimodal therapy is increasingly the standard of care for locally advanced esophageal cancer. Numerous measures of pathologic response have b...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Donohoe CL,O'Farrell NJ,Grant T,King S,Clarke L,Muldoon C,Reynolds JV

    更新日期:2013-11-01 00:00:00

  • A prospective study of thymectomy and serum acetylcholine receptor antibodies in myasthenia gravis.

    abstract::Forty-seven consecutively presenting myasthenia gravis (MG) patients with generalized weakness were treated according to a standardized prospective protocol. All patients underwent a sternal splitting "total" thymectomy. Medical status before surgery was optimized by plasmapheresis without immunosuppression. Medicatio...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Olanow CW,Wechsler AS,Roses AD

    更新日期:1982-08-01 00:00:00

  • Clinicopathological aspects of high bile duct cancer. Experience with resection and bypass surgical treatments.

    abstract::This report reviews the experience of the Hepatobiliary Unit, Royal Postgraduate Medical School, Hammersmith Hospital, London with 16 patients having proximal extrahepatic bile duct malignancy who underwent resection and a comparable group of 15 patients who had surgical bypass. The purposes of the review were to eval...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Beazley RM,Hadjis N,Benjamin IS,Blumgart LH

    更新日期:1984-06-01 00:00:00

  • Current concepts in the mediastinal lymph node staging of nonsmall cell lung cancer.

    abstract:OBJECTIVE:To review the current concepts in the mediastinal staging of nonsmall cell lung cancer (NSCLC), evaluating traditional and modern staging modalities. SUMMARY BACKGROUND DATA:Staging of NSCLC includes the assessment of mediastinal lymph nodes. Traditionally, computed tomography (CT) and mediastinoscopy are us...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审


    authors: Kramer H,Groen HJ

    更新日期:2003-08-01 00:00:00

  • Gallstone pancreatitis: biliary tract pathology in relation to time of operation.

    abstract::During a 29-month trial, 65 patients with acute gallstone pancreatitis were randomly selected for biliary tract explorations either within 73 hours of admission (36 patients) or at three months following remission with nonoperative measures (29 patients, with five others awaiting elective operation). The details of su...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Stone HH,Fabian TC,Dunlop WE

    更新日期:1981-09-01 00:00:00

  • New technique for liver resection using heat coagulative necrosis.

    abstract:OBJECTIVE:To assess a new bloodless technique using radiofrequency energy for segmental liver resection of hepatic tumors. SUMMARY BACKGROUND DATA:Liver resection remains a formidable surgical procedure; safe performance requires a high level of training and skill. Intraoperative blood loss during liver resection rema...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Weber JC,Navarra G,Jiao LR,Nicholls JP,Jensen SL,Habib NA

    更新日期:2002-11-01 00:00:00

  • Long-term follow-up of a randomized trial comparing the beger and frey procedures for patients suffering from chronic pancreatitis.

    abstract:OBJECTIVE:To report on the long-term follow-up of a randomized clinical trial comparing pancreatic head resection according to Beger and limited pancreatic head excision combined with longitudinal pancreatico-jejunostomy according to Frey for surgical treatment of chronic pancreatitis. SUMMARY BACKGROUND DATA:Resectio...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Strate T,Taherpour Z,Bloechle C,Mann O,Bruhn JP,Schneider C,Kuechler T,Yekebas E,Izbicki JR

    更新日期:2005-04-01 00:00:00

  • Depressed high-energy phosphate content in hypertrophied ventricles of animal and man: the biologic basis for increased sensitivity to ischemic injury.

    abstract::It is frequently stated that hypertrophied ventricles tolerate ischemia less well than nonhypertrophied ventricles. The authors' earlier studies in a rat supravalvular aortic stenosis model and canine valvular aortic stenosis model, both with concentric left ventricular hypertrophy, disclosed accelerated rates of isch...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Peyton RB,Jones RN,Attarian D,Sink JD,Van Trigt P,Currie WD,Wechsler AS

    更新日期:1982-09-01 00:00:00

  • Wait times for cancer surgery in the United States: trends and predictors of delays.

    abstract:BACKGROUND:Patients frequently voice concerns regarding wait times for cancer treatment; however, little is known about the length of wait times from diagnosis to surgery in the United States. Our objectives were (1) to assess changes in wait times over the past decade and (2) to identify patient, tumor, and hospital f...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Bilimoria KY,Ko CY,Tomlinson JS,Stewart AK,Talamonti MS,Hynes DL,Winchester DP,Bentrem DJ

    更新日期:2011-04-01 00:00:00

  • Comparison of cancer-associated genetic abnormalities in columnar-lined esophagus tissues with and without goblet cells.

    abstract:OBJECTIVE:To determine and compare the frequency of cancer-associated genetic abnormalities in esophageal metaplasia biopsies with and without goblet cells. BACKGROUND:Barrett's esophagus is associated with increased risk of esophageal adenocarcinoma (EAC), but the appropriate histologic definition of Barrett's esopha...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Bandla S,Peters JH,Ruff D,Chen SM,Li CY,Song K,Thoms K,Litle VR,Watson T,Chapurin N,Lada M,Pennathur A,Luketich JD,Peterson D,Dulak A,Lin L,Bass A,Beer DG,Godfrey TE,Zhou Z

    更新日期:2014-07-01 00:00:00

  • Perineal transanal approach: a new standard for laparoscopic sphincter-saving resection in low rectal cancer, a randomized trial.

    abstract:BACKGROUND:Laparoscopic sphincter preservation for low rectal cancer is challenging because of the high risk of positive circumferential resection margin. We hypothesized that perineal dissection of the distal rectum may improve quality of surgery, compared with the conventional abdominal dissection. METHODS:Between 2...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验


    authors: Denost Q,Adam JP,Rullier A,Buscail E,Laurent C,Rullier E

    更新日期:2014-12-01 00:00:00

  • Personal experience with 411 hepatic resections.

    abstract::Over a 24-year period, 411 partial hepatic resections were performed: 142 right or left trisegmentectomies, 158 lobectomies, 25 segmentectomies, and 86 local excisions. The operations were performed for benign lesions in 182 patients, for primary hepatic malignancies in 106, and for hepatic metastases in 123, includin...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Iwatsuki S,Starzl TE

    更新日期:1988-10-01 00:00:00

  • Patterns of failure in patients with resected stage I and II non-small-cell carcinoma of the lung. The Ludwig Lung Cancer Study Group.

    abstract::The pattern of failure was studied in 1012 patients with resected Stage I or II non-small-cell carcinoma of the lung. Initial intrathoracic failure (41%) was more common than initial extrathoracic failure (34%) even though a complete resection was the intent in all patients. The most frequent sites of initial failure ...

    journal_title:Annals of surgery

    pub_type: 杂志文章



    更新日期:1987-01-01 00:00:00

  • 2,500 living donor kidney transplants: a single-center experience.

    abstract:OBJECTIVE:To review a single center's experience and outcome with living donor transplants. SUMMARY BACKGROUND DATA:Outcome after living donor transplants is better than after cadaver donor transplants. Since the inception of the authors' program, they have performed 2,540 living donor transplants. For the most recent...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Matas AJ,Payne WD,Sutherland DE,Humar A,Gruessner RW,Kandaswamy R,Dunn DL,Gillingham KJ,Najarian JS

    更新日期:2001-08-01 00:00:00

  • Long term transhepatic intubation for hilar hepatic duct strictures.

    abstract::A technique for repairing benign hilar hepatic duct strictures using transhepatic intubation with a large bore silastic stent is described. This procedure has been used in 10 patients. In 9 instances the stricture involved the common hepatic duct, and in one patient the right and left hepatic ducts. Nine of the strict...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Cameron JL,Skinner DB,Zuidema GD

    更新日期:1976-05-01 00:00:00

  • The preoperative and intraoperative hemodynamic predictors of postoperative myocardial infarction or ischemia in patients undergoing noncardiac surgery.

    abstract::Among hypertensive and diabetic patients undergoing elective noncardiac surgery, preoperative status and intraoperative changes in mean arterial pressure (MAP) were evaluated as predictors of postoperative ischemic complications. Of 254 patients evaluated before operation and monitored during operation, 30 (12%) had p...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Charlson ME,MacKenzie CR,Gold JP,Ales KL,Topkins M,Fairclough GP Jr,Shires GT

    更新日期:1989-11-01 00:00:00

  • A lethally irradiated allogeneic granulocyte-macrophage colony stimulating factor-secreting tumor vaccine for pancreatic adenocarcinoma. A Phase II trial of safety, efficacy, and immune activation.

    abstract:PURPOSE:Surgical resection provides the only possibility of cure for pancreas cancer. A standard adjuvant approach has not been established. We tested the safety and efficacy of a granulocyte-macrophage colony-stimulating factor (GM-CSF)-based immunotherapy administered in patients with resected pancreatic adenocarcino...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Lutz E,Yeo CJ,Lillemoe KD,Biedrzycki B,Kobrin B,Herman J,Sugar E,Piantadosi S,Cameron JL,Solt S,Onners B,Tartakovsky I,Choi M,Sharma R,Illei PB,Hruban RH,Abrams RA,Le D,Jaffee E,Laheru D

    更新日期:2011-02-01 00:00:00

  • Choledochal cyst in the adult.

    abstract:OBJECTIVE:The authors examined the natural history of choledochal cysts in adults treated surgically. BACKGROUND:An initial diagnosis of choledochal cyst is uncommon in adults. The recommended treatment is excision, rather than bypass, to achieve effective biliary drainage and because of the risk of cancer. METHODS:A...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Stain SC,Guthrie CR,Yellin AE,Donovan AJ

    更新日期:1995-08-01 00:00:00

  • Outcomes After Multidisciplinary Management of Primary Mediastinal Germ Cell Tumors.

    abstract:OBJECTIVE:We examined management strategies, overall survival (OS), and progression-free survival (PFS) among patients with PMNSGCTs undergoing resection and multidisciplinary management at a high-volume institution. SUMMARY OF BACKGROUND DATA:Outcomes after resection of PMNSGCTs are not well-characterized, with limit...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Caso R,Jones GD,Bains MS,Hsu M,Tan KS,Feldman DR,Funt SA,Reuter VE,Bosl GJ,McHugh D,Huang J,Molena D,Amar D,Fischer G,Rusch VW,Jones DR

    更新日期:2020-01-21 00:00:00

  • Aneurysm of sinus of Valsalva with coronary atherosclerosis: successful surgical correction.

    abstract::A case of acquired aneurysm of the sinus of Valsalva, associated with severe coronary atherosclerosis and successfully treated surgically, is reported. The unusual features of the case are the presenting symptom (angina pectoris) and the cause of the aneurysm (severe coronary atherosclerosis). ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Debakey ME,Lawrie GM

    更新日期:1979-03-01 00:00:00