Abstract:
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.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Moore L,Stelfox HT,Turgeon AF,Nathens A,Bourgeois G,Lapointe J,Gagné M,Lavoie Adoi
10.1097/SLA.0000000000000624subject
Has Abstractpub_date
2014-07-01 00:00:00pages
179-87issue
1eissn
0003-4932issn
1528-1140journal_volume
260pub_type
杂志文章,多中心研究abstract:OBJECTIVE:The aim of this study was to obtain feedback from key stakeholders and end users to identify program strengths and weaknesses to plan for wider dissemination and implementation of the Virtual Acute Care for Elders (Virtual ACE) program, a novel intervention that improves outcomes for older surgical patients. ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004433
更新日期:2020-11-16 00:00:00
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
doi:10.1097/SLA.0000000000003514
更新日期:2019-11-01 00:00:00
abstract::Two patients with aortic abdominal aneurysms in association with horseshoe kidney are presented, making a total of 34 cases recorded in the literature. In 29 patients, the aneurysm was resected and five patients were non-resectable. Because of the abnormalities in vascular supply to the abnormal kidney, it is importan...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197503000-00015
更新日期:1975-03-01 00:00:00
abstract::Arterial blood flow was measured in dogs simultaneously with electromagnetic flow probes and with ultrasonic "flow probes." The ultrasonic probes were used to determine transcutaneously the mean velocity of arterial flow and the cross-sectional area of the blood vessel. A 10 MHz probe was used for blood vessels 1 cm d...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198204000-00013
更新日期:1982-04-01 00:00:00
abstract:OBJECTIVE:To identify patient characteristics associated with the development of local recurrence and the effect of local recurrence on subsequent morbidity and mortality in patients with intermediate- to high-grade extremity soft tissue sarcomas. SUMMARY BACKGROUND DATA:Numerous studies on extremity soft tissue sarco...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.SLA.0000048448.56448.70
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:To determine the DNA replication error (RER) status in young patients with colorectal cancer (CRC), and to compare the clinical and pathologic characteristics of RER-positive and RER-negative cases. SUMMARY BACKGROUND DATA:Recent studies suggest that patients with RER-positive CRC have an improved prognosis....
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199801000-00008
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:To determine the incidence of Wnt pathway activation in patients with stage I NSCLC and its influence on lung cancer recurrence. BACKGROUND:Despite resection, the 5-year recurrence with localized stage I nonsmall cell lung cancer (NSCLC) is 18.4%-24%. Aberrant Wnt signaling activation plays an important role...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31826d81fd
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:To analyze the histopathological indicators significantly associated with surgical outcome and the pattern of recurrence in the setting of preoperative gemcitabine-based chemoradiation therapy (CRT) and subsequent pancreatectomy. BACKGROUND:Clinicopathological assessment of the resected specimen is an indisp...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31823d813c
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:To assess relative clinical and economic performance of the revised American Thyroid Association (ATA) thyroid cancer guidelines compared to current standard of care. BACKGROUND:Diagnosis of thyroid cancer in the United States has tripled whereas mortality has only marginally increased. Most patients present...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003074
更新日期:2020-04-01 00:00:00
abstract::Blunt carotid artery trauma is uncommon but has been associated with severe, permanent neurologic deficits in 42% and mortality in 30% of 96 patients previously reported in the English literature. Since neurologic symptoms characteristically develop only after a latent interval and since physical evidence of significa...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198003000-00014
更新日期:1980-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the preoperative relationships of hypertension and diabetes mellitus in severe obesity and the effects of gastric bypass (GBP)-induced weight loss. SUMMARY BACKGROUND DATA:Severe obesity is associated with multiple comorbidities, particularly hypertension and type 2 diabetes mellitus, that may af...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.SLA.0000071560.76194.11
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:The advice to individuals with identified CDH1 mutations is generally to undertake prophylactic total gastrectomy (PTG). This study evaluated the effect of PTG on health-related quality of life (HRQL) in asymptomatic individuals with identified CDH1 mutations at high risk for gastric cancer. METHODS:Individ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000000446
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:To determine the survival curves for laparoscopic resection (LR) of colorectal cancer. SUMMARY BACKGROUND DATA:Laparoscopic resection for cure of colorectal cancer is controversial, and survival curves have not been determined. METHODS:A prospective database of 177 consecutive LRs of colorectal cancers perf...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199904000-00006
更新日期:1999-04-01 00:00:00
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
doi:10.1097/00000658-199009000-00002
更新日期:1990-09-01 00:00:00
abstract:OBJECTIVE:To investigate adverse event free admissions as a potential, patient-centered indicator aligned directly with the goal of patient safety-freedom from harm. BACKGROUND:Preventable adverse event rates in healthcare could be further reduced. These are generally measured separately, one adverse event at a time. ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001792
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:Evaluate the value of cytology relative to imaging features in risk assessment for malignancy as defined in the Sendai Guidelines. BACKGROUND:The Sendai Guidelines list symptoms, cyst size >30 mm, dilated main pancreatic duct (MPD) >6 mm, mural nodule (MN) and "positive" cytology as high risk stigmata for ma...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182383118
更新日期:2011-12-01 00:00:00
abstract::Is colon cancer surgery justified in the very elderly from the standpoint of cost and 3-year survival rates? Two hundred eighty patients undergoing major surgery for colon cancer during 1981-1983 were divided into a group of 61 with ages greater than or equal to 80 (GE80) and 219 less than 80 (LT80). Although those GE...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198602000-00003
更新日期:1986-02-01 00:00:00
abstract:OBJECTIVE:To compare the accuracy of the modified Fried Index (mFI) and the Clinical Frailty Scale (CFS) to predict death or patient-reported new disability 90 days after major elective surgery. BACKGROUND:The association of frailty with patient-reported outcomes, and comparisons between preoperative frailty instrumen...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000002967
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:The aim of this study is to assess CT-PET and endoscopic assessment postneoadjuvant chemoradiotherapy (nCRT) in predicting complete pathologic response (pCR) in locally advanced esophageal cancer (LAEC). DESIGN:A prospective cohort study. BACKGROUND:nCRT is increasingly standard of care in LAEC, with pCR a ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001902
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Hospitals increasingly rely on surgical quality assessment programs that require considerable resources to capture outcomes after hospital discharge. However, it is unclear whether capturing postdischarge complications and deaths is important. Our objectives were (1) to determine the frequency of postdischar...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181e4846e
更新日期:2010-07-01 00:00:00
abstract::In a five-year study of massive upper gastrointestinal hemorrhage, 143 patients had esophageal varices diagnosed on emergency endoscopic examination. Seventy-one patients had active bleeding from varices and required Sengstaken tube tamponade during at least one hospital admission. The remaining patients included 33 w...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198110000-00015
更新日期:1981-10-01 00:00:00
abstract:OBJECTIVE:To investigate the safety of radical resection for retroperitoneal sarcoma (RPS). BACKGROUND:The surgical management of RPS frequently involves complex multivisceral resection. Improved oncologic outcomes have been demonstrated with this approach compared to marginal excision, but the safety of radical resec...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000002250
更新日期:2018-05-01 00:00:00
abstract::This study determines the infiltration rate of proximal and distal margins of resection in patients operated on for gastric cancer at the Istituto Nazionale Tumori of Milan. Two hundred and eighty-five proximal margins and 286 distal margins were reviewed, and the incidence of infiltration was related to the length of...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198212001-00012
更新日期:1982-12-01 00:00:00
abstract::Staging laparotomy (multiple liver and lymph node biopsies and splenectomy) was performed at the North Carolina Baptist Hospital in 123 patients with Hodgkin's disease. There were no deaths. Wound, pulmonary, intra-abdominal or urinary tract complications developed in 17 patients. Of those complications, one case each...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198005000-00008
更新日期:1980-05-01 00:00:00
abstract::Human lymphocyte antigen (HLA) class I and class II antigens and beta 2 microglobulin (B2M) were identified in peritoneal dialysate (PD) and serum from patients with end-stage renal disease (ESRD) using monoclonal antibodies in an enzyme-linked immunoassay. The HLA class I and class II antigens each exhibited approxim...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199106000-00009
更新日期:1991-06-01 00:00:00
abstract::This prospective study evaluated host resistance in a surgical population who walked into the hospital for elective surgery. Patients were stratified into Hospital Reactive (HR, n = 19) if they reacted to two or more of five recall skin test antigens and Walk-in Anergic (WA, n = 26) if they did not react to the antige...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198404000-00011
更新日期:1984-04-01 00:00:00
abstract::Emergency portacaval shunt for variceal bleeding is associated with a high operative mortality, particularly if used as a last resort. Because of this, a strong case has been made against emergency shunt. This report describes an experience with emergency portacaval shunt for the treatment of variceal bleeding when us...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198707000-00007
更新日期:1987-07-01 00:00:00
abstract:OBJECTIVE:To examine whether case managers affect patient evaluation/treatment/outcome and staffing requirements during Multiple Casualty Incidents (MCIs). SUMMARY BACKGROUND DATA:Multiple patient relocations during MCIs may contribute to chaos. One hospital changed its MCI patient relocation policy during a wave of M...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31819a6f17
更新日期:2009-03-01 00:00:00
abstract::One hundred forty-eight patients were treated with preoperative radiation therapy and surgery for resectable rectal adenocarcinoma at the University of Florida between 1975 and 1986. All patients had at least 5 years' follow-up; no patient was lost to follow-up. Three treatment protocols were used over the study perio...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199206000-00017
更新日期:1992-06-01 00:00:00
abstract::Thirty-two conditioned 15-18 kg dogs underwent laparotomy, heparinization, left lateral hepatic lobe injury and subsequent partial left lateral hepatic lobectomy. The hemostatic capabilities of the surgical scalpel combined with suture ligatures and stay sutures, the Bovie, and the CO2 laser were compared. The CO2 las...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197501000-00016
更新日期:1975-01-01 00:00:00