Abstract：
BACKGROUND:Several reports have indicated the benefits of the acute care surgery (ACS) model in surgical outcomes. We tried to delineate the impact of the ACS model on surgical efficiency and quality. METHODS:Before the ACS model was implemented, abdominal surgical emergencies were evaluated by an on-call nontrauma general surgeon (pre-ACS model). An in-house trauma surgeon treated all patients with trauma or nontrauma abdominal surgical emergencies after the ACS model. Patients with acute appendicitis who underwent appendectomies were included. We conducted a pre- and poststudy to compare the time patients were in the emergency department and surgical qualities. RESULTS:There were 146 and 159 patients enrolled in the pre-ACS model and ACS model, respectively. The overall ED length of stay in the ACS model was significantly shorter than that in the pre-ACS model (300.3 ± 61.7 vs 719.1 ± 339.0 minutes, P < .001). Hospital LOS was also significantly shorter in the ACS model than in the pre-ACS model (2.44 ± 1.39 vs 3.83 ± 2.21 days, P = .022). CONCLUSION:The ACS model may improve abdominal surgical efficiency and quality. Our study results echoed the benefits of the implementation of the ACS model shown in North America.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Fu CY,Huang HC,Chen RJ,Tsuo HC,Tung HJdoi
10.1016/j.amjsurg.2013.04.016subject
Has Abstractpub_date
2014-11-01 00:00:00pages
794-799issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(13)00452-2journal_volume
208pub_type
杂志文章abstract：BACKGROUND:Laparoscopic adjustable gastric banding (LAGB) is an option for the treatment of severe obesity. Few US studies have reported long-term outcomes. We aimed to present long-term outcomes with LAGB. METHODS:Retrospective study of patients who underwent LAGB at an academic medical center in the US from 1/2005 t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.06.027
更新日期：2018-01-01 00:00:00
abstract：:Meckel's diverticulum is the most common congenital abnormality of the small intestine, occurring in about 2 per cent of the population. Complications of a Meckel's diverticulum, including hemorrhage, inflammation, bowel obstruction, and neoplasms, occur in 15 to 33 per cent of cases and invariably demand operative tr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90345-1
更新日期：1975-06-01 00:00:00
abstract：BACKGROUND:Since 1977, we have studied preoperative treatments using 5-fluorouracil (5-FU) suppositories alone or in combination with radiation to reduce local recurrence and improve survival of patients with rectal cancer. PATIENTS AND METHODS:We developed a novel preoperative therapy combining radiation, intralumina...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/S0002-9610(97)89639-0
更新日期：1996-03-01 00:00:00
abstract：:Reports in the surgical literature are conflicting as to whether appendectomy "in passing" during laparotomy for trauma or for some other disease state does or does not significantly increase patient morbidity or mortality. A chart survey of all appendectomies (342 for acute appendicitis and 146 as incidental procedur...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0002-9610(83)90150-2
更新日期：1983-06-01 00:00:00
abstract：BACKGROUND:Emergency hernia repairs comprise one of the most common procedures performed in elderly patients and also carry a high risk of mortality and morbidity. The aim of this study was to examine the factors that might have an influence on the outcome of emergency hernia repairs in elderly patients. METHODS:A rev...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(01)00765-6
更新日期：2001-11-01 00:00:00
abstract：BACKGROUND:Trovafloxacin, a broad-spectrum fourth-generation quinolone with gram-positive and gram-negative aerobic and anaerobic bacterial activity, is available in oral and intravenous formulations. The objective of this prospective, multicenter, double-blind, randomized study was to compare the efficacy of trovaflox...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1016/s0002-9610(98)00223-2
更新日期：1998-12-01 00:00:00
abstract：:The diagnosis of ventilator-associated pneumonia in the surgical intensive care unit continues to be problematic. The majority of intensive care units use clinical criteria based on chest x-ray; fever; leukocytosis; alterations in the pulse oximeter observations; the need to alter modes and amounts of ventilatory supp...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：
更新日期：2000-02-01 00:00:00
abstract：:The records of patients treated for upper gastrointestinal bleeding from 1974 through 1978 were reviewed. Five percent of this group (69 patients) had bleeding due to the Mallory-Weiss syndrome. Only 36 percent of patients had a correct admitting diagnosis. Esophagogastroscopy proved the most reliable diagnostic tool,...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90425-6
更新日期：1981-11-01 00:00:00
abstract：PURPOSE:Vascular smooth muscle cell (VSMC) proliferation is an early event in the pathogenesis of atherosclerosis. Insulin and glucose are known to stimulate the growth of VSMC. Cell membrane receptors play an important role in the proliferation of VSMC in response to growth factors. Insulin and insulin-like growth fac...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)00150-6
更新日期：1999-08-01 00:00:00
abstract：BACKGROUND:An ideal treatment method for the widely prevalent pilonidal sinus disease is not yet available. The most commonly practiced technique is simple closure following resection of the effected tissue. However, high recurrence rates in some series have led to the search for other methods. One of these methods is ...
journal_title：American journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2008.12.030
更新日期：2010-02-01 00:00:00
abstract：:Severe fasting hypoglycemia and hypoinsulinemia occurred in a sixty-six year old woman with an intrahepatic mesenchymal tumor. An extract from the tumor was potent in inhibiting the arginine-induced glucagon secretion from the isolated perfused porcine pancreas. This observation supports the theory recently advanced t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90095-8
更新日期：1978-02-01 00:00:00
abstract：:The role of preoperative localization tests in patients undergoing initial neck exploration for hyperparathyroidism (HPT) is controversial. The use of parathyroid ultrasonography (US) in 46 patients (7 men, 39 women; mean age: 60 years) who underwent initial neck exploration for hypercalcemia and who had the diagnosis...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80900-6
更新日期：1992-10-01 00:00:00
abstract：:AbdCT for the evaluation of AAP in the ED in the US may be excessive and is potentially (although rarely) misleading and harmful. A selective policy of 'AbdUS first' combined with an observation unit and/or surgeon evaluation prior to AbdCT is preferred to a 'routine AbdCT' policy. Repeated AbdCTs for abdominal pain a...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2019.02.003
更新日期：2019-05-01 00:00:00
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 f...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.09.007
更新日期：2014-03-01 00:00:00
abstract：BACKGROUND:Recent literature suggests that peritoneal drainage (PD) is not helpful after elective pancreatectomy and may be detrimental. Data specific to distal pancreatectomy (DP) have not received prior evaluation. METHODS:We performed a retrospective review of patients who underwent DP. Factors examined included po...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.02.005
更新日期：2012-10-01 00:00:00
abstract：BACKGROUND:Skin-sparing mastectomy represents a new surgical approach that allows a mastectomy while preserving the natural skin envelope of the breast. It facilitates immediate breast reconstruction using an implant or myocutaneous flap, resulting in excellent cosmesis. DATA SOURCES:A PubMed database literature searc...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2004.02.004
更新日期：2004-07-01 00:00:00
abstract：BACKGROUND:Recent advances in computed tomographic (CT) imaging have improved the detection rate of pulmonary metastasis. The aim of this study was to test the hypothesis that the pulmonary nodule detection rate for preoperative CT imaging and intraoperative palpation are now equivalent. METHODS:A retrospective review...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2011.01.005
更新日期：2011-05-01 00:00:00
abstract：OBJECTIVE:To assess the oncologic effectiveness of the selective neck dissection (SND) in patients with both clinically and pathologically proven regional metastases. METHODS:A 4-year retrospective medical chart review was conducted in an academic tertiary care referral center. Twenty-nine patients with a newly diagno...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(96)00296-6
更新日期：1996-12-01 00:00:00
abstract：BACKGROUND:Despite impressive results with the Lap-Band in Europe and Australia, the early Food and Drug Administration A trial in the United States showed fairly poor results. This prospective study attempts to determine if the Lap-Band can produce effective weight loss in morbidly obese Americans. METHODS:Five hundr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.08.059
更新日期：2004-12-01 00:00:00
abstract：:Three hundred eight patients underwent parotidectomy for a benign parotid tumor between 1948 and 1979. Two hundred seventy-four had operation for primary tumor, and 34, for recurrent tumor. Ninety-eight percent of those with primary tumors had superficial or total parotidectomy, and 2 percent had local excision with a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90321-1
更新日期：1986-10-01 00:00:00
abstract：:We compared the prevalence of stroke and death in 133 patients aged 75 and older in whom 170 carotid endarterectomies were performed with that in 501 patients less than age 75 in whom 640 carotid endarterectomies were performed. There were three strokes (2%) in patients aged 75 and older and nine strokes (1%) in young...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80753-6
更新日期：1990-12-01 00:00:00
abstract：:The purpose of this experimental study was to test the potential value of heat welding to cut the ends of knotted surgical sutures. This heat process resulted in knot security in a coated polyglactin suture with fewer throws than those needed for the same suture with knotted ends cut by scissors. Results of mechanical...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90069-8
更新日期：1985-09-01 00:00:00
abstract：BACKGROUND:In hepato-pancreato-biliary (HPB) surgery higher volumes are associated with improved outcomes; however, there are limitations to regionalization. Here we report our experience establishing multidisciplinary HPB program at a university-affiliated community hospital. METHODS:This is a retrospective review of...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.03.015
更新日期：2019-11-01 00:00:00
abstract：PURPOSE:Hanging has become the second most common method of attempted suicide among adolescents, but there is little relevant epidemiologic or outcome data in the trauma literature. Additionally, there are no studies examining the degree of functional disability among survivors of hanging injury. METHODS:The National ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.05.051
更新日期：2005-12-01 00:00:00
abstract：BACKGROUND:Peritoneal macrophages play an important role in the immune response after abdominal operations. The stress response after these operations has been associated with impaired phagocytosis by peritoneal macrophages. This study examined the influence of minimally invasive techniques and preoperative corticoster...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.07.023
更新日期：2008-12-01 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：BACKGROUND:We surveyed surgeons to document their attitudes, practice, and risk tolerance regarding the treatment of appendicitis. METHODS:A web-based survey was sent to the EAST membership. The primary composite endpoint was defined as 1-year incidence of perioperative complications, antibiotic failure, infections, E...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.08.019
更新日期：2019-07-01 00:00:00
abstract：:Surgical experience with adrenal disease from 1970 to 1979 was reviewed in 315 patients. The pathologic conditions that were encountered were hypercortisolism (74 patients), hyperaldosteronism (46 patients), adrenocortical carcinoma (35 patients), pheochromocytoma (77 patients), and nonfunctioning adenoma (47 patients...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90571-2
更新日期：1982-11-01 00:00:00
abstract：BACKGROUND:Administrative data can be used to identify cases of postoperative respiratory failure (PRF). We aimed to determine if recent changes to the Agency for Healthcare Research and Quality Patient Safety Indicator 11 (PSI 11) and adoption of clinical documentation improvement programs have improved the validity o...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2019.11.019
更新日期：2020-07-01 00:00:00
abstract：BACKGROUND:Predicting length of stay (LOS) is difficult for trauma and emergency general surgery (TEGS) patients. Our aim was to determine the accuracy of LOS predictions by TEGS team members and the NSQIP Risk Calculator and the patient factors associated with inaccurate predictions. METHODS:LOS for 200 TEGS patients...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.01.055
更新日期：2020-09-01 00:00:00
