Abstract：
BACKGROUND:The objective of this study was to characterize variations in packed red blood cell (PRBC) transfusion practices in critically ill patients and to identify which factors influence such practices. We hypothesized that significant variation in transfusion triggers exists among acute care surgeons. METHODS:A survey of PRBC transfusion practices was administered to the American Association for the Surgery of Trauma members. The scenarios examined hemoglobin thresholds for which participants would transfuse PRBCs. RESULTS:A hemoglobin threshold of less than or equal to 7 g/dL was adopted by 45% of respondents in gastrointestinal bleeding, 75% in penetrating trauma, 66% in sepsis, and 62% in blunt trauma. Acute care surgeons modified their transfusion trigger significantly in the majority of the modifications of these scenarios, often inappropriately so. CONCLUSIONS:This study documents continued evidence-practice gaps and wide variations in the PRBC transfusion practices of acute care surgeons. Numerous clinical factors altered such patterns despite a lack of supporting evidence (for or against).
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Sim V,Kao LS,Jacobson J,Frangos S,Brundage S,Wilson CT,Simon R,Glass NE,Pachter HL,Todd SRdoi
10.1016/j.amjsurg.2014.08.024subject
Has Abstractpub_date
2015-07-01 00:00:00pages
45-51issue
1eissn
0002-9610issn
1879-1883pii
S0002-9610(14)00518-2journal_volume
210pub_type
杂志文章abstract：BACKGROUND:Medical students often experience difficulty comprehending anatomic relationships of complex operations to which they are exposed during surgical clerkship. Pancreaticoduodenectomy, the Whipple procedure, is one such operation. Although video recordings are available to facilitate the learning of the Whipple...
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/s0002-9610(98)00201-3
更新日期：1998-10-01 00:00:00
abstract：BACKGROUND:To assess the impact of adding a surgical oncologist to our faculty we examined the operative experience in our program before and after the addition. METHODS:Operative case numbers reported to the American Board of Surgery over a 10-year period were analyzed. This time period encompassed 5 years before and...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.01.001
更新日期：2004-01-01 00:00:00
abstract：BACKGROUND:Hepatic portal venous gas is an unusual entity associated with a variety of abdominal catastrophes. There is usually a grave prognosis when hepatic portal venous gas is associated with ischemic bowel disease. We reported a 57-year-old man with hepatic portal venous gas associated with extensive infarction of...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.09.014
更新日期：2005-04-01 00:00:00
abstract：BACKGROUND:We describe the presentation, diagnostic pathway, and management of 28 patients with benign retroperitoneal schwannomas. METHODS:A prospectively kept soft-tissue tumor database was reviewed to identify patients who presented to the Royal Marsden Hospital with retroperitoneal schwannomas. RESULTS:From 2001 ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.06.036
更新日期：2011-08-01 00:00:00
abstract：BACKGROUND:Approximately 91% of urologists are male and 9% female. We aim to characterize gender differences amongst urology society awardees over the past six decades. METHODS:We queried 16 American urology societies. Inclusion criteria were active membership enrollment, majority urologist members, and awards provide...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.06.062
更新日期：2020-11-01 00:00:00
abstract：:The records of 125 consecutive patients with unresectable pancreatic cancer treated between 1958 and 1979 were evaluated to determine the benefit or morbidity of gastroenterostomy performed on a routine basis. One hundred three patients had no evidence of gastric outlet obstruction from tumor extension as determined a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90203-4
更新日期：1984-06-01 00:00:00
abstract：:Familial visceral myopathy is a form of chronic intestinal pseudoobstruction in which fibrosis of the smooth muscle of the alimentary tract causes protean symptoms of disordered visceral motility. Based on our 8 year observation of six members of one family with familial visceral myopathy and review of the few well-do...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90017-0
更新日期：1985-07-01 00:00:00
abstract：:Metastatic malignancies of the hand are rare and usually develop from lung, breast, or kidney tumors. Metastases from tumors and sarcomas of the gastrointestinal system are even more uncommon. The authors report a case of differentiated adenocarcinoma of the colon in a 76-year-old man who presented with distal phalang...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.02.016
更新日期：2010-11-01 00:00:00
abstract：BACKGROUND:This study examined trends in breast conservation surgery (BCS) at our hospital and factors associated with BCS. METHODS:We retrospectively reviewed breast cancer surgeries in patients eligible for BCS (size <4 cm, N0, N1) from 1990 through 1996 (n = 634). We calculated the yearly prevalence of BCS and used...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：
更新日期：1998-12-01 00:00:00
abstract：BACKGROUND:Rurality adversely impacts the continuum of cancer care. However, investigations of rural cancer surgery are notably absent. We examined patterns and outcomes of oncologic resections at rural US hospitals. METHODS:We identified 928,370 hospital admissions in which 1 of 20 oncologic resections was performed ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.07.012
更新日期：2012-11-01 00:00:00
abstract：:(1) Emergency thoracotomy can be a lifesaving procedure in critically injured patients who present with no detectable pulse or blood pressure. (2) Emergency thoracotomy is nonproductive if cardiac electrical activity is absent. (3) Best results are achieved in patients with chest injuries and the worst results in thos...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(81)80034-7
更新日期：1981-07-01 00:00:00
abstract：:The histopathology, clinical features, treatment, and results are reported in twenty-nine patients with thymoma. Benign and malignant thymomas are differentiated by their invasive characteristics. Surgical excision is recommended for benign lesions. Surgical excision and postoperative irradiation are recommended for m...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90199-x
更新日期：1978-07-01 00:00:00
abstract：BACKGROUND:Identifying factors associated with resident autonomy may help improve training efficiency. This study evaluates resident and procedural factors associated with level of guidance needed in the operating room. METHODS:Intraoperative performance and yearly performance on Fundamentals of Laparoscopic Surgery (...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.03.019
更新日期：2019-05-01 00:00:00
abstract：:Wounds will readily acquire bacteria, unless protective measures are taken. The bacterial protection afforded by conventional absorbent cellulose dressings has been shown to be limited, particularly in the presence of serous exudate that may compromise dressing integrity. In addition, dressings may shed particles that...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/0002-9610(94)90006-x
更新日期：1994-01-01 00:00:00
abstract：BACKGROUND:The type of inguinal hernia repair used depends on many factors but predominantly the surgeon's training, interpretation of the literature, and personal preference. This prospective cohort study describes a consecutive series of open mesh inguinal hernia repairs (modified Lichtenstein technique) performed as...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/j.amjsurg.2015.04.019
更新日期：2016-01-01 00:00:00
abstract：BACKGROUND:The objective of this study was to compare the outcome of patients presenting with heel ulcers or gangrene (HEEL group) with those having lesions in other parts of the foot (non-HEEL group). METHODS:Treatment and outcomes of all HEEL and non-HEEL patients between June 2001 and October 2006 were compared. R...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.08.008
更新日期：2007-11-01 00:00:00
abstract：BACKGROUND:We propose a simple algorithm for management of patients with challenging abdominal fascial defects. METHODS:The medical records of 64 patients with complicated abdominal wall defects representing a consecutive series by a single surgeon over a 4-year period were reviewed. Group I patients presented with ma...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00566-3
更新日期：2001-02-01 00:00:00
abstract：BACKGROUND:The management of surgical sepsis is challenging because of the complexity of interventions. The authors therefore created a computerized clinical decision support program to facilitate this process, with the goal of improving abdominal sepsis mortality. METHODS:The authors evaluated a prospective database ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.07.036
更新日期：2010-12-01 00:00:00
abstract：:A total of 1,180 patients underwent palliative surgery for pancreatic cancer in the 158 hospitals of the U.S. Department of Veterans Affairs from 1987 to 1991. Using computerized data files, we analyzed these procedures according to type of procedure (gastric bypass only [GO], biliary bypass only [BO], or combined bil...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80669-5
更新日期：1993-12-01 00:00:00
abstract：:The integrity of the normal mature intestinal mucosal barrier to unaltered proteins was evaluated with tritiated bovine albumin in rats. Intact H3-BSA placed into either colon or small intestinal lumen regularly reached the bloodstream in quantities sufficient to be antigenic or toxigenic, although the fraction of H3-...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90193-3
更新日期：1977-01-01 00:00:00
abstract：BACKGROUND:Training and experience vary widely among surgeons performing laparoscopic surgery (LS). Visual perceptual demands are greater for LS than for traditional surgery, necessitating greater understanding of surgeon variables in skill acquisition and performance. METHODS:During an LS skills course incorporating ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(01)00574-8
更新日期：2001-04-01 00:00:00
abstract：:Multiple organ failure (MOF) emerged 30 years ago and became our research focus. Over the years, we have proposed a series of cartoons that rallied multidisciplinary translational research teams around common themes to generate "win-win" hypotheses that when tested (right or wrong) have advanced our understanding of M...
journal_title：American journal of surgery
pub_type：
doi：10.1016/j.amjsurg.2010.05.009
更新日期：2010-12-01 00:00:00
abstract：BACKGROUND:Robotic surgery is increasingly adopted into surgical practice, but it remains unclear what level of robotic training general surgery residents receive. The purpose of our study was to assess the variation in robotic surgery training amongst general surgery residency programs in the United States. METHODS:A...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.11.006
更新日期：2019-02-01 00:00:00
abstract：BACKGROUND:Prognosis in peritoneal carcinomatosis from gastric cancer has improved with cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy. The aim of this study was to identify predictive factors for incomplete CS. METHODS:Forty-five patients undergoing laparotomy for gastric cancer with periton...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.06.009
更新日期：2013-06-01 00:00:00
abstract：BACKGROUND:Academic institutions have increasingly focused on educating physicians and surgeons in concepts of value-based care, including quality improvement (QI). The extent to which QI curricular competencies are addressed in specialty surgical residency training is unclear. METHODS:A survey instrument was develope...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.09.036
更新日期：2020-09-29 00:00:00
abstract：:A selected group of men whose eponyms are currently used in biliary tract surgery are described. The eponyms chosen comprise two areas: gross anatomy (Glisson, Wirsung, Santorini, Winslow, Heister, and Vater) and operative anatomy (Kocher, Courvoisier, Morison, Hartmann, Calot, Roux, and Oddi). A brief review of bilia...
journal_title：American journal of surgery
pub_type： 历史文章,杂志文章
doi：10.1016/0002-9610(79)90290-3
更新日期：1979-12-01 00:00:00
abstract：:The effects of the intravenous bolus administration of famotidine versus the administration of Mylanta II liquid every 2 hours on the pH of the gastric antrum, body, and fundus for 24 hours were compared in 10 critically ill patients admitted to the intensive care unit with isolated cranial trauma. Patients received 3...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-9610(05)80667-1
更新日期：1993-12-01 00:00:00
abstract：BACKGROUND:There is a paucity of literature concerning general anesthesia and surgery in patients with amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease). This report summarizes the largest series of surgical cases in ALS during multicenter prospective trials of the laparoscopic diaphragm pacing system (DPS) t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.11.008
更新日期：2009-03-01 00:00:00
abstract：:Feeding gastrostomy and jejunostomy provide effective access for long-term enteral nutrition. Traditional operative techniques for the performance of these procedures requires laparotomy and often, general anesthesia. This report describes our experience with two relatively new methods, percutaneous endoscopic gastros...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80017-9
更新日期：1985-01-01 00:00:00
abstract：INTRODUCTION:The purpose of this study was to determine if there are clinical features that raise suspicion for parathyroid hyperplasia. MATERIALS & METHODS:We retrospectively reviewed patients with primary hyperparathyroidism who underwent parathyroidectomy from 1991 to 2017, analyzing demographics, calcium and PTH, ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.10.051
更新日期：2018-03-01 00:00:00
