Abstract:
OBJECTIVE:To review the methodology employed in surgical mortality studies to control for potential confounders. SUMMARY BACKGROUND DATA:Nationwide hospital data are increasingly used to investigate surgical outcomes. However, poor data granularity and coding inaccuracies may lead to flawed findings. METHODS:We conducted a systematic review in accordance with the PRISMA statement in 6 major journals (NEJM, Lancet, BMJ, JAMA, Medical Care, Annals of Surgery) using PubMed from its inception until December 31, 2014. Two reviewers independently reviewed citations. Using a predesigned data collection form, we extracted information about study aim and design, data source, selected population, outcome definition, patient and hospital adjustment, statistics, and sensitivity analyses. The methodological quality of studies was assessed based on 5 criteria and explored over time. RESULTS:Among 89 included studies from 1987 to 2014, 54 explored surgical mortality determinants, 13 compared surgical procedure effectiveness, 13 evaluated the impact of healthcare policy, and 9 described outcome trends for specific procedures. A total of 89% (n = 79) of studies did not describe population selection criteria at patient and hospital level, 64% (n = 57) did not consider secular trends, 52% (n = 46) neglected hospital clustering or characteristics, 21% (n = 19) did not perform sensitivity analyses, and 4% did not adjust outcomes for patient risk (n = 4). The percentage of studies satisfying at least 3 of these criteria increased significantly from 44% before 1999 to 52% between 2000 and 2009 and 78% after 2010 (P = 0.008). CONCLUSIONS:Although methodological quality of studies has improved over time, confounder control could be improved through better study design, homogeneous population selection, the consideration of hospital factors and secular trends influencing surgical mortality, and the systematic performance of sensitivity analyses.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Payet C,Lifante JC,Carty MJ,Rabilloud M,Duclos Adoi
10.1097/SLA.0000000000002119subject
Has Abstractpub_date
2017-06-01 00:00:00pages
1113-1118issue
6eissn
0003-4932issn
1528-1140journal_volume
265pub_type
杂志文章,评审abstract:OBJECTIVE:The aim of the study was to assess feasibility and outcomes of a multicenter training program in laparoscopic pancreatoduodenectomy (LPD). BACKGROUND:Whereas expert centers have reported promising outcomes of LPD, nationwide analyses have raised concerns on its safety, especially during the learning curve. M...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000002563
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To report on the results of a prospective longitudinal study of a new bowel-sparing procedure (side-to-side isoperistaltic strictureplasty [SSIS]) in patients with extensive Crohn's disease. METHODS:Between January 1992 and April 1999, the authors operated on 469 consecutive patients for Crohn's disease of t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200009000-00012
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVE:To investigate the expression of interferon regulatory factors 1 and 2 (IRF-1 and IRF-2) in human breast cancer. SUMMARY BACKGROUND DATA:Interferon regulatory factors 1 and 2 are transcription factors in the interferon gamma signal transduction pathway. IRF-1 acts as the effector arm of the interferon gamma ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200105000-00005
更新日期:2001-05-01 00:00:00
abstract::Most patients with Marfan's syndrome have cardiovascular manifestations and complications of these abnormalities lead to death in 50% of patients by the age of 32. This report is concerned with the performance of 79 operations to control these problems in 41 patients during a 16-year period. There were 3 early deaths ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198310000-00009
更新日期:1983-10-01 00:00:00
abstract:OBJECTIVE:The authors evaluated the outcome and potential prognostic factors of 60 patients with surgically resected periampullary tumors. SUMMARY BACKGROUND DATA:Periampullary carcinomas exhibit different clinical behaviors according to their site of origin. There are no prognostic factors for deciding the type of su...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199511000-00005
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVE:We reviewed our experience with pediatric chest wall tumors (CWTs) to identify variables associated with survival, scoliosis development, and need for corrective scoliosis surgery. BACKGROUND:Chest wall neoplasms in children or adolescents are rare. Consequently, there are few large series that detail surviv...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003495
更新日期:2019-07-25 00:00:00
abstract::One-hundred and forty eight patients operated upon for chronic pancreatitis were reviewed retrospectively in 5-20 year followup. Treatment was by drainage of the duct of Wirsung to adefunctionalized jejunal loop, distal pancreatectomy, pancreato-duodenectomy, splanchnicectomy with an operative mortality of 5%. Influen...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197408000-00010
更新日期:1974-08-01 00:00:00
abstract::Twenty-one children from the ages of 4 to 12 years old were treated for esophageal hemorrhage by distal splenorenal shunt (DSS). In four patients, thrombosis of the shunt occurred within the first 24 hours after operation. In the other 17 children, long-term shunt patency was verified. Only one thrombosis has occurred...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198204000-00004
更新日期:1982-04-01 00:00:00
abstract::Analysis of experience with chronic bleeding peptic ulcer in 504 patients, admitted from 1960 to 1971, shows a hospital mortality of 12%. This retrospective review suggested that early endoscopic diagnosis, adequate resuscitation and a policy of early selective surgery was necessary if mortality was to be reduced. Wit...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198401000-00008
更新日期:1984-01-01 00:00:00
abstract::Extracorporeal Membrane Oxygenation (ECMO) has been available to neonates with respiratory failure at the University of Michigan School of Medicine since June 1981. In order to evaluate the impact of this type of pulmonary support, a retrospective analysis of 50 neonates with posterolateral congenital diaphragmatic he...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-198902000-00014
更新日期:1989-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the potential benefit of cytology of the peritoneal lavage obtained during diagnostic laparoscopy for staging gastrointestinal (GI) malignancies. SUMMARY BACKGROUND DATA:Peritoneal lavage is a simple procedure that can be performed during laparotomy for GI tumors. Tumor cells in the lavage fluid ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199812000-00002
更新日期:1998-12-01 00:00:00
abstract::The use of amputation in extremity soft tissue sarcoma has been decreasing at Memorial Sloan-Kettering Cancer Center (MSKCC) over the last 15 years. In an attempt to define the efficacy and future role of amputation in extremity soft tissue sarcoma, a prospective sarcoma database compiled at MSKCC from July 1982 to Ja...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199203000-00012
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:While stereotactic ablative radiotherapy (SABR) is increasingly emerging as an alternative to surgery for node-negative non-small cell lung cancer (NSCLC), there is poor understanding of patients who may most benefit SABR compared to surgery. OBJECTIVE:This study examined the relationship between tumor size...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004730
更新日期:2021-01-07 00:00:00
abstract::Inclusion of vagotomy and pyloroplasty in the surgical treatment of gastroesophageal reflux associated with hiatal hernia has long been controversial. To evaluate the morbidity of vagotomy in the treatment of reflux esophagitis, a retrospective study of 311 patients treated by the Hill posterior gastropexy technique o...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197606000-00003
更新日期:1976-06-01 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 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
doi:10.1097/01.sla.0000157268.78543.03
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVE:To compare surgical versus medical treatment of type 2 diabetes mellitus (T2DM) remission and comorbidities in patients with a body mass index (BMI) less than 35 kg/m2. BACKGROUND:Obesity surgery can achieve remission of T2DM and its comorbidities. Metabolic surgery has been proposed as a treatment option fo...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1097/SLA.0000000000001014
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:To examine the financial impact of quality improvement using Medicare payment data. BACKGROUND:Demonstrating a business case for quality improvement--that is, that fewer complications translates into lower costs--is essential to justify investment in quality improvement. Prior research is limited to cross-se...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001069
更新日期:2015-08-01 00:00:00
abstract::The purpose of this report is to review the results of mitral valve replacement since a first report in the Annals of Surgery in 1961, in order to determine the relative importance of new valve designs versus other surgical variables. The continued use of the silastic ball valve in its 1966 configuration (Model 6120),...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198509000-00016
更新日期:1985-09-01 00:00:00
abstract:OBJECTIVE:This study evaluates surgical procedures for Crohn's colitis. The risk of recurrence and how it interacts with future avoidance of permanent stoma and quality of life (QoL) is studied. BACKGROUND:Segmental and subtotal colectomy are widely used surgical options in isolated Crohn's colitis. It is not clear wh...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318212b1a4
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the influence of modest endotoxemia on postoperative antithrombin deficiency and cholestasis. SUMMARY BACKGROUND DATA:It has not been determined whether endotoxin translocation in small amounts is a physiological phenomenon or whether it is a potential health hazard. METHODS:Blood endotoxin, ant...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000082711.77096.71
更新日期:2003-08-01 00:00:00
abstract::Infected (mycotic) aortic aneurysms are infrequent and, without surgical intervention, usually lead to uncontrolled sepsis or catastrophic hemorrhage. Symptoms are frequently absent or non-specific during the early stages, and a high index of suspicion is essential to make the diagnosis. Surgery performed after ruptur...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199205000-00005
更新日期:1992-05-01 00:00:00
abstract:OBJECTIVE:To assess the impact of a laparoscopic approach on female fecundity in ileoanal pouch surgery. BACKGROUND:Restorative proctocolectomy with ileal pouch anal anastomosis (IPAA) is associated with tubal factor infertility in female patients. Different studies showed less adhesion formation after laparoscopic co...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SLA.0b013e318250caa9
更新日期:2012-12-01 00:00:00
abstract::Fifty-one adult patients were referred for surgical treatment during the time period from July 1980 to November 1985. The average age was 59 +/- 6 years (19-70 years). All patients had symptomatic ventricular tachycardia that was refractory to standard or experimental drug therapy. On the basis of patient condition, s...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198606000-00013
更新日期:1986-06-01 00:00:00
abstract::Five patients were studied before and two to three days after major, uncomplicated abdominal operation. Muscle tissue was obtained by needle biopsy from m. quadriceps femoris after eight hours overnight fast. Plasma free amino acids were analyzed in simultaneously obtained samples. In the homogenized muscle samples th...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197512000-00001
更新日期:1975-12-01 00:00:00
abstract::Current treatment modalities for thrombotic thrombocytopenic purpura (TTP) include plasmapheresis (PP), splenectomy, steroids, dextran, other antiplatelet agents, and vinca alkaloids. Prior to the development of PP and use of multimodality treatment for TTP, mortality rates exceeded 50%. This report reviews 11 patient...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198509000-00007
更新日期:1985-09-01 00:00:00
abstract::Thromboxane (Tx) synthase but not cyclo-oxygenase inhibitors prevent acute tubular necrosis (ATN) after renal ischemia, a phenomenon believed to be due to stimulation of the endogenous production of vasodilating prostaglandins (PG). This study directly tests that vasodilating PG protect against the consequences of ren...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198702000-00015
更新日期:1987-02-01 00:00:00
abstract:OBJECTIVE:To measure plasma levels of angiopoietin-1 (Ang-1), angiopoietin-2 (Ang-2), and vascular endothelial growth factor (VEGF) early after trauma and to determine their clinical significance. BACKGROUND:Angiopoietins and VEGF play a central role in the physiology and pathophysiology of endothelial cells. Ang-2 ha...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318162d616
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:The management and outcome of 138 abdominal shotgun wounds were examined over a 5-year period. SUMMARY BACKGROUND DATA:It has been proposed that exploratory laparotomy may be unnecessary and even overused in a subset of patients with abdominal shotgun wounds. METHODS:Data on shotgun wound patients from Octo...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199503000-00009
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVE:To report survival, functional, and quality-of-life (QoL) outcomes after extended radical resection for advanced pelvic tumors with en bloc sciatic or femoral nerve resection. BACKGROUND:Advanced pelvic tumors involving the sciatic or femoral nerve have traditionally been considered inoperable. Small studies...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003390
更新日期:2019-06-07 00:00:00