Abstract：
BACKGROUND:ACS-NSQIP classifies hospitals as "high outliers" if their performance is significantly worse than expected. We determined how often hospitals return to as-expected performance after being newly identified as outliers. METHODS:Outlier status was identified in ACS-NSQIP semi-annual reports (SARs) 2008-2011 for 13 postoperative adverse events. Pearson correlation and R2 measured the relationship between frequency of changes in outlier status, frequency of outlier identification, and adverse event rate. RESULTS:Among 284 hospitals, 75% were classified as high outliers for an adverse event at least once. New high outliers frequently did not remain outliers in the next SAR. Of new outliers, mortality had the highest percentage return to as-expected performance (62.7%), while surgical site infection had the lowest (20.5%). The likelihood of an outlier hospital returning to as-expected performance was inversely related to the percentage of hospitals classified as outliers. The percentage of hospitals classified as outliers for an event explained 60% of variation in outlier hospitals returning to as-expected performance. CONCLUSIONS:Outlier status may be less meaningful for adverse events with relatively few outlier hospitals.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Lawson EH,Roberts PL,Francone TD,Marcello PW,Read TE,Ricciardi Rdoi
10.1016/j.amjsurg.2017.07.026subject
Has Abstractpub_date
2018-08-01 00:00:00pages
213-216issue
2eissn
0002-9610issn
1879-1883pii
S0002-9610(17)30792-4journal_volume
216pub_type
杂志文章,多中心研究abstract：BACKGROUND:We conducted a national survey of general surgeons to address the association between surgeon characteristics and the tendency to recommend surgery. METHODS:We used a web-based survey with 25 hypothetical clinical scenarios with clinical equipoise regarding the decision to operate. The respondent-level tend...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.08.018
更新日期：2013-12-01 00:00:00
abstract：:The results of the present study emphasize the importance of minimizing the time delay between a significant elevation in CEA and a second-look operation. Equally important are the frequency of serial determinations, a thorough understanding of the limitations of the assay, and careful evaluation of the clinical condi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90137-5
更新日期：1979-02-01 00:00:00
abstract：:We reviewed the results of 133 bone scans and 63 liver scans (computed tomography, liver-spleen radionuclide scan, or ultrasonography) obtained for the preoperative evaluation of breast cancer patients. Information on the preoperative staging of breast cancer (TNM classification) was available in 131 of 133 patients. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80512-4
更新日期：1993-02-01 00:00:00
abstract：BACKGROUND:A clear understanding of simulation-based curricula in use at American College of Surgeons Accredited Education Institutes (ACS-AEIs) is lacking. METHODS:A 25-question online survey was sent to ACS-AEIs. RESULTS:The response rate approached 60%. The most frequent specialties to use the ACS-AEIs are general...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.08.011
更新日期：2017-04-01 00:00:00
abstract：:Vertebral arteriovenous fistulas are rare. A report of two cases is presented with problems related to diagnosis and therapy. An alternative approach to surgical management is given. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90320-9
更新日期：1979-12-01 00:00:00
abstract：BACKGROUND:Patients with radiographically-identified traumatic brain injury are often transferred to our regional trauma center for neurosurgical evaluation, yet few injuries require neurosurgical intervention. Transfer is costly, inconvenient, and potentially risky in inclement weather. We propose that previously-publ...
journal_title：American journal of surgery
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abstract：:In the period from 1976 through 1986, 62 procedures were performed. Of these, 42 were posterior flap hemipelvectomies, 5 anterior flap hemipelvectomies, and 15 internal hemipelvectomies. The median duration of these procedures was 6.5 hours, and the median blood loss was 2,541 ml. Postoperatively, there were no wound ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90273-0
更新日期：1989-11-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(01)00770-x
更新日期：2001-08-01 00:00:00
abstract：:The ability of the liver to control blood glucose levels was studied in relation to the blood ketone body ratio, which reflects the hepatic mitochondrial redox state. In partially hepatectomized rabbits, postoperative continuous administration of a hyperosmolar glucose solution revealed the following findings: (1) The...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80410-0
更新日期：1988-04-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90204-5
更新日期：1977-01-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90208-0
更新日期：1989-12-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)81207-3
更新日期：1993-02-01 00:00:00
abstract：BACKGROUND:Race and insurance status influence the likelihood of undergoing laparoscopic appendectomy (LA) versus open appendectomy for the treatment of acute appendicitis. We hypothesized that these disparities are caused by presenting hospitals' use of LA. METHODS:The analysis included 26,104 appendectomies for acut...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.11.024
更新日期：2007-07-01 00:00:00
abstract：BACKGROUND:The accuracy of a molecular reverse transcriptase-polymerase chain reaction (RT-PCR)-based assay for metastases detection in axillary sentinel lymph nodes (SLNs) has recently been validated in our institution and adopted as an intraoperative test for breast cancer patient management. METHODS:Molecular assay...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.09.012
更新日期：2009-08-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90115-6
更新日期：1979-04-01 00:00:00
abstract：BACKGROUND:We proposed to develop a novel virtual reality (VR) team training system. The objective of this study was to determine the feasibility of creating a VR operating room to simulate a surgical crisis scenario and evaluate the simulator for construct and face validity. METHODS:We modified ICE STORM (Integrated ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.01.024
更新日期：2015-09-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90128-9
更新日期：1983-06-01 00:00:00
abstract：INTRODUCTION:Sleeve gastrectomy (SG) can be associated with inadequate weight loss, insufficient resolution of co-morbidities and severe reflux. Conversion to Roux-en-Y Gastric Bypass (RYGB) is a potential solution. The aim of this study was to determine the common indications for conversion from SG to RYGB at our cent...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.04.003
更新日期：2017-05-01 00:00:00
abstract：BACKGROUND:The Centers for Disease Control and Prevention reported that surgical site infections (SSIs) create a significant hospital burden. To date, few multi-institutional studies have been performed to evaluate the risk factors for SSIs in mastectomy patients. METHODS:By using the American College of Surgeons' Nat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.05.007
更新日期：2013-02-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90338-0
更新日期：1983-12-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.12.005
更新日期：2011-02-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90154-1
更新日期：1987-06-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(92)90043-q
更新日期：1992-04-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90320-3
更新日期：1983-12-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.10.046
更新日期：2020-07-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.02.003
更新日期：2011-04-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90334-9
更新日期：1984-11-01 00:00:00
abstract：BACKGROUND:The transformation of a trainee into a surgeon is influenced strongly by communication patterns in the operating room (OR). In the current era of limited educational opportunities, elucidation of teaching and learning strategies in this environment is critical. The aim of this study was to further understand...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.01.004
更新日期：2008-05-01 00:00:00
abstract：BACKGROUND:Vacuum Assisted Closure (VAC; Kinetic Concepts, Inc., San Antonio, TX) has been used to successfully treat a variety of complex wounds. This technique was investigated for use in managing Fournier's gangrene following initial debridement. METHODS:Ten patients with Fournier's gangrene were treated in this st...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.04.018
更新日期：2009-05-01 00:00:00
abstract：BACKGROUND:Increased anesthesia time may lead to respiratory complications in patients receiving tracheostomy, which contributes to patient morbidity. METHODS:The American College of Surgeon's National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for cases of planned tracheostomy (CPT 31600) f...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.07.059
更新日期：2018-10-01 00:00:00
