Abstract：
BACKGROUND:This study aims to test associations between perioperative blood transfusion and postoperative morbidity and mortality after major abdominal operations. METHODS:The 2014 ACS NSQIP dataset was queried for all patients who underwent one of the ten major abdominal operations. Separate multivariable regression models, were developed to evaluate the independent effects of perioperative blood transfusion on morbidity and mortality. RESULTS:Of 48,854 patients in the study cohort, 4887 (10%) received a blood transfusion. Rates of transfusion ranged from 4% for laparoscopic gastrointestinal resection to 58% for open AAA. After adjusting for significant effects of NSQIP-estimated probabilities, transfusion was independently associated with morbidity and mortality after open AAA repair (OR = 1.99/14.4 respectively, p ≤ 0.010), esophagectomy (OR = 2.80/3.0, p < 0.001), pancreatectomy (OR = 1.88/3.01, p < 0.001), hepatectomy (OR = 2.82/5.78, p < 0.001), colectomy (OR = 2.15/3.17, p < 0.001), small bowel resection (OR = 2.81/3.83, p ≤ 0.004), and laparoscopic gastrointestinal operations (OR = 2.73/4.05, p < 0.001). CONCLUSIONS:Perioperative blood transfusion is independently associated with an increased risk of morbidity and mortality after most major abdominal operations.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Elwood NR,Martin AN,Turrentine FE,Jones RS,Zaydfudim VMdoi
10.1016/j.amjsurg.2018.02.015subject
Has Abstractpub_date
2018-09-01 00:00:00pages
487-491issue
3eissn
0002-9610issn
1879-1883pii
S0002-9610(17)31742-7journal_volume
216pub_type
杂志文章,多中心研究abstract：BACKGROUND:Many surgeons continue to use prosthetic arteriovenous grafts for dialysis access despite the clear superiority of native arteriovenous fistulas. This study was undertaken to review our experience with elevated brachial-basilic fistulas as an alternative to prosthetic grafts in patients lacking veins suitabl...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)00102-6
更新日期：1999-06-01 00:00:00
abstract：:The relative merits of the anterior and posterior approaches to the adrenal gland were assessed in a series of 103 patients with bilateral cortical hyperplasia or unilateral cortical adenoma (less than 25 g). In none of the patients was additional concomitant surgery planned. Sixty-four patients were operated on throu...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90010-1
更新日期：1982-09-01 00:00:00
abstract：:The difficulties encountered in the diagnosis of solitary pancreatic injury when there is no other indication for surgical exploration of the abdomen are discussed. We suggest that endoscopic transduodenal pancreatography is a reliable diagnostic tool of great help in evaluating such injuries with little morbidity. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90404-9
更新日期：1976-09-01 00:00:00
abstract：BACKGROUND:Metastatic colorectal carcinoma to the liver is a potentially curable disease. The purpose of this study was to determine the safety and efficacy of hepatic resection for metastatic colorectal carcinoma. METHODS:One hundred twenty-one consecutive hepatic resections in 110 patients with metastatic colorectal...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)00070-7
更新日期：1999-05-01 00:00:00
abstract：BACKGROUND:The use of 5 or more medications is defined as polypharmacy (PPM). The clinical impact of PPM on the isolated severe traumatic brain injury (TBI) patient has not been defined. METHODS:A retrospective cohort study was performed at our academic level 1 trauma center examining patients with isolated TBI. Pre-i...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.07.010
更新日期：2017-06-01 00:00:00
abstract：BACKGROUND:Hawaii has the highest incidence of hepatocellular cancer (HCC) in the United States and the largest proportion of Asians and Pacific Islanders. HCC studies generally combine these groups into 1 ethnicity, and we sought to examine differences between Asian and Pacific Islander subpopulations. METHODS:Demogr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2011.06.055
更新日期：2012-06-01 00:00:00
abstract：BACKGROUND:Prospective evaluation of the percutaneous tracheostomy by the guide wire dilating forceps (GWDF) technique. METHODS:In 50 selected patients percutaneous tracheostomy with fiberscopic control was performed and evaluated. RESULTS:Most percutaneous tracheostomies were performed without any adverse effect. No...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-9610(99)00049-5
更新日期：1999-04-01 00:00:00
abstract：BACKGROUND:The aim of this study was to calculate and analyze the cost of treatment for stage IV pressure ulcers. METHODS:A retrospective chart analysis of patients with stage IV pressure ulcers was conducted. Hospital records and treatment outcomes of these patients were followed up for a maximum of 29 months and ana...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.12.021
更新日期：2010-10-01 00:00:00
abstract：:Recent progress in the surgical treatment of carcinoma of the esophagus has changed the pessimistic outlook for this malignancy. With reasonably early diagnosis, it is feasible to achieve a resectability rate of 75 to 85 percent, an operative mortality of about 5 percent and a 5 year survival rate of about 30 percent....
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90386-4
更新日期：1980-06-01 00:00:00
abstract：:We performed a 1 year review of mammographic interpretations and breast biopsy experiences at Madigan Army Medical Center, correlating biopsy results with mammographic interpretations when possible. Fibrocystic mammary dysplasia was reported in two thirds of our patients, with interpretations heavily weighted toward f...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90130-2
更新日期：1984-05-01 00:00:00
abstract：:Thirty extrathoracic operations in twenty-six patients with occlusive disease involving the primary branches of the aortic arch were reviewed. Spanning a fourteen year experience, these operations included carotid-subclavian artery bypass, retrograde common carotid artery thrombectomy, carotid-carotid artery bypass, a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90056-8
更新日期：1976-08-01 00:00:00
abstract：:As discussed by Urschel [13], 50 to 70 percent of patients with symptoms of thoracic outlet syndrome may be treated conservatively by nonsurgical methods. Patients who still have symptoms after years of such therapy are referred to us for surgical treatment. Failure to obtain symptomatic relief after scalenotomy alone...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90351-7
更新日期：1980-05-01 00:00:00
abstract：BACKGROUND:The appropriate surgical approach of a pancreatic multifocal disease that skips the body of the gland remains unknown. We sought to analyze a parenchyma-sparing surgical technique consisting of a middle-preserving pancreatectomy (MPP) evaluating feasibility, safety, and oncological and functional outcomes. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.02.017
更新日期：2009-09-01 00:00:00
abstract：:The insertion of pancreaticobiliary drains at the time of endoscopic retrograde cholangiopancreatography can provide access to the bile or pancreatic duct, decompress an obstructed biliary tree, and allow infusion of solubilizing agents to effect gallstone dissolution. Twenty-six patients underwent 32 attempts at drai...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90384-7
更新日期：1983-08-01 00:00:00
abstract：:The multicentric occurrence of tumors of the upper aerodigestive tract has been well described, with an incidence ranging from 5 to 16 percent. Detection of a synchronous primary tumor at the time of initial work-up is crucial both for management and final outcome. However, there is a diversity of opinions regarding t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80036-9
更新日期：1988-06-01 00:00:00
abstract：BACKGROUND:Two decades since the advent of laparoscopic cholecystectomy, the rate of bile duct injuries still remains higher than in the open cholecystectomy era. METHODS:The rate and complexity of bile duct injuries was evaluated in 83,449 patients who underwent laparoscopic cholecystectomy between 1995 and 2008 in t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2011.08.018
更新日期：2012-04-01 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:Laparoscopic deroofing has been shown to produce good patient satisfaction and to have results similar to those of open surgical techniques. We evaluated the feasibility and efficacy of laparoscopic deroofing using an argon beam coagulator (ABC) in the patients with nonparasitic liver cysts. METHODS:Laparos...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01361-2
更新日期：2003-03-01 00:00:00
abstract：BACKGROUND:Laparoscopic cholecystectomy is increasingly being employed as the initial surgical approach in patients with acute cholecystitis. Gangrenous cholecystitis will be unexpectedly encountered in a proportion of these patients. The applicability of laparoscopic techniques and its outcome in this group of patient...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00525-0
更新日期：2001-01-01 00:00:00
abstract：BACKGROUND:Laparoscopic adrenalectomy has gained acceptance in the treatment of adrenal tumors. We examine our initial 73 patients and highlight the change in patient selection and outcome that experience brings. METHODS:A prospective study from 2000 to 2005 enrolled 73 consecutive laparoscopic adrenalectomy patients ...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2006.01.042
更新日期：2006-05-01 00:00:00
abstract：BACKGROUND:The relationship between hospital volume and patient outcomes remains controversial for rectal cancer. METHODS:This is a population-based database study. Patients treated with surgery for a stage I to III rectal adenocarcinoma from 2003 to 2009 were identified. High-volume hospitals (HVH) were those centers...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.07.007
更新日期：2017-02-01 00:00:00
abstract：:Over a 13-month period (November 1988 to December 1989), we performed our first 104 laparoscopic cholecystectomies using an intracorporeal ultrasonic lithotripsy technique. The procedure in three of these patients was converted to an open operation because of hemorrhage with unexpected findings of cirrhosis in two pat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90600-i
更新日期：1991-03-01 00:00:00
abstract：BACKGROUND:Perianal fistula disease (PAD) occurs in up to 40% of patients with Crohn's disease (CD). Medical therapy is often unsuccessful, and, with surgical therapy, healing is unreliable and management is frequently painful and unsatisfactory. Outpatient CO(2) laser ablation of PAD has emerged as an alternative. ME...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.10.050
更新日期：2006-03-01 00:00:00
abstract：:Significant hemorrhage during hepatic resections for malignancies can result in increased mortality due to liver failure or acute blood loss. Massive hemorrhage is often related to loss of control or injury to the hepatic veins or inferior vena cava. Prevention or reduction of intraoperative blood loss, through improv...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00199-7
更新日期：1996-10-01 00:00:00
abstract：BACKGROUND:The role of frozen section (FS) in thyroid disease is controversial. The goal of this study was to identify a cohort of patients who may or may not benefit from FS. METHODS:Two hundred thirty-one patients who underwent thyroidectomy were evaluated in regard to fine-needle aspiration (FNA), FS, and the exten...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01074-7
更新日期：2002-12-01 00:00:00
abstract：BACKGROUND:Rectopexy is one of the accepted treatment options for full-thickness rectal prolapse, but the details of the technique remain controversial. This unit has adopted a laparoscopic approach as an alternative to open surgery, and has used three techniques: mesh, suture, and resection. This retrospective study c...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(01)00672-9
更新日期：2001-08-01 00:00:00
abstract：:Fine-needle aspiration (FNA) biopsy of a thyroid nodule was performed in 797 patients. Ninety-six patients had resection of the thyroid nodule performed subsequent to a one-time FNA biopsy. The surgical pathology of these 96 cases demonstrated a 5.8% false-negative rate and a 9.9% false-positive rate. As a consequence...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80330-7
更新日期：1993-10-01 00:00:00
abstract：PURPOSE:This study aimed to determine one-year outcomes and the impact of various factors on the need for readmission and reoperation following abdominoperineal resection (APR). METHOD:A multivariate logistic regression analysis was conducted to determine predictors of readmission and/or reoperation within one year of...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.08.021
更新日期：2019-07-01 00:00:00
abstract：BACKGROUND:Core biopsy finding of atypical ductal hyperplasia (ADH) are generally followed by open biopsy to avoid underestimation of malignant disease. METHODS:Retrospective examination of 11 gauge stereotactic-guided vacuum-assisted core biopsies was made with respect to ADH diagnosis, follow-up open biopsy, and upg...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(01)00727-9
更新日期：2001-10-01 00:00:00
abstract：:Arteriovenous fistulas were performed in 100 patients over a three year period with a 90 per cent overall success rate. Various technics for construction of the fistula using autologous veins are discussed, with emphasis on pre- and intraoperative assessment of vessel condition and its relation to the prevention of im...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90009-x
更新日期：1976-05-01 00:00:00
