Abstract:
INTRODUCTION:Assessing outcomes in patients with colon cancer (CC) undergoing surgical intervention is challenging. Frailty has been as established tool for assessing patient outcomes. The aim was of this study was to assess role of frailty in patients with CC. METHODS:National estimates for patients with CC were abstracted from the National Inpatient Sample (NIS) database (2011). Frailty was calculated using a 11 variable CCFI. Patient was stratified as frail (FL) (mFI≥0.25) and non-frail (Non-FL). Outcome measures were: in-hospital complications, hospital and intensive care unit (ICU) length of stay (LOS), discharge disposition, and mortality. Regression analysis was performed. RESULTS:A total of 53,652 patients with CC who underwent surgery were analyzed. The mean age was 69 ± 19 years with 62% males and mean CCFI being 0.13. 34% of patients were frail. 22.3% patients had in-hospital complications and mortality rate was 3.2%. Frail patients were more likely to have in-hospital complications (p = 0.001), longer hospital LOS (p = 0.001), more likely to be discharged to a facility (p = 0.001). On regression analysis after controlling for age, gender, type of procedure, hospital status, insurance status, frail status was independently associated with in-hospital complications (OR[95% CI]: 1.8[1.1-2.9], p = 0.035) and adverse discharge disposition (OR[95% CI]: 1.3[1.08-3.5], p = 0.043). CONCLUSION:Frailty status is an independent predictor of adverse outcomes (complications, discharge disposition, and LOS) in CC patient undergoing surgical intervention. Age was not independently associated with outcome and had poor correlation with frailty status. Pre-operative assessment of frailty in CC patient may help early identifications and risk stratification to help improve outcomes and discharge planning.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Pandit V,Khan M,Martinez C,Jehan F,Zeeshan M,Koblinski J,Hamidi M,Omesieta P,Osuchukwu O,Nfonsam Vdoi
10.1016/j.amjsurg.2018.07.006subject
Has Abstractpub_date
2018-12-01 00:00:00pages
1090-1094issue
6eissn
0002-9610issn
1879-1883pii
S0002-9610(18)30413-6journal_volume
216pub_type
杂志文章abstract:BACKGROUND:blood loss during liver resection and the need for perioperative blood transfusions have negative impact on perioperative morbidity, mortality, and long-term outcomes. METHODS:a randomized controlled trial was performed on patients undergoing liver resection comparing hemihepatic vascular inflow occlusion, ...
journal_title:American journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.amjsurg.2009.09.029
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Hemoglobin-based blood substitutes appear poised to deliver the promise of a universally compatible, disease-free alternative to banked blood. However, vasoconstriction following administration of tetrameric hemoglobins has been problematic, likely because of nitric oxide binding. Polymerized hemoglobin is e...
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)00275-x
更新日期:1998-12-01 00:00:00
abstract::Seven patients with carcinoma in a thyroglossal duct cyst have received treatment over a 15 year period. Findings in all of these patients reflect the likelihood of carcinoma arising within thyroglossal duct tissue. In each patient there was sufficient histologic evidence of the presence of a thyroglossal duct cyst an...
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doi:10.1016/0002-9610(83)90077-6
更新日期:1983-02-01 00:00:00
abstract:BACKGROUND:Definitive practice guidelines regarding the utility of chest x-ray (CXR) following chest tube removal in trauma patients have not been established. The authors hypothesized that the selective use of CXR following chest tube removal is safe and cost effective. METHODS:A retrospective review of chest tube in...
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abstract:BACKGROUND:In this study, we explore surgical resident communication with simulated patient surrogates (SPs), in an Objective Structured Clinical Examination (OSCE). METHODS:We use discourse analysis (DA), a qualitative approach to analyzing language, to evaluate our residents' interactions with simulated patient surr...
journal_title:American journal of surgery
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doi:10.1016/j.amjsurg.2017.10.041
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abstract:BACKGROUND:Patients with cancer who undergo pancreaticoduodenectomy (PD) followed by radiation and 5-fluorouracil (5-FU) therapy have experienced median overall survival from 18 to 24 months and an actuarial 2-year overall survival from 34% to 48%. We previously reported an 84% 2-year survival using a novel adjuvant ch...
journal_title:American journal of surgery
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abstract::Ninety-four routine subclavian vein catheterizations in patients with abdominal surgical procedures were performed by the resident surgical staff at the Medical University of South Carolina Hospital over a ten month period. This was done primarily to have ready access to large veins during surgery and to free the pati...
journal_title:American journal of surgery
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更新日期:1976-02-01 00:00:00
abstract:BACKGROUND:Previous studies on the efficacy of primary treatments for ductal carcinoma-in-situ (DCIS) have focused on local recurrence rates. Our objective was to detail the outcomes of local invasive recurrence, distant recurrence, and breast cancer mortality in patients previously treated for DCIS. METHODS:Clinical,...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.06.005
更新日期:2006-10-01 00:00:00
abstract::A new way to stabilize nasogastric tubes is presented, aimed at preventing decubitus ulcerations of the mucosa of the nose and pharynx. ...
journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:1975-07-01 00:00:00
abstract:BACKGROUND:Venous thromboembolism is a common cause of morbidity. Guidelines recommend perioperative thromboprophylaxis, but clinicians remain cautious of bleeding after major oncologic resections. METHODS:Retrospective analysis of a single institution's prospective hepatopancreatobiliary database was performed for pa...
journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:There is little evidence supporting or refuting clamping trials, a period of clamping thoracostomy tubes prior to removal. We sought to evaluate whether clamping trials reduce the need for subsequent pleural drainage procedures. METHODS:We conducted a retrospective cohort study of trauma patients who underw...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.01.007
更新日期:2020-08-01 00:00:00
abstract:INTRODUCTION:A breast cancer synoptic operative report was developed using a modified Delphi process METHODS: Data from the British Columbia Cancer Breast Cancer Outcomes Unit (BCOU) was used to analyze the association between the completion of a synoptic operative report and reporting of operative details and The Amer...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.02.053
更新日期:2020-05-01 00:00:00
abstract:PURPOSE:Stoma closure has been associated with a high rate of surgical site infection (SSI) and the optimal skin closure method is still controversial. The aim of this study was to compare the short-term and long-term outcomes between the conventional linear closure (CC) and the persestring closure (PC) using propensit...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.09.031
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Following appendectomy, management is often guided by surgeon determination of whether the appendicitis is uncomplicated or complicated. Our objectives were to determine the incidence of discordance between intraoperative and pathological findings and determine effect on outcomes. METHODS:We performed a ret...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.05.004
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Symptomatic hypocalcemia remains the main postoperative complication after total thyroidectomy. The aim of the present study was to evaluate the role of oral supplementation of calcitriol and calcium salts in preventing severe postoperative hypocalcemia after total thyroidectomy. METHODS:A consecutive serie...
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/j.amjsurg.2005.04.017
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:To improve surgical training standards, it is necessary to first define the elements of high-quality training and methods for measuring them. METHODS:Semistructured interviews were conducted with attending (n = 10) and resident (n = 10) general surgeons. An interview topic guide was used to elicit end users...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.07.044
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Transluminal balloon angioplasty offers advantages to patch angioplasty. We evaluated the primary patency of thrombosed hemodialysis grafts that had undergone balloon angioplasty versus patch angioplasty as a salvage method. METHODS:We reviewed our experience with 22 consecutive intraoperative balloon angio...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(97)90072-6
更新日期:1997-08-01 00:00:00
abstract:INTRODUCTION:Despite the use of radiologic, endoscopic, and laparoscopic staging techniques, the rate of nontherapeutic laparotomies in patients with hilar cholangiocarcinoma remains high. This study evaluated the accuracy of preoperative high-resolution computed tomography (HRCT) to determine resectability in this set...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.10.024
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Graft pancreatitis is a major complication after pancreas transplantation. Antithrombin III (AT III) is an anticoagulatory and anti-inflammatory substance. The aim of our study was to evaluate a prophylactic application of AT III in experimental pancreas transplantation. METHODS:Pancreas transplantation was...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.03.017
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:We hypothesized that the method of breast cancer margin assessment may be associated with different rates of positive margins and residual carcinoma. METHODS:A total of 178 breast cancer specimens were divided into 2 groups (A and B) based on the margin assessment method used. Rates of positive margins, re-...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.06.009
更新日期:2006-10-01 00:00:00
abstract::Despite the very high accuracy rate of imaging studies (ultrasound, computed tomography, liver-lung-spleen scans and gallium-67 scans) in detecting intraabdominal abscesses, our experience with 80 recent cases indicate that these techniques have not significantly altered traditional methods of decision-making about wh...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90195-7
更新日期:1982-04-01 00:00:00
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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:10.1016/0002-9610(92)90264-r
更新日期:1992-01-01 00:00:00
abstract:INTRODUCTION:The few series of synchronous lung cancers have included small cell and carcinoid tumors. We wished to determine the prognosis for patients with synchronous non-small cell lung cancer (NSCLC). METHODS:A database of 3034 lung cancer patients was reviewed for synchronous NSCLC. Survival was determined by Ka...
journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to examine the outcomes of checklist-driven preoperative briefings and postoperative debriefings during the Veterans Health Administration (VHA) medical team training program. METHODS:A briefing score (1, never started; 2, started then discontinued; 3, maintained on original ta...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.07.011
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Many approaches to treat rectal prolapse exists, yet little is known regarding their safety in the elderly. METHOD:NSQIP (2008-2014) was queried to identify patients ≥ 70 years who underwent open rectopexy (OR), laparoscopic rectopexy (LR) and perineal rectosigmoidectomy (PR). Patients were selected using N...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.02.010
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:In women undergoing breast conserving surgery (BCS), up to 60% can require re-excision. Our objective is to develop an optically based technology which can differentiate benign from malignant breast tissues intraoperatively through differences in tissue composition factors. METHODS:A prospective study of op...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
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更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:Survival in breast cancer maybe more accurately predicted by a scoring system based on the biologic characteristics of the tumor such as diameter, number of involved nodes, and hormone receptor status than by conventional staging. METHODS:Medical records of 419 patients with a diagnosis of breast cancer fro...
journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:After enthusiasm for total pancreatectomy for pancreatic adenocarcinoma peaked in the 1970s, a failure to improve outcomes in the 1980s led to fewer reports of this procedure. METHODS:We retrieved records from 252 Whipple and 47 total pancreatectomies for pancreatic cancer performed at U.S. Department of Ve...
journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:1994-12-01 00:00:00
abstract::A new break-away needle for subclavian catheter insertion has been described. This needle functions exactly as the usual 14 gauge needle, but it can be completely removed from the catheter while leaving the integral Luer adaptor intact. ...
journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:1984-06-01 00:00:00
abstract::An improved technic for total thyroidectomy, utilizing magnification, is described. A method of preservation of the parathyroid glands with intact blood supply has been developed. The completeness of total thyroidectomy has been confirmed in 91 per cent of patients studied by postoperative radioactive iodine scan. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90472-9
更新日期:1975-10-01 00:00:00