Textbook Outcomes Among Medicare Patients Undergoing Hepatopancreatic Surgery.


OBJECTIVE:To define and test "Textbook Outcome" (TO)-a composite measure for healthcare quality-among Medicare patients undergoing hepatopancreatic resections. Hospital variation in TO and Medicare payments were analyzed. BACKGROUND:Composite measures of quality may be superior to individual measures for the analysis of hospital performance. METHODS:The Medicare Provider Analysis and Review (MEDPAR) Inpatient Files were reviewed to identify Medicare patients who underwent pancreatic and liver procedures between 2013 and 2015. TO was defined as: no postoperative surgical complications, no prolonged length of hospital stay, no readmission ≤ 90 days after discharge, and no postoperative mortality ≤ 90 days after surgery. Medicare payments were compared among patients who achieved TO versus patients who did not. Multivariable logistic regression was used to investigate patient factors associated with TO. A nomogram to predict probability of TO was developed and validated. RESULTS:TO was achieved in 44% (n = 5919) of 13,467 patients undergoing hepatopancreatic surgery. Adjusted TO rates at the hospital level varied from 11.1% to 69.6% for pancreatic procedures and from 16.6% to 78.7% for liver procedures. Prolonged length of hospital stay represented the major obstacle to achieve TO. Average Medicare payments were substantially higher among patients who did not have a TO. Factors associated with TO on multivariable analysis were age, sex, Charlson comorbidity score, previous hospital admissions, procedure type, and surgical approach (all P > 0.05). CONCLUSIONS:Less than one-half of Medicare patients achieved a TO following hepatopancreatic procedures with a wide variation in the rates of TO among hospitals. There was a discrepancy in Medicare payments for patients who achieved a TO versus patients who did not. TO could be useful for the public reporting of patient level hospital performance and hospital variation.


Ann Surg


Annals of surgery


Merath K,Chen Q,Bagante F,Beal E,Akgul O,Dillhoff M,Cloyd JM,Pawlik TM




Has Abstract


2020-06-01 00:00:00












  • Effects of bombesin on fasting bile formation.

    abstract::Adult dogs were previously prepared by cholecystectomy, ligation of the lesser pancreatic duct, and insertion of cannulae into the duodenum and stomach. After a 2-week period of postoperative recovery and an overnight fast, bile ducts were cannulated, gastric cannulae placed to open drainage and sodium taurocholate 50...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Kortz WJ,Nashold JR,Delong E,Meyers WC

    更新日期:1986-01-01 00:00:00

  • The surgical management of acute occlusion of the superior mesenteric artery.

    abstract::A study of 103 cases of acute occlusion of the superior mesenteric artery is presented. The relation of site of occlusion to etiology, extent of infarction, and survival following resection and revascularization is described. Included is an analysis of the technical factors contributing to successful revascularization...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Ottinger LW

    更新日期:1978-12-01 00:00:00

  • A Longitudinal Assessment of Outcomes and Healthcare Resource Utilization After Immediate Breast Reconstruction-Comparing Implant- and Autologous-based Breast Reconstruction.

    abstract:OBJECTIVES:Immediate breast reconstruction (IBR) after mastectomy for cancer has increased in recent years, yet long-term, modality-specific comparative data are lacking. We performed this study to compare short- and long-term outcomes after expander, autologous (AT), and direct-to-implant (DI) breast reconstruction. ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Fischer JP,Fox JP,Nelson JA,Kovach SJ,Serletti JM

    更新日期:2015-10-01 00:00:00

  • Combination of SELDI-TOF-MS and data mining provides early-stage response prediction for rectal tumors undergoing multimodal neoadjuvant therapy.

    abstract:OBJECTIVE:We investigated whether proteomic analysis of the low molecular weight region of the serum proteome could predict histologic response of locally advanced rectal cancer to neoadjuvant radiochemotherapy (RCT). SUMMARY BACKGROUND DATA:Proteomic analysis of serum is emerging as a powerful new modality in cancer,...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Smith FM,Gallagher WM,Fox E,Stephens RB,Rexhepaj E,Petricoin EF 3rd,Liotta L,Kennedy MJ,Reynolds JV

    更新日期:2007-02-01 00:00:00

  • Long-term results of intraoperative electron beam irradiation (IOERT) for patients with unresectable pancreatic cancer.

    abstract:SUMMARY BACKGROUND DATA:To analyze the effects of a treatment program of intraoperative electron beam radiation therapy (IOERT) and external beam radiation therapy and chemotherapy on the outcome of patients with unresectable or locally advanced pancreatic cancer. METHODS:From 1978 to 2001, 150 patients with unresecta...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Willett CG,Del Castillo CF,Shih HA,Goldberg S,Biggs P,Clark JW,Lauwers G,Ryan DP,Zhu AX,Warshaw AL

    更新日期:2005-02-01 00:00:00

  • Thrombotic thrombocytopenic purpura (TTP) and splenectomy: a current appraisal.

    abstract::Thrombotic thrombocytopenic purpura (TTP) is a disease process characterized by microangiopathic anemia, fever, neurologic manifestations, renal abnormalities, and thrombocytopenia. These clinical findings are caused by vascular occlusions of the microcirculation. At present the utilization of splenectomy, in the trea...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Rutkow IM

    更新日期:1978-11-01 00:00:00

  • A Clinical Nomogram for Predicting Node-positive Disease in Esophageal Cancer.

    abstract:OBJECTIVE:We developed and validated a nomogram predicting the likelihood of occult lymph node metastases in surgically resectable esophageal cancers. BACKGROUND:Patients with esophageal cancer with positive lymph nodes benefit from neoadjuvant therapy, but limitations in current clinical staging techniques mean nodal...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Semenkovich TR,Yan Y,Subramanian M,Meyers BF,Kozower BD,Nava R,Patterson GA,Kreisel D,Puri V

    更新日期:2019-07-03 00:00:00

  • Duodenum-preserving resection of the head of the pancreas in chronic pancreatitis. A prospective, randomized trial.

    abstract:OBJECTIVE:Two techniques of duodenum-preserving resection of the head of the pancreas were compared in a prospective, randomized trial. The technical feasibility and effects on quality of life were assessed. SUMMARY BACKGROUND DATA:Drainage and resection are the principles of surgery in chronic pancreatitis. The techn...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Izbicki JR,Bloechle C,Knoefel WT,Kuechler T,Binmoeller KF,Broelsch CE

    更新日期:1995-04-01 00:00:00

  • Pathologic Response to Pretransplant Locoregional Therapy is Predictive of Patient Outcome After Liver Transplantation for Hepatocellular Carcinoma: Analysis From the US Multicenter HCC Transplant Consortium.

    abstract:OBJECTIVE:The aim of the study was to determine the rate, predictors, and impact of complete pathologic response (cPR) to pretransplant locoregional therapy (LRT) in a large, multicenter cohort of hepatocellular carcinoma (HCC) patients undergoing liver transplantation (LT). BACKGROUND:LRT is used to mitigate waitlist...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究


    authors: DiNorcia J,Florman SS,Haydel B,Tabrizian P,Ruiz RM,Klintmalm GB,Senguttuvan S,Lee DD,Taner CB,Verna EC,Halazun KJ,Hoteit M,Levine MH,Chapman WC,Vachharajani N,Aucejo F,Nguyen MH,Melcher ML,Tevar AD,Humar A,Mobley

    更新日期:2020-04-01 00:00:00

  • Effect of ethanol on pancreatic interstitial pH and blood flow in cats with chronic pancreatitis.

    abstract:OBJECTIVE:The objective of this study was to investigate the effects of ethanol on pancreatic blood flow and interstitial pH in chronic pancreatitis. BACKGROUND:Ethanol is known to contribute to the development of both acute and chronic pancreatitis. However, it is unclear how ethanol precipitates episodes of acute pa...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Toyama MT,Patel AG,Nguyen T,Ashley SW,Reber HA

    更新日期:1997-02-01 00:00:00

  • Prehospital intravenous fluid administration is associated with higher mortality in trauma patients: a National Trauma Data Bank analysis.

    abstract:OBJECTIVE:Prehospital intravenous (IV) fluid administration is common in trauma patients, although little evidence supports this practice. We hypothesized that trauma patients who received prehospital IV fluids have higher mortality than trauma patients who did not receive IV fluids in the prehospital setting. METHODS...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Haut ER,Kalish BT,Cotton BA,Efron DT,Haider AH,Stevens KA,Kieninger AN,Cornwell EE 3rd,Chang DC

    更新日期:2011-02-01 00:00:00

  • Chronic Opioid Usage in Surgical Patients in a Large Academic Center.

    abstract:OBJECTIVE:The objective of this study is to investigate the prevalence and disparity of chronic opioid usage in surgical patients and the potential risk factors associated with chronic opioid usage. BACKGROUND:Chronic opioid usage is common in surgical patients; however, the characteristics of opioid usage in surgical...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Jiang X,Orton M,Feng R,Hossain E,Malhotra NR,Zager EL,Liu R

    更新日期:2017-04-01 00:00:00

  • Duodenal switch provides superior weight loss in the super-obese (BMI > or =50 kg/m2) compared with gastric bypass.

    abstract:OBJECTIVES:Although weight loss following Roux-en-Y gastric bypass is acceptable in patients with preoperative body mass index (BMI) between 35 and 50 kg/m, results from several series demonstrate that failure rates approach 40% when BMI is > or =50 kg/m. Here we report the first large single institution series directl...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Prachand VN,Davee RT,Alverdy JC

    更新日期:2006-10-01 00:00:00

  • Repeat hepatectomy for colorectal liver metastases.

    abstract:OBJECTIVE:The authors assess the long-term results of repeat hepatectomies for recurrent metastases of colorectal cancer and determine the factors that can predict survival. SUMMARY BACKGROUND DATA:Safer techniques of hepatic resection have allowed surgeons to consider repeat hepatectomy for colorectal metastases in a...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Adam R,Bismuth H,Castaing D,Waechter F,Navarro F,Abascal A,Majno P,Engerran L

    更新日期:1997-01-01 00:00:00

  • Exclusion of nonisolated splenic vein in distal splenorenal shunt for prevention of portal malcirculation.

    abstract::In an attempt to prevent portoprival malcirculation after distal splenorenal shunt (DSRS), a splenic hilar renal shunt (HRS) with proximal flush ligation of splenic vein was designed. To accomplish this procedure, two methods were compared: HRS alone (Group A) and HRS plus proximal flush ligation of the splenic vein (...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Inokuchi K,Beppu K,Koyanagi N,Nagamine K,Hashizume M,Sugimachi K

    更新日期:1984-12-01 00:00:00

  • Living Donor Liver Transplantation in Children: Surgical and Immunological Results in 250 Recipients at Université Catholique de Louvain.

    abstract:OBJECTIVES:To evaluate the outcome of pediatric living donor liver transplantation (LDLT) regarding portal vein (PV) reconstruction, ABO compatibility, and impact of maternal donation on graft acceptance. BACKGROUND:LDLT and ABO-mismatched transplantation constitute feasible options to alleviate organ shortage in chil...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Gurevich M,Guy-Viterbo V,Janssen M,Stephenne X,Smets F,Sokal E,Lefebvre C,Balligand JL,Pirotte T,Veyckemans F,Clapuyt P,Menten R,Dumitriu D,Danse E,Annet L,Clety SC,Detaille T,Latinne D,Sempoux C,Laterre PF,de Mag

    更新日期:2015-12-01 00:00:00

  • Unique Tracheal Fluid MicroRNA Signature Predicts Response to FETO in Patients With Congenital Diaphragmatic Hernia.

    abstract:OBJECTIVE AND BACKGROUND:Our objective was to determine the fetal in vivo microRNA signature in hypoplastic lungs of human fetuses with severe isolated congenital diaphragmatic hernia (CDH) and changes in tracheal and amniotic fluid of fetuses undergoing fetoscopic endoluminal tracheal occlusion (FETO) to reverse sever...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Pereira-Terra P,Deprest JA,Kholdebarin R,Khoshgoo N,DeKoninck P,Munck AA,Wang J,Zhu F,Rottier RJ,Iwasiow BM,Correia-Pinto J,Tibboel D,Post M,Keijzer R

    更新日期:2015-12-01 00:00:00

  • Bronchopulmonary foregut malformations. The spectrum of anomalies.

    abstract::Ventral anomalies of accessory pulmonary tissue have been classified as "bronchopulmonary foregut malformations." Between July 1, 1981, and May 31, 1985, 10 children with bronchopulmonary malformations have been cared for on the Pediatric Surgical Service at the University of Virginia. Six patients had bronchogenic cy...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Rodgers BM,Harman PK,Johnson AM

    更新日期:1986-05-01 00:00:00

  • Laparoscopic liver resection for malignant liver tumors: preliminary results of a multicenter European study.

    abstract:OBJECTIVE:To assess the feasibility, safety, and outcome of laparoscopic liver resection for malignant liver tumors. SUMMARY BACKGROUND DATA:The precise role of laparoscopy in resection of liver malignancies (hepatocellular carcinoma [HCC] and liver metastases) remains controversial despite an increasing number of pub...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究


    authors: Gigot JF,Glineur D,Santiago Azagra J,Goergen M,Ceuterick M,Morino M,Etienne J,Marescaux J,Mutter D,van Krunckelsven L,Descottes B,Valleix D,Lachachi F,Bertrand C,Mansvelt B,Hubens G,Saey JP,Schockmel R,Hepatobiliary a

    更新日期:2002-07-01 00:00:00

  • Adenocarcinoma of the esophagus.

    abstract::Adenocarcinoma involving the distal esophagus usually is far advanced when the patient is first seen. Adenocarcinoma differs from squamous carcinoma of the esophagus since it is relatively unresponsive to radiation therapy or chemotherapy. Adenocarcinoma of the esophagus resembles gastric cancer in its tendency to for...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Mahoney JL,Condon RE

    更新日期:1987-05-01 00:00:00

  • Optimizing Surveillance and Re-intervention Strategy Following Elective Endovascular Repair of Abdominal Aortic Aneurysms.

    abstract:BACKGROUND:EVAR for abdominal aortic aneurysm has an initial survival advantage over OR, but more frequent complications increase costs and long-term aneurysm-related mortality. Randomized controlled trials of EVAR versus OR have shown EVAR is not cost-effective over a patient's lifetime. However, in the EVAR-1 trial, ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Kim LG,Sweeting MJ,Epstein D,Venermo M,Rohlffs FEV,Greenhalgh RM

    更新日期:2019-10-07 00:00:00

  • Prospective Creation and Validation of the PREVENTT (Prediction and Enaction of Prevention Treatments Trigger) Scale for Surgical Site Infections (SSIs) in Patients With Diverticulitis.

    abstract:OBJECTIVE:Create and validate diverticulitis surgical site infection prediction scale. BACKGROUND:Surgical site infections cause significant morbidity after colorectal surgery. An infection prediction scale could target infection prevention bundles to high-risk patients. METHODS:Prospectively collected National Surgi...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Bordeianou L,Cauley CE,Patel R,Bleday R,Mahmood S,Kennedy K,Ahmed KF,Yokoe D,Hooper D,Rubin M,Partners Colorectal Collaborative.

    更新日期:2019-12-01 00:00:00

  • Carotid artery disease following external cervical irradiation.

    abstract::A retrospective study of 910 patients surviving at least five years after cervical irradiation for Hodgkin's disease, non-Hodgkin's lymphoma, or primary head an neck neoplasms showed the incidence of stroke following cervical irradiation was 63 of 910 patients (6.3%) during a mean period of observation of nine years. ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Elerding SC,Fernandez RN,Grotta JC,Lindberg RD,Causay LC,McMurtrey MJ

    更新日期:1981-11-01 00:00:00

  • Assessment of the amylase--creatinine clearance ratio in postoperative patients.

    abstract::The value of the amylase--creatinine clearance ratio (ACCR) in the diagnosis of postoperative pancreatitis was prospectively assessed. In 77 patients undergoing operations known to have a significant incidence of postoperative pancreatitis (gastric, biliary or pancreatic) i.e. "high risk" group, the ACCR was abnormall...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Leckie PA,Ferreira P,Debas HT

    更新日期:1980-08-01 00:00:00

  • Post-traumatic changes in, and effect of colloid osmotic pressure on the distribution of body water.

    abstract::The aim of this study was to define the post-traumatic changes in body fluid compartments and to evaluate the effect of plasma colloid osmotic pressure (COP) on the partitioning of body fluid between these compartments. Forty-two measurements of plasma volume (green dye), extracellular volume (bromine), and total body...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Böck JC,Barker BC,Clinton AG,Wilson MB,Lewis FR

    更新日期:1989-09-01 00:00:00

  • The advantages of 131I-orthoiodohippurate scintiphotography in the management of patients after renal transplantation.

    abstract::Renal scintiphotography with (131)I-hippurate was the primary diagnostic procedure in evaluating renal failure and complications in over 500 transplant patients. This diagnostic test has become our principal method of evaluation and followup of renal transplants, especially in the early post-transplant period. It has ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Salvatierra O Jr,Powell MR,Price DC,Kountz SL,Belzer FO

    更新日期:1974-09-01 00:00:00

  • Is there still a glass ceiling for women in academic surgery?

    abstract::Despite the dramatically increased entry of women into general surgery and surgical subspecialties, traditionally male-dominated fields, there remains a gross under-representation of women in the leadership positions of these departments. Women begin their careers with fewer academic resources and tend to progress thr...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审


    authors: Zhuge Y,Kaufman J,Simeone DM,Chen H,Velazquez OC

    更新日期:2011-04-01 00:00:00

  • Experience with 100 consecutive simultaneous kidney-pancreas transplants with bladder drainage.

    abstract::From December 1985 to December 1989, 100 consecutive simultaneous pancreas-kidney (SPK) transplants were performed at the University of Wisconsin Hospital and Clinics. Bladder drainage technique was used for all grafts. One- and three-year patient survival was 93% and 90%; kidney survival, 90% and 85%; and pancreas su...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Sollinger HW,Knechtle SJ,Reed A,D'Alessandro AM,Kalayoglu M,Belzer FO,Pirsch J

    更新日期:1991-12-01 00:00:00

  • "Contemplating the Next Maneuver": Functional Neuroimaging Reveals Intraoperative Decision-making Strategies.

    abstract:OBJECTIVE:To investigate differences in the quality, confidence, and consistency of intraoperative surgical decision making (DM) and using functional neuroimaging expose decision systems that operators use. SUMMARY BACKGROUND DATA:Novices are hypothesized to use conscious analysis (effortful DM) leading to activation ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Leff DR,Yongue G,Vlaev I,Orihuela-Espina F,James D,Taylor MJ,Athanasiou T,Dolan R,Yang GZ,Darzi A

    更新日期:2017-02-01 00:00:00

  • Changes in lung ultrastructure following heterologous and homologous serum albumin infusion in the treatment of hemorrhagic shock.

    abstract::The object of this study was to compare the ultrastructure pulmonary effects of the infusion of homologous and heterologous serum albumin solution in the treatment of hemorrhagic shock in baboons. Adult baboons subjected to hemorrhagic shock were resuscitated with either baboon serum albumin, human serum albumin, or R...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Moss GS,Das Gupta TK,Brinkman R,Sehgal L,Newsom B

    更新日期:1979-02-01 00:00:00