Abstract:
OBJECTIVES:The aims of this study were to: (1) measure the rate of failure to provide defect-free postoperative venous thromboembolism (VTE) chemoprophylaxis, (2) identify reasons for failure to provide defect-free VTE chemoprophylaxis, and (3) examine patient- and hospital-level factors associated with failure. SUMMARY BACKGROUND DATA:Current VTE quality measures are inadequate. VTE outcome measures are invalidated for interhospital comparison by surveillance bias. VTE process measures (e.g., SCIP-VTE-2) do not comprehensively capture failures throughout patients' entire hospitalization. METHODS:We examined adherence to a novel VTE chemoprophylaxis process measure in patients who underwent colectomies over 18 months at 36 hospitals in a statewide surgical collaborative. This measure assessed comprehensive VTE chemoprophylaxis during each patient's entire hospitalization, including reasons why chemoprophylaxis was not given. Associations of patient and hospital characteristics with measure failure were examined. RESULTS:The SCIP-VTE-2 hospital-level quality measure identified failures of VTE chemoprophylaxis in 0% to 3% of patients. Conversely, the novel measure unmasked failure to provide defect-free chemoprophylaxis in 18% (736/4086) of colectomies. Reasons for failure included medication not ordered (30.4%), patient refusal (30.3%), incorrect dosage/frequency (8.2%), and patient off-unit (3.4%). Patients were less likely to fail the chemoprophylaxis process measure if treated at nonsafety net hospitals (OR 0.62, 95% CI 0.39-0.99, P = 0.045) or Magnet designated hospitals (OR 0.45, 95% CI 0.29-0.71, P = 0.001). CONCLUSIONS:In contrast to SCIP-VTE-2, our novel quality measure unmasked VTE chemoprophylaxis failures in 18% of colectomies. Most failures were due to patient refusals or ordering errors. Hospitals should focus improvement efforts on ensuring patients receive VTE prophylaxis throughout their entire hospitalization.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Yang AD,Hewitt DB,Blay E Jr,Kreutzer LJ,Quinn CM,Cradock KA,Prachand V,Bilimoria KY,Illinois Surgical Quality Improvement Collaborative (ISQIC).doi
10.1097/SLA.0000000000003124subject
Has Abstractpub_date
2020-06-01 00:00:00pages
1072-1079issue
6eissn
0003-4932issn
1528-1140journal_volume
271pub_type
杂志文章,多中心研究abstract::Sixty patients with chronic alcohol-induced pancreatitis with endoscopic retrograde cholangiopancreatography evidence of common bile duct stenosis were studied to determine the clinical spectrum and natural history of this complication, as well as the indications for biliary bypass. In 17% of patients, common bile duc...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198911000-00007
更新日期:1989-11-01 00:00:00
abstract:OBJECTIVE:This multicenter study sought to evaluate the accuracy of the American College of Surgeons National Surgical Quality Improvement Program's (ACS-NSQIP) surgical risk calculator for predicting outcomes after pancreatoduodenectomy (PD) and to determine whether incorporating other factors improves its predictive ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000001796
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:To analyze the clinical course, treatment, complications, outcome, and quality of life (QOL) in patients with perineal/perianal rhabdomyosarcoma (PRMS) treated within the CWS-86, -91, -96, and -2002P trials. BACKGROUND:Although multiple international study trials exist for the treatment of rhabdomyosarcoma, ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0b013e3182a6f320
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate the incidence of parastomal hernias (PSHs) after end-colostomy formation using a polypropylene mesh in a randomized controlled trial versus conventional colostomy formation. BACKGROUND:A PSH is the most frequent complication after stoma formation. Symptoms may range f...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000001903
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:Our goal was to describe contemporary management and in-hospital mortality associated with blunt thoracic aortic intimal tears (IT) within the American College of Surgeons Trauma Quality Improvement Program. SUMMARY BACKGROUND DATA:The evidence basis for nonoperative expectant management of traumatic IT of t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004415
更新日期:2020-09-01 00:00:00
abstract::: The field of Endocrine Surgery is linked to extraordinary contributions made by Hopkins leaders in surgery including William Stewart Halsted, Harvey Cushing, and John L Cameron. Halsted's contributions to the anatomic basis of thyroid and parathyroid surgery were based on his experimental and clinical work performed...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002519
更新日期:2018-02-01 00:00:00
abstract::Two types of 4 mm ID prostheses were studied in the carotid arteries of the dog. These were noncrimped polypropylene-supported filamentous velour knitted Dacron (PPSFV) and expanded polytetrafluoroethylene (e-PTFE, Gore-Tex). Thrombus-"Free" Surface TFS) areas and patency rates were determined at the end of the implan...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198003000-00016
更新日期:1980-03-01 00:00:00
abstract:OBJECTIVE:To determine the factors that may predict music-induced relaxation in friends and family of patients in the emergency department. BACKGROUND:It remains unclear to date which demographic and experiential factors predict the effectiveness of music-induced relaxation. Furthermore, in-hospital stressors for frie...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e31828ee1da
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVE:To achieve consensus on the best practices in the management of ventral hernias (VH). BACKGROUND:Management patterns for VH are heterogeneous, often with little supporting evidence or correlation with existing evidence. METHODS:A systematic review identified the highest level of evidence available for each ...
journal_title:Annals of surgery
pub_type: 共识发展会议,杂志文章
doi:10.1097/SLA.0000000000001701
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:To study the impact of LT experience on the outcome of CLR for locally advanced hepatobiliary malignancy SUMMARY OF BACKGROUND DATA:: Despite evolution in LT knowledge and surgical techniques in the past decades, there is yet data to evaluate the significance of LT experience in performing CLR. METHODS:Posto...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004227
更新日期:2020-07-09 00:00:00
abstract::Total hepatic protein synthesis was measured in vivo with a flooding-dose technique, and the production of total secreted proteins, albumin, complement component C3, and seromucoid fraction was measured in perfused livers of septic rats that received one of three different solutions infused intravenously; Group 1 rece...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198812000-00007
更新日期:1988-12-01 00:00:00
abstract:OBJECTIVE:To quantitate disease-specific hospital-based medical costs in 34 patients with chronic pancreatitis before and after treatment by either duodenal-preserving pancreatic head resection (DPPHR) or pylorus-preserving pancreaticoduodenectomy (PPPD). SUMMARY BACKGROUND DATA:Pancreatic head resection in selected p...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200111000-00012
更新日期:2001-11-01 00:00:00
abstract::Grafting the circumflex coronary artery has been more difficult technically than the right or anterior descending because of its posterior location and the angles of its marginal branches. However, grafting this artery has been substantially simplified by a method wherein the graft is passed directly through the trans...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197606000-00012
更新日期:1976-06-01 00:00:00
abstract::A series of patients showing a previously unrecognized type of sliding hiatus hernia is presented and analyzed. This type of hernia is characterized by reflux of the mucous membrane of the Hiss angle into the lumen of the esophagus. The occurrence of mucosal prolapse is a secondary phase of gastroesophageal reflux. Th...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198508000-00004
更新日期:1985-08-01 00:00:00
abstract:OBJECTIVE:To examine whether case managers affect patient evaluation/treatment/outcome and staffing requirements during Multiple Casualty Incidents (MCIs). SUMMARY BACKGROUND DATA:Multiple patient relocations during MCIs may contribute to chaos. One hospital changed its MCI patient relocation policy during a wave of M...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31819a6f17
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of growth hormone (GH) treatment on skeletal muscle protein catabolism in patients with multiple organ failure in the intensive care unit (ICU). SUMMARY BACKGROUND DATA:Skeletal muscle depletion affects the incidence of complications and the length of hospital stay. A protein-sparin...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-200004000-00018
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVE:To analyze long-term weight loss, changes in comorbidities and quality of life, and late complications after laparoscopic and open gastric bypass. SUMMARY BACKGROUND DATA:Early results from our prospective randomized trial comparing the outcome of laparoscopic versus open gastric bypass demonstrated less pos...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.sla.0000197381.01214.76
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:To assess our outcomes after minimally invasive esophagectomy (MIE). SUMMARY BACKGROUND DATA:Esophagectomy has traditionally been performed by open methods. Results from most series include mortality rates in excess of 5% and hospital stays frequently greater than 10 days. MIE has the potential to improve th...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000089858.40725.68
更新日期:2003-10-01 00:00:00
abstract::A right axillary to left brachial arterial bypass (saphenous vein) was used in the treatment of a left subclavian artery obstruction secondary to radical mastectomy and irradiation 28 years previously. The axillary bypass was chosen over other surgical approaches because of its simplicity and efficacy. ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197406000-00001
更新日期:1974-06-01 00:00:00
abstract:OBJECTIVE:To examine treatment trends in invasive lobular carcinoma (ILC) over the last 15 years and, in particular, to compare rates of recurrence and disease-free survival associated with breast conservation therapy compared with mastectomy. SUMMARY BACKGROUND DATA:The biologic characteristics of ILC make it difficu...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000171306.74366.22
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVE:To assess the distant metastatic potential of duodeno-pancreatic neuroendocrine tumors (DP-NETs) in patients with MEN1, according to functional status and size. SUMMARY BACKGROUND DATA:DP-NETs, with their numerous lesions and endocrine secretion-related symptoms, continue to be a medical challenge; unfortuna...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003162
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of inhalation of aerosolized opsonized dead Escherichia coli on inflammatory pulmonary neutrophil (PMN) apoptosis, lung injury, and survival in a PMN-mediated lung injury model in vivo. SUMMARY BACKGROUND DATA:Neutrophils that have transmigrated into an inflammatory focus display incre...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200202000-00018
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:We sought to define the prognostic significance of histologic subtype for extremity/truncal liposarcoma (LPS). BACKGROUND:LPS, the most common sarcoma, is comprised of 5 histologic subtypes. Despite their distinct behaviors, LPS outcomes are frequently reported as a single entity. METHODS:We analyzed data o...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003453
更新日期:2019-07-05 00:00:00
abstract::Study A included 30 patients who received immediate postoperative enteral feeding with a nonelemental diet. The nonelemental diet was well tolerated. Study patients rapidly achieved nitrogen equilibrium and had a cumulative nitrogen balance of -11.1 g verus -46.7 g for the control group. In part B, 16 patients with va...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198011000-00003
更新日期:1980-11-01 00:00:00
abstract::An experimental model was developed in dogs to correlate radioisotope scan findings of iatrogenic, in vivo, splenic injury with the natural history of the injury as determined by the clinical course and both gross and microscopic observations. It was found that small subcapsular injuries do not appear as discrete foca...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197804000-00011
更新日期:1978-04-01 00:00:00
abstract::Nasogastric (NG) decompression after colorectal surgery is practiced commonly. Our aim was to determine whether routine NG decompression benefitted patients undergoing this type of surgery. Five hundred thirty-five patients were randomized prospectively to either NG decompression or no decompression. Stratification wa...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-198906000-00003
更新日期:1989-06-01 00:00:00
abstract::The aim of this study was to compare the immediate postoperative results and the long-term outcome of ileal pouch-anal anastomosis in 94 patients with familial adenomatous polyposis to those in 758 patients with ulcerative colitis. Two colitis patients died after operation (0.3%), but no polyposis patients died. Overa...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198909000-00002
更新日期:1989-09-01 00:00:00
abstract::From 1980 to 1984, 326 patients requiring splenectomy or splenorrhaphy were treated at one urban trauma center. Splenic injuries were graded in severity from one to five at the time of celiotomy. Splenorrhaphy was attempted in all patients, except when the spleen was shattered or avulsed or when multiple injuries were...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198505000-00005
更新日期:1985-05-01 00:00:00
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
doi:10.1097/00000658-199701000-00006
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of early, routine antioxidant supplementation using alpha-tocopherol and ascorbic acid in reducing the rate of pulmonary morbidity and organ dysfunction in critically ill surgical patients. SUMMARY BACKGROUND DATA:Oxidative stress has been associated with the development of the...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-200212000-00014
更新日期:2002-12-01 00:00:00