Abstract:
OBJECTIVE:The aim of the study was to investigate whether patients who undergo surgery in hospitals experiencing significant length of stay (LOS) reductions over time are exposed to a higher risk of severe adverse events in the postoperative period. SUMMARY BACKGROUND DATA:Surgical care innovation has encouraged hospitals to shorten LOS under financial pressures with uncertain impact on patient outcomes. METHODS:We selected all patients who underwent elective colectomy or urgent hip fracture repair in French hospitals between 2013 and 2016. For each procedure, hospitals were categorized into 3 groups according to variations in their median LOS as follows: major decrease, moderate decrease, and no decrease. These groups were matched using propensity scores based on patients' and hospitals' potential confounders. Potentially avoidable readmission for severe adverse events and death at 6 months were compared between groups using Cox regressions. RESULTS:We considered 98,713 patients in 540 hospitals for colectomy and 206,812 patients in 414 hospitals for hip fracture repair before matching. After colectomy, patient outcomes were not negatively impacted when hospitals reduced their LOS [hazard ratio (95% confidence interval): 0.93 (0.78-1.10)]. After hip fracture repair, patients in hospitals with major decreases in LOS had a higher risk of severe adverse events [1.22 (1.11-1.34)] and death [1.17 (1.04-1.32)]. CONCLUSIONS:Patients who underwent surgical procedures in hospitals experiencing major decreases in LOS were demonstrated worse postoperative outcomes after urgent hip fracture repair and not after elective colectomy. Development of care bundles to enhance recovery after emergency surgeries may allow better control of LOS reduction and patient outcomes.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Pascal L,Polazzi S,Piriou V,Cotte E,Wegrzyn J,Carty MJ,Chollet F,Sanchez S,Lifante JC,Duclos Adoi
10.1097/SLA.0000000000003206subject
Has Abstractpub_date
2020-07-01 00:00:00pages
105-112issue
1eissn
0003-4932issn
1528-1140journal_volume
272pub_type
杂志文章abstract::The relationship of transcutaneous oxygen tension (PtcO2) to arterial oxygen tension (PaO2), pulmonary shunt (Qsp/Qt), mixed venous oxygen tension (PVO2), and O2 delivery was determined in patients with respiratory failure in order to explore the possible usefulness of PtcO2 to titrate the level of positive end expira...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198102000-00014
更新日期:1981-02-01 00:00:00
abstract:OBJECTIVE:The aim of the randomized clinical trial was to compare the 2 years of clinical outcomes of a lightweight (Ultrapro) vs a heavyweight (Prolene) mesh for laparoscopic total extraperitoneal (TEP) inguinal hernia repair. BACKGROUND:Lightweight meshes reduce postoperative pain and stiffness in open anterior ingu...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000001579
更新日期:2016-05-01 00:00:00
abstract:PURPOSE:To assess the efficacy of isolated pelvic perfusion (IPP) with tumor necrosis factor (TNF)-α and melphalan in patients with locally advanced cancers in the pelvic and groin area requiring mutilating surgery. METHODS:A total of 27 patients were enrolled (carcinoma, n = 17; sarcoma/melanoma, n = 4; and endocrine...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318242ebe7
更新日期:2012-02-01 00:00:00
abstract::The etiology of hepatic insufficiency associated with the multiple systems organ failure (MSOF) syndrome is unclear. The authors have investigated the possibility that a macrophage/Kupffer cell mediated modulation of hepatocyte function may play a role in this phenomenon. Isolated rat hepatocytes were cultured, and th...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::The subcutaneous administration of insulin did not induce a significant effect on oxidative phosphorylation of the mitochondria from normal rat liver. However, in rats subjected to ligation of a branch of portal vein, the phosphorylative activity of the mitochondria from the ligated lobe deprived of portal blood fell ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197411000-00002
更新日期:1974-11-01 00:00:00
abstract:OBJECTIVE:This study aimed to investigate the therapeutic impact of a new oncolytic vaccinia virus in a triple-negative breast cancer (TNBC) murine model and its potential for treating distant metastatic disease. BACKGROUND:TNBCs are aggressive tumors associated with a high metastatic rate. Their lack of targets for h...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182654572
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:Patients frequently voice concerns regarding wait times for cancer treatment; however, little is known about the length of wait times from diagnosis to surgery in the United States. Our objectives were (1) to assess changes in wait times over the past decade and (2) to identify patient, tumor, and hospital f...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318211cc0f
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Fine-needle aspiration (FNA) is currently the primary diagnostic procedure in diagnosing thyroid malignancy and guides surgeons on patient selection for thyroidectomy for thyroid nodules. Diagnostic sensitivity is reported to be approximately 80%; however, patients with negative FNA results do not necessaril...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e3180f61adc
更新日期:2007-11-01 00:00:00
abstract::The effects of two levels of protein intake on protein metabolism in six severely burned adult patients were studied (means of 70% BSA burned). A crossover experimental design enabled the authors to study each patient at the end of two three-day dietary regimens. All diets were isocaloric and provided approximately 25...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198302000-00007
更新日期:1983-02-01 00:00:00
abstract:OBJECTIVE:To explore challenges and opportunities for surgery departments' academic missions as they become increasingly affiliated with expanding health systems. SUMMARY BACKGROUND DATA:Academic medicine is in the midst of unprecedented change. In addition to facing intense competition, narrower margins, and decrease...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004462
更新日期:2020-11-12 00:00:00
abstract:OBJECTIVE:Because of rising costs and shrinking reimbursements, hospitals must continually find ways to improve efficiency and productivity. This study attempts to increase caseloads in ambulatory surgery operating rooms while maintaining patient satisfaction and safety. SUMMARY BACKGROUND DATA:In most hospitals, pati...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000193600.97748.b1
更新日期:2006-01-01 00:00:00
abstract::Five patients were studied before and two to three days after major, uncomplicated abdominal operation. Muscle tissue was obtained by needle biopsy from m. quadriceps femoris after eight hours overnight fast. Plasma free amino acids were analyzed in simultaneously obtained samples. In the homogenized muscle samples th...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197512000-00001
更新日期:1975-12-01 00:00:00
abstract:OBJECTIVE:This study determined whether the neurotensin gene (NT/N) is expressed in the normal adult liver and focal nodular hyperplasia (FNH) and confirmed NT/N expression in fibrolamellar carcinoma; whether NT/N or the neurotensin receptor is expressed in the fetal liver; and whether hepatic resection leads to expres...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199410000-00007
更新日期:1994-10-01 00:00:00
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
doi:10.1097/00000658-198412000-00007
更新日期:1984-12-01 00:00:00
abstract:OBJECTIVE:To construct and validate a scoring system for evidence-based selection of bariatric and metabolic surgery procedures according to severity of type 2 diabetes (T2DM). BACKGROUND:Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) account for >95% of bariatric procedures in United States in patients w...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002407
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVES:To compare the effects of intraoperative goal-directed fluid therapy (GDFT) with conventional fluid therapy, and determine whether there was a difference in outcome between studies that did and did not use Enhanced Recovery After Surgery (ERAS) protocols. METHODS:Meta-analysis of randomized controlled trial...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析
doi:10.1097/SLA.0000000000001366
更新日期:2016-03-01 00:00:00
abstract:SUMMARY BACKGROUND DATA:Previous studies have suggested a variety of factors that may affect the false negative (FN) rate for sentinel lymph node (SLN) biopsy in breast cancer. Because FN results are relatively rare, no prior studies have had sufficient sample size to allow detailed statistical analysis of factors pred...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/01.sla.0000165200.32722.02
更新日期:2005-06-01 00:00:00
abstract::The combined Cambridge/King's College Hospital series of 64 orthotopic liver grafts' experience dates back to 1968. Many patients were referred for liver grafting late in the course of their diseases and were operated on when they were too ill or died before suitable livers could be found. Complications of biliary dra...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197709000-00006
更新日期:1977-09-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to assess how thermal ablation of colorectal liver metastases affects the outgrowth of micrometastases in the transition zone (TZ) between ablated tissue and the unaffected reference zone (RZ) in 2 different murine models. BACKGROUND:Thermal destruction therapies of nonresectable co...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181a38ef5
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:We sought to test whether postconditioning, a series of brief mechanical interruptions of reperfusion applied during the onset of reperfusion, can prevent neurologic injury of the spinal cord after transient ischemia. SUMMARY BACKGROUND DATA:Ischemia-reperfusion injury of the spinal cord is the principal mec...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000217608.08582.35
更新日期:2006-07-01 00:00:00
abstract::Forty-nine patients with chronic ulcerative colitis refractory to medical therapy and four with multiple polyposis have undergone total colectomy, mucosal protectomy, and endorectal ileal pull-through with ileoanal anastomosis at the UCLA Medical Center during the past 12 years (mean age, 19.4 years). Thirty-eight pat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198402000-00003
更新日期:1984-02-01 00:00:00
abstract:BACKGROUND:Over the past 2 decades, there has been an increase in opioid use and subsequently, opioid deaths. The amount of opioid prescribed to surgical patients has also increased. The aim of this systematic review was to determine postdischarge opioid consumption in surgical patients compared with the amount of opio...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002591
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the preoperative relationships of hypertension and diabetes mellitus in severe obesity and the effects of gastric bypass (GBP)-induced weight loss. SUMMARY BACKGROUND DATA:Severe obesity is associated with multiple comorbidities, particularly hypertension and type 2 diabetes mellitus, that may af...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.SLA.0000071560.76194.11
更新日期:2003-06-01 00:00:00
abstract:OBJECTIVE:To determine the DNA replication error (RER) status in young patients with colorectal cancer (CRC), and to compare the clinical and pathologic characteristics of RER-positive and RER-negative cases. SUMMARY BACKGROUND DATA:Recent studies suggest that patients with RER-positive CRC have an improved prognosis....
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199801000-00008
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:The aims of this study were to use a comprehensive whole-mount pathologic analysis to characterize microscopic patterns of residual disease, as well as circumferential and distal resection margins, in rectal cancer treated with preoperative CMT; and to identify clinicopathologic factors associated with residu...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000232540.82364.43
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:This article describes a preliminary work on virtual reality applied to liver surgery and discusses the repercussions of assisted surgical strategy and surgical simulation on tomorrow's surgery. SUMMARY BACKGROUND DATA:Liver surgery is considered difficult because of the complexity and variability of the org...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199811000-00001
更新日期:1998-11-01 00:00:00
abstract:OBJECTIVE:To assess the feasibility of developing a simulated ward environment in which to assess the ward-based care of surgical patients by clinicians of varying levels of experience (construct validation). BACKGROUND:Increasing evidence points to the importance of the postoperative or ward-based phase of surgical c...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318288e1d4
更新日期:2014-02-01 00:00:00
abstract::Percutaneous transluminal angioplasty (PTA) was performed as an adjunct to an operation in 43 patients with peripheral arterial insufficiency. This represents 26% of patients undergoing PTA over the past 44 months. In 23 patients PTA was done in conjunction with planned vascular reconstruction. It was successful in al...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198206000-00016
更新日期:1982-06-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to assess the effect of Ω3 fatty acids (Ω3FA) on fatty and lean liver in hepatic surgery. BACKGROUND:The global spread of energy-dense diets has led to an endemic rise in fatty liver disease and obesity. Besides metabolic pathologies, steatosis enhances hepatic sensitivity to ischem...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001968
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:The goal of this scoping review was to summarize the literature on facilitators and barriers to surgical practice change. This information can inform research to implement best practices and evaluate new surgical innovations. BACKGROUND:In an era of accelerated innovations, surgeons face the difficult decisi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004355
更新日期:2020-08-26 00:00:00