Abstract：
:Understanding variation in perioperative opioid exposure and its effect on patients' outcomes is critical for pain management. This study characterized perioperative exposure to morphine and its association with postoperative pain and 30-day readmissions. We utilized nationwide Veterans Healthcare Administration (VHA) data on four high-volume surgical procedures, 2007-2014. We identified 235,239 Veterans undergoing orthopedic, general, or vascular surgery; 5.4% high trajectories (116.1 OME/Day), 53.2% medium trajectories (39.7 OME/Day), and 41.4% low trajectories (19.1 OME/Day). Modeled estimates suggest that patients in the high OME group had higher risk of a pain-related readmission (OR: 1.59; CI: 1.39, 1.83) compared to the low OME trajectory. Yet when stratified by pain trajectory, patients with high pain and high OME had lower risk of a pain-related readmission compared to patients in the high pain low OME group (OR: 0.76, CI: 0.62, 0.94). In conclusion, patients receiving high perioperative OME are more likely to return to care for pain-related problems. This study highlights opportunities to reduce the amount of prescriptions opioids in the communities.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Hernandez-Boussard T,Graham LA,Carroll I,Dasinger EA,Titan AL,Morris MS,Hawn MTdoi
10.1016/j.amjsurg.2019.06.022subject
Has Abstractpub_date
2020-06-01 00:00:00pages
969-975issue
6eissn
0002-9610issn
1879-1883pii
S0002-9610(19)30581-1journal_volume
219pub_type
杂志文章abstract：:Enteral (gut) alimentation appears to offer greater benefit for patients than calories delivered via a parenteral (intravenous) route. Enteral alimentation prevents mucosal atrophy, maintains normal gut flora, decreases bacterial translocation, and enhances enteral immunological competence. Reliable delivery into the ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80235-9
更新日期：1995-06-01 00:00:00
abstract：:A safe and rapid technic for internal jugular vein cannulation is described. The success rate is almost as high and the serious complication rate is much lower than subclavian vein cannulation. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90148-4
更新日期：1978-05-01 00:00:00
abstract：BACKGROUND:Established methods for assessing surgical performance face limitations. Global rating scales and procedure-specific checklists are resource intensive and rely on expert opinions. Alternatives that use technology to track hand movements, such as magnetic and optical tracking systems, are generally expensive ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2011.08.008
更新日期：2012-01-01 00:00:00
abstract：BACKGROUND:Mesenteric vein thrombosis (MVT) is an uncommon type of intestinal ischemia associated with significant mortality and morbidity because of its delay in diagnosis. METHODS:A retrospective analysis of 9 patients treated surgically for MVT during 1982 to 1997 was performed. RESULTS:Nine patients underwent sur...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00532-8
更新日期：2001-01-01 00:00:00
abstract：:A total of 1,180 patients underwent palliative surgery for pancreatic cancer in the 158 hospitals of the U.S. Department of Veterans Affairs from 1987 to 1991. Using computerized data files, we analyzed these procedures according to type of procedure (gastric bypass only [GO], biliary bypass only [BO], or combined bil...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80669-5
更新日期：1993-12-01 00:00:00
abstract：:Cases of symptomatic Meckel's diverticulum treated surgically on an emergency basis during the last decade are reviewed. A series of 18 patients were divided into two groups depending on the presence or absence of ectopic tissue in the diverticulum. Group 1 consisted of five patients (28 percent) without ectopic tissu...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90576-3
更新日期：1986-05-01 00:00:00
abstract：BACKGROUND:Retractions of scientific articles represent attempts to correct the literature. Our goal was to examine retracted surgical papers. METHODS:NCBI PubMed database was queried using the search terms "surgery," "surg," or "surgical" and "retracted" or "retraction." Article details were recorded. RESULTS:There ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2017.11.033
更新日期：2018-11-01 00:00:00
abstract：:Primary non-Hodgkin's lymphomas of the gastrointestinal tract are rare in children, and few of these lymphomas are located in the sigmoid colon. The preoperative diagnosis rate is low. Complete resection is indicated if it can be done safely. Combination chemotherapy after resection is indicated. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.12.063
更新日期：2009-01-01 00:00:00
abstract：BACKGROUND:Open abdomen with temporary abdominal closure remains a controversial management strategy for surgical abdominal sepsis compared with primary abdominal closure (PAC) and on-demand laparotomy. The primary objective was to compare mortality between PAC and open abdomen with vacuum assisted closure (VAC). METH...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.01.012
更新日期：2016-05-01 00:00:00
abstract：BACKGROUND:Hypercapnia and local pressure effects unique to CO(2) base minimally invasive surgery alter renal blood flow. We have demonstrated laparoscopic antireflux surgery to have an additional impact upon hemodynamics (decreased cardiac output), potentially extending known effects upon renal blood flow. METHODS:We...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)00824-3
更新日期：2002-04-01 00:00:00
abstract：BACKGROUND:Laparoscopic donor nephrectomy (LDN) is a new technique. While the short-term recipient renal function is equivalent to that of the traditional open nephrectomy (ODN), long-term function and potential exclusion criteria, such as the presence of multiple renal arteries, are as yet unknown. METHODS:Retrospect...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(98)00260-8
更新日期：1998-12-01 00:00:00
abstract：BACKGROUND:The results and advantages of laparoscopic cholecystectomy in the geriatric population have received minimal attention. Several early reports related high conversion rates complications and mortality. This case series review is focused on the results of laparoscopic cholecystectomy in the geriatric populatio...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.11.031
更新日期：2004-06-01 00:00:00
abstract：BACKGROUND:The Trauma Evaluation and Management (TEAM) module orients medical students to the initial assessment of an injured patient. At the Medical College of Wisconsin, a course based on expanded TEAM (eTEAM) was developed for junior medical students. This study determined whether eTEAM improved the ability to perf...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.08.033
更新日期：2006-02-01 00:00:00
abstract：BACKGROUND:The presence of an "open abdomen" after a trauma laparotomy can complicate the nutritional management of injured patients. METHODS:The medical records of patients admitted to an American College of Surgeons-verified level 1 trauma center were evaluated. The timing of nutritional support was noted. The metho...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.08.033
更新日期：2010-03-01 00:00:00
abstract：:A retrospective review of 58 rare breast neoplasms encountered at the British Columbia Cancer Agency between 1972 and 1992 was undertaken. There were 38 cystosarcoma phyllodes tumors, 6 carcinosarcomas, and 14 other sarcomas. Initial management involved total mastectomy in 37 cases, wide excision in 14, and excision b...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(94)90238-0
更新日期：1994-05-01 00:00:00
abstract：OBJECTIVE:To demonstrate chest roentgenograms after central venous line changes over a guidewire delay the use of the central lines and increases charges with no change of morbidity or the rate of complication. METHODS:Retrospective study using the Surgical Intensive Care database followed by a nonrandomized, prospect...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(98)00142-1
更新日期：1998-09-01 00:00:00
abstract：BACKGROUND:Although increasingly administered to patients with pancreatic ductal adenocarcinoma, the role of preoperative therapy for patients with distal cholangiocarcinoma is undefined. METHODS:All patients with distal cholangiocarcinoma who underwent pancreatoduodenectomy between 1999 and 2014 were retrospectively ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.08.024
更新日期：2019-07-01 00:00:00
abstract：:Between 1979 and 1988, we created intestinal anastomoses in 1,000 patients using a single-layer, continuous suturing technique and a polypropylene suture. The technique is easily learned, flexible in its application, and incurs less cost than most other techniques. The anastomoses involved all levels of the colon and ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90262-c
更新日期：1991-11-01 00:00:00
abstract：BACKGROUND:It was hypothesized that routine operative drainage is unnecessary for elective hepatic resection. METHODS:A review was made of the clinical records of patients undergoing liver resection at a tertiary referral hepatobiliary surgery center since the conclusion in April of 1994 of our previous randomized dra...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)00998-4
更新日期：2002-11-01 00:00:00
abstract：:The hospital and office records of 86 patients who underwent proctectomy for cancer of inflammatory bowel disease with primary closure of the perineal wound were reviewed. Almost one fourth of all patients suffered a significant perineal wound complication, the majority of which were infections. The incidence of posto...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90187-3
更新日期：1983-01-01 00:00:00
abstract：BACKGROUND:The treatment for a contralateral breast cancer (CBC) presents a growing dilemma given the expanding number of long-term survivors. We hypothesize that there will be specific surgical treatment trends with demographic differences between the treatment groups. METHODS:The Surveillance, Epidemiology, and End ...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2014.05.010
更新日期：2014-10-01 00:00:00
abstract：:A new technique has been described for the placement of an implantable percutaneous triple-lumen catheter. This procedure eliminates the need for a large bore introducer. It also provides a mechanism to change these catheters over a wire if necessary. This cannot be accomplished with the Hickman or Broviac catheters. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80116-1
更新日期：1985-03-01 00:00:00
abstract：BACKGROUND:Open and laparoscopic antireflux surgeries are standard for the treatment of gastroesophageal reflux disease (GERD). The in-hospital outcomes of laparoscopic and open antireflux procedures were analyzed and compared at US academic medical centers. METHODS:Using International Classification of Diseases, Nint...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2008.07.041
更新日期：2008-12-01 00:00:00
abstract：:Paraplegia or paraparesis after operations on the thoracic and abdominal aorta is a devastating event, both for the patient and the surgeon. While its incidence varies from under 1% with operations at the top and bottom of the aorta, its occurrence in the midportion of the aorta, just above the diaphragm, even in the ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(98)00133-0
更新日期：1998-08-01 00:00:00
abstract：BACKGROUND:The risk of an injury of the laryngeal recurrent nerve is an important issue during any surgical procedure in the lower neck. METHODS:Based on our experience with the transcervical-subxiphoid bilateral videothoracoscopic maximal thymectomies, we developed an original technique of visualization for both of t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.08.064
更新日期：2005-02-01 00:00:00
abstract：BACKGROUND:The upper thigh is an alternative but infrequently used site to the forearm for placement of subcutaneous polytetrafluoroethylene (PTFE) arteriovenous conduits in patients requiring hemodialysis for end stage renal failure. This site has the great advantage of easier accessibility for self-cannulation. METH...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00405-9
更新日期：1997-04-01 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
doi：10.1016/0002-9610(75)90467-5
更新日期：1975-07-01 00:00:00
abstract：BACKGROUND:Since any intraductal papillary mucinous neoplasm (IPMN) is at least premalignant, avoiding conversion to invasion by pancreatic resection should provide a survival advantage-but how much? METHODS:We reviewed 100 cases of IPMN that were resected. Survival was compared between 3 groups: noninvasive IPMN (n =...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.01.020
更新日期：2005-05-01 00:00:00
abstract：BACKGROUND:Physiologic variables used in trauma triage criteria may be significantly affected by age, decreasing their predictive value in geriatric trauma. METHODS:The study population was all adult patients in the Washington State Trauma Registry from 2000 to 2004. Elderly patients were defined as those aged >65 yea...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.12.037
更新日期：2009-05-01 00:00:00
abstract：BACKGROUND:This study was designed to compare short-term laparoscopic total gastrectomy (LTG) with open total gastrectomy (OTG) outcomes in gastric cancer. METHODS:Seventy patients who underwent total gastrectomy via LTG or OTG were included. All cases were matched for stage, age, and sex by means of statistically gen...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.11.011
更新日期：2013-09-01 00:00:00
