Abstract:
BACKGROUND:Geriatric patients, age ≥65, frequently require no operation and only short observation after injury; yet many are prescribed opioids. We reviewed geriatric opioid prescriptions following a statewide outpatient prescribing limit. METHODS:Discharge and 30-day pain prescriptions were collected for geriatric patients managed without operation and with stays less than two midnights from May and June of 2015 through 2018. Patients were compared pre- and post-limit and with a non-geriatric cohort aged 18-64. Fall risk was also assessed. RESULTS:We included 218 geriatric patients, 57 post-limit. Patients received fewer discharge prescriptions and lower doses following the limit. However, this trend preceded the limit. Geriatric patients received fewer opioid prescriptions but higher doses than non-geriatric patients. Fall risk was not associated with reduced prescription frequency or doses. CONCLUSIONS:Opioid prescribing has decreased for geriatric patients with minor injuries. However, surgeons have not reduced dosage based on age or fall risk.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Young BT,Zolin SJ,Ferre A,Ho VP,Harvey AR,Beel KT,Tseng ES,Conrad-Schnetz K,Claridge JAdoi
10.1016/j.amjsurg.2019.10.041subject
Has Abstractpub_date
2020-03-01 00:00:00pages
400-403issue
3eissn
0002-9610issn
1879-1883pii
S0002-9610(19)30894-3journal_volume
219pub_type
杂志文章abstract::From 1972 to 1987, 403 patients underwent a composite resection consisting of segmental mandibulectomy and neck dissection for the treatment of bucco-pharynx squamous cell carcinoma (303 patients had postoperative radiotherapy [XRT], 29 patients had preoperative XRT, and 100 patients had tissue salvage performed after...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80350-2
更新日期:1993-10-01 00:00:00
abstract::Experience with 22 cases of reconstruction of the cervical esophagus, hypopharynx and oral cavity using free jejunal transfer is presented. The method requires an experienced team with high technical competence, but the benefits related to rapid single-stage completion and low morbidity certainly justify its use. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90197-x
更新日期:1980-10-01 00:00:00
abstract:BACKGROUND:Although several methods of repair of extremity venous injuries have been shown to be efficacious, patency rates have varied significantly from center to center. METHODS:A retrospective review was made of treatment outcomes of adult and pediatric patients with major venous injuries of the lower extremity. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.08.006
更新日期:2003-12-01 00:00:00
abstract::Aortoesophageal fistula secondary to a thoracic aortic aneurysm is usually a fatal disease with few survivors reported previously. We encountered 2 consecutive patients who were treated successfully with esophagectomy and in situ aorta reconstruction using cryopreserved homograft that was wrapped completely with oment...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.09.011
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:Percutaneous endoscopic gastrostomy and jejunostomy tube placement have long been considered the standard for supplying enteral nutrition when oral intake is not possible. Both have well-documented roles and limitations and are associated with a higher than generally appreciated incidence of aspiration. A di...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(98)00298-0
更新日期:1999-01-01 00:00:00
abstract::The surgical management of an infectious and fistulous wound with a pharyngoesophageal tumor is one of the greatest challenges for head and neck and plastic surgeons. The free jejunal transfer has been the standard technique for pharyngoesophageal reconstruction, and the free omental flap has been one of the most reli...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00392-5
更新日期:2000-06-01 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:BACKGROUND:The aim of the study was to evaluate the efficacy of adjuvant chemotherapy on survival after resection for gastric cancer. METHODS:Patients were enrolled if they underwent resection of gastric cancer but had lymph node or serosal involvement or both. Surgical resection was either total or partial gastrectom...
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.2003.12.014
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:Letters of recommendation (LoR) are considered one of the most important predictors of matching into a pediatric surgery fellowship. We determined if gendered differences exist in LoR written for resident candidates. METHODS:A retrospective review of blinded LoR to a fellowship program between 2015 and 2017...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.08.005
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Studies on stress hyperglycemia in trauma patients have largely ignored diabetes, a potential confounder. The purpose of this study was to assess the relationship between diabetes and outcome in trauma patients. METHODS:Data were obtained from the National Trauma Data Bank (version 4.0). The primary outcome...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.08.031
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Prognosis in peritoneal carcinomatosis from gastric cancer has improved with cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy. The aim of this study was to identify predictive factors for incomplete CS. METHODS:Forty-five patients undergoing laparotomy for gastric cancer with periton...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.06.009
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Alcohol use may alter mental status and vital signs in injured patients, leading to increased testing during emergency department (ED) evaluation. We hypothesized that alcohol use increases the hospital charges when caring for these injured patients. METHODS:The National Hospital Ambulatory Medical Care Sur...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.08.014
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:The availability and utility of public statements and policies on gender equity from professional surgical societies has not been studied. METHODS:Professional surgical society websites were searched for publicly available statements and policies related to gender equity. These were compiled and assessed fo...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.06.041
更新日期:2020-11-01 00:00:00
abstract:INTRODUCTION:The integrity of the medical literature about robotic surgery remains unclear despite wide-spread adoption. We sought to determine if payment from Intuitive Surgical Incorporated (ISI) affected quality of the research produced by surgeons. METHODS:Publicly available financial data from the CMS website reg...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2017.08.017
更新日期:2018-07-01 00:00:00
abstract::Although few trauma patients sustain fatal pulmonary embolism, a large population is at risk from nonfatal embolism due to unrecognized deep vein thrombosis (DVT). Thirty-eight of 39 immobilized trauma patients at bed rest for 10 days or longer had venographic study of their lower extremities to evaluate for the prese...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90182-7
更新日期:1989-12-01 00:00:00
abstract::Approximately 60% of patients who die from melanoma have gastrointestinal (GI) metastases at autopsy, yet antemortem diagnosis is uncommon. A retrospective review was completed on 32 patients who underwent an operation at Memorial Sloan-Kettering Cancer Center between 1977 and 1987 for complications of melanoma metast...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90070-t
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:In the 1990s, partial stomach-partitioning gastrojejunostomy (PSPG) was introduced. Benefits of this method are that it preferentially shunts food away from the obstructed duodenum or pylorus, thus reducing reflex emesis. METHODS:A retrospective review of patients undergoing PSPG for malignant obstruction f...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.11.015
更新日期:2013-09-01 00:00:00
abstract::Colonic and rectal anastomotic strictures occur with an incidence ranging from 3% to 30%. Several factors, such as defunctionalization, anastomotic leak, ischemia, radiation, and neoplasms, have been implicated in their pathogenesis. Management of large bowel strictures is generally based on their cause, location, and...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.02.030
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to analyze the influence of age on both the risk of hepatectomy and the prognosis in patients with hepatocellular carcinoma (HCC). METHODS:Patients undergoing an initial hepatectomy for HCC were classified into 2 age groups: 75 years or over (n = 113) and less than 75 years (n ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.05.026
更新日期:2015-04-01 00:00:00
abstract::Three hundred eight patients underwent parotidectomy for a benign parotid tumor between 1948 and 1979. Two hundred seventy-four had operation for primary tumor, and 34, for recurrent tumor. Ninety-eight percent of those with primary tumors had superficial or total parotidectomy, and 2 percent had local excision with a...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90321-1
更新日期:1986-10-01 00:00:00
abstract:BACKGROUND:Currently, >200 meshes are commercially available in the United States. To help guide appropriate mesh selection, the investigators examined the postsurgical experiences of all patients undergoing ventral hernia repair at their facility from 2008 to 2011 with ≥12 months of follow-up. METHODS:A retrospective...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.01.026
更新日期:2013-05-01 00:00:00
abstract::Eighty-two femoropopliteal reconstructions were performed on sixty-six consecutive patients. Of seventeen late failures, thirteen were secondarily reconstructed. Clinical and angiographic studies demonstrated the reasons for failure in all patients except one. Seven patients were improved and six unimproved by reopera...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90107-1
更新日期:1978-02-01 00:00:00
abstract::Obesity is a serious health problem in the United States today, and surgical treatment is recognized as long-term effective therapy. Minimally invasive techniques are becoming the "gold standard" approach to the treatment of disease, and robotic surgery has the potential to advance the use and development of minimally...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.08.027
更新日期:2004-10-01 00:00:00
abstract::Mediastinal tracheostomy has been associated with high morbidity and mortality, often due to skin necrosis, with resultant exposure of the great vessels and subsequent hemorrhage. During a 4 year period, 11 patients underwent mediastinal tracheostomy. Reconstruction included the use of a pectoralis major musculocutane...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90377-5
更新日期:1984-10-01 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:On July 1st, 2012, the University of Minnesota Medical Centers adopted a policy requiring all personnel to wear cover jackets in perioperative areas. This policy is based on the Association of Perioperative Registered Nurses recommended practice for cover jacket usage. We hypothesized that the cover jacket p...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.02.015
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Identifying factors associated with resident autonomy may help improve training efficiency. This study evaluates resident and procedural factors associated with level of guidance needed in the operating room. METHODS:Intraoperative performance and yearly performance on Fundamentals of Laparoscopic Surgery (...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.03.019
更新日期:2019-05-01 00:00:00
abstract::After a biliary-enteric anastomosis, the development of cholangitis is usually assumed to be due to obstruction of the stoma. Six patients in whom this was not the case are described. Achlorhydria, duodenal diverticula, and foreign bodies are important predisposing factors. When bacterial contamination is severe in an...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90038-7
更新日期:1983-04-01 00:00:00
abstract::Since feeding increases intestinal fluid and electrolyte losses in short bowel syndrome, an agent increasing postprandial small bowel absorption might have a therapeutic role. Peptide YY (PYY) has recently been shown to increase net small bowel absorption under basal conditions. The aim of this study was to determine ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(94)90100-7
更新日期:1994-06-01 00:00:00
abstract::William Stewart Halsted and John Chalmers DaCosta are two of the most distinguished surgeons in the history of medicine in the United States. Although their personalities were completely opposite, they enjoyed a long and devoted friendship. During their relationship, a fairly continuous correspondence was maintained. ...
journal_title:American journal of surgery
pub_type: 传,历史文章,杂志文章
doi:10.1016/0002-9610(89)90622-3
更新日期:1987-09-01 00:00:00