Abstract：
BACKGROUND:The Emergency Surgery Score (ESS) is an accurate mortality risk calculator for emergency general surgery (EGS). We sought to assess whether ESS can accurately predict 30-day morbidity, mortality, and requirement for postoperative Intensive Care Unit (ICU) care in patients with missing data variables. METHODS:All EGS patients with one or more missing ESS variables in the 2007-2015 ACS-NSQIP database were included. ESS was calculated assuming that a missing variable is normal (i.e. no additional ESS points). The correlation between ESS and morbidity, mortality, and postoperative ICU level of care was assessed using the c-statistics methodology. RESULTS:Out of a total of 4,456,809 patients, 359,849 were EGS, and of those 256,278 (71.2%) patients had at least one ESS variable missing. ESS correlated extremely well with mortality (c-statistic = 0.94) and postoperative requirement of ICU care (c-statistic = 0.91) and well with morbidity (c-statistic = 0.77). CONCLUSION:ESS performs well in predicting outcomes in EGS patients even when one or more data elements are missing and remains a useful bedside tool for counseling EGS patients and for benchmarking the quality of EGS care.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Naar L,El Hechi M,Kokoroskos N,Parks J,Fawley J,Mendoza AE,Saillant N,Velmahos GC,Kaafarani HMAdoi
10.1016/j.amjsurg.2020.02.034subject
Has Abstractpub_date
2020-12-01 00:00:00pages
1613-1622issue
6eissn
0002-9610issn
1879-1883pii
S0002-9610(20)30113-6journal_volume
220pub_type
杂志文章abstract：INTRODUCTION:The Affordable Care Act (ACA) expanded Medicaid eligibility to persons with income up to 138% of the federal poverty line. We investigated how Medicaid expansion (ME) impacted the access to cancer-specific surgical care in the US. METHODS:We used a nationwide population-based database (SEER) to identify p...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.06.023
更新日期：2020-01-01 00:00:00
abstract：:We devised a new technique to increase the safety of pancreaticojejunostomy in patients with an extended operation for pancreatic cancer. This new pancreaticojejunostomy was created by end-to-side anastomosis with four layers about 7 cm distal to the jejunal stump. The cut surface of the pancreas was placed on the ser...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80524-0
更新日期：1993-02-01 00:00:00
abstract：BACKGROUND:Breast-associated morphea (BAM) can mimic benign and malignant inflammatory breast disorders. The aim of the current study was to document our experience with this rare sclerosing dermatologic disorder. METHOD:We conducted a retrospective study at a single institution of all patients who had pathological di...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.06.024
更新日期：2010-07-01 00:00:00
abstract：:Surgeons have a history of almost 100 years of being in the forefront of efforts to standardize medical care and improve patients' health outcomes. Recently, increases in the "for-profit" sector have made it more difficult for patients to receive quality medical care. In this new era, surgeons need to stay involved in...
journal_title：American journal of surgery
pub_type： 社论
doi：10.1016/s0002-9610(97)00101-3
更新日期：1997-09-01 00:00:00
abstract：BACKGROUND:In view of the indolent nature of most cancers of the thyroid, particularly of the papillary and follicular variety, the decision to remove a segment of the upper aerodigestive tract when the cancer is either close to or invading this area is a difficult one. It was felt relevant to review the experience at ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80136-9
更新日期：1994-12-01 00:00:00
abstract：:Extracorporeal shock-wave lithotripsy (ESWL) in combination with adjuvant litholytic therapy using chenodeoxycholic acid and ursodeoxycholic acid (7 to 8 mg/kg body weight/day of each acid) is a safe and effective, novel nonsurgical approach to gallbladder stones, provided the patients are carefully selected. Experien...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/0002-9610(89)90249-3
更新日期：1989-09-01 00:00:00
abstract：BACKGROUND:Surgeons who have demonstrated excellence through extensive publication in the medical education literature can provide valuable guidance for new surgeons interested in educational research. METHODS:National databases identified members of the Association for Surgical Education (ASE) who have accumulated th...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00301-9
更新日期：2000-03-01 00:00:00
abstract：:One hundred seven patients with pseudocyst managed during the past decade were reviewed. The mortality rate of 11.2 percent compares favorably with the rates in other recent series. Twenty-two percent of the patients were managed conservatively, and 76 underwent exploration. None of the nonoperative patients died from...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90052-0
更新日期：1981-05-01 00:00:00
abstract：BACKGROUND:Recurrent laryngeal nerve (RLN) injury is a serious complication of thyroidectomy. The purpose of this study is to determine the predictors and consequences of RLN injury during thyroidectomy. METHODS:A retrospective analysis was conducted using the ACS-NSQIP 2016-2017 main and thyroidectomy targeted proced...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.07.023
更新日期：2021-01-01 00:00:00
abstract：:The popliteal artery entrapment syndrome is increasingly recognized as a cause of arterial insufficiency in the leg. Diagnosis is based on a clinical history of claudication, which may be atypical, physical examination, noninvasive exercise testing and angiography. Patients with normal ankle pulses and resting ankle/b...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90285-8
更新日期：1980-03-01 00:00:00
abstract：:Careful intraoperative surgical staging should be considered routine for all patients undergoing thoracotomy for lung cancer. In addition, conservative resection is indicated for T1N0 lesions. Surgical adjuvant immunotherapy has not proved as effective as originally hoped. However, the advent of more effective combina...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90037-x
更新日期：1982-06-01 00:00:00
abstract：BACKGROUND:Strategies for splenic preservation for trauma patients have gained acceptance; however, meaningful outcome evaluations have not been performed. To better understand the consequences of managing patients with splenic injuries, the short-term outcomes of different types of management strategies were examined....
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.07.037
更新日期：2008-08-01 00:00:00
abstract：:A technique for the repair of inguinal hernias in elderly patients with weak abdominal muscles has been presented. It consists of the overlapping of the flaps of the aponeurosis of the external oblique muscle according to the method previously proposed by Andrews. To date, the technique has given good results, even in...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90419-1
更新日期：1983-09-01 00:00:00
abstract：:Herein, we have described the surgical management of 23 patients with chronic intestinal ischemia. The patients presented most commonly with postprandial pain and weight loss. Diagnosis was confirmed by angiography, including lateral aortography. Surgery included bypass with Dacron being the most common graft material...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90301-5
更新日期：1984-07-01 00:00:00
abstract：BACKGROUND:Medical student mistreatment remains a concern, particularly in the surgery clerkship. This is a single academic institution's report of medical student perceptions of a mistreatment program embedded in the surgery clerkship. METHODS:Students who completed the surgery clerkship and the mistreatment program ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.01.001
更新日期：2018-04-01 00:00:00
abstract：:Mean fasting preoperative pancreatic polypeptide levels in a group of 18 patients with duodenal ulcer disease were 462 +/- 88 pg/ml, with 13 patients having markedly elevated levels (mean 600 +/- 106 pg/ml) and 5 patients having normal or minimally elevated levels (mean 112 +/- 32 pg/ml). Mean fasting postoperative pa...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90040-1
更新日期：1986-06-01 00:00:00
abstract：INTRODUCTION:The few series of synchronous lung cancers have included small cell and carcinoid tumors. We wished to determine the prognosis for patients with synchronous non-small cell lung cancer (NSCLC). METHODS:A database of 3034 lung cancer patients was reviewed for synchronous NSCLC. Survival was determined by Ka...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00019-0
更新日期：1996-05-01 00:00:00
abstract：BACKGROUND:The role of frozen section (FS) in thyroid disease is controversial. The goal of this study was to identify a cohort of patients who may or may not benefit from FS. METHODS:Two hundred thirty-one patients who underwent thyroidectomy were evaluated in regard to fine-needle aspiration (FNA), FS, and the exten...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01074-7
更新日期：2002-12-01 00:00:00
abstract：:Significant salvage of patients with a wide variety of cysts and benign tumors of the liver and of some patients with biliary strictures can be achieved by hepatic resection in carefully selected clinical situations with a low operative mortality rate and an acceptable postoperative complication rate. Still to be dete...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90123-5
更新日期：1979-04-01 00:00:00
abstract：BACKGROUND:A multicenter, randomized, clinical trial was initiated to evaluate the possible benefits of extended D2 (D2+) lymphadenectomy after potentially curative resection of gastric cancer. METHODS:Standard D2 lymphadenectomy was defined according to the Japanese Gastric Cancer Association classification. D2+ lymp...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.amjsurg.2006.04.018
更新日期：2007-01-01 00:00:00
abstract：BACKGROUND:Few data exist regarding surveillance for multiple primary melanoma (MPM) in elderly patients or whether the incidence and risk factors are the same as for younger patients. Thus, we studied the frequency and characteristics of MPM in the elderly melanoma patients. METHODS:From our prospective melanoma regi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.05.023
更新日期：2016-01-01 00:00:00
abstract：INTRODUCTION:Intestinal-cutaneous fistulas (ICFs) constitute a major surgical challenge. Definitive surgical treatment of ICFs continues to be associated with significant morbidity. The purpose of this study was to utilize a nationwide database to define the morbidity associated with current treatment strategies in the...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.08.038
更新日期：2020-09-02 00:00:00
abstract：:Three patients who underwent 95 percent removal of the pancreas for chronic pancreatitis with autotransplantation of the body and tail of the gland to the femoral area are described. The follow-up periods are 18, 6, and 2 months. Pain lessened in all patients and none required exogenous insulin. Patency of the graft w...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90036-3
更新日期：1983-04-01 00:00:00
abstract：:Patients who had undergone inguinal herniorrhaphy with local, general, or spinal anesthesia were surveyed for satisfaction with the anesthesia. A review of complications was carried out for these same patients to determine comparative rates in the three anesthesia groups. Patients were stratified by age and concomitan...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90154-1
更新日期：1987-06-01 00:00:00
abstract：BACKGROUND:Previous reports of minimally invasive antireflux surgery for gastroesophageal reflux disease (GERD) have been small, short-term series utilizing only a laparoscopic approach. We conducted a retrospective review and report our 66-month experience with more than 1,000 laparoscopic and thoracoscopic antireflux...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(98)00034-8
更新日期：1998-04-01 00:00:00
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 p...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.10.041
更新日期：2020-03-01 00:00:00
abstract：BACKGROUND:Esophageal cancer mortality is increased in African Americans relative to white patients. The reasons for this are unknown but are thought to be related to inadequate access to health care secondary to a higher poverty rate in African American populations. METHODS:The National Health Interview Survey databa...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.12.055
更新日期：2004-07-01 00:00:00
abstract：BACKGROUND:The 5-HT3 receptor is a serotonin receptor believed to reside on enteric neurons. However, several studies belie an exclusive neural localization. Our hypothesis is that the 5-HT3 receptor agonist, 2-methyl-5-HT (2Me5HT), induces chloride secretion despite neural blockade, which can be blocked by a 5-HT3 rec...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.07.012
更新日期：2005-11-01 00:00:00
abstract：BACKGROUND:Multifocal breast cancers (MFBCs) present a challenge to surgeons. Although its feasibility is still controversial, breast-conserving surgery (BCS) is not contraindicated for MFBCs. The investigators retrospectively evaluated the feasibility of BCS and reviewed histopathologic findings in patients with MFBC....
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.08.008
更新日期：2014-09-01 00:00:00
abstract：BACKGROUND:This meta-analysis was performed to determine the degree to which improvements in open hernia repair (OHR) in the last decade have altered the relative benefit of laparoscopic hernia repair (LHR). METHODS:Twenty-seven comparative trials including 4,688 randomized patients were evaluated. RESULTS:Within the...
journal_title：American journal of surgery
pub_type： 杂志文章,meta分析
doi：10.1016/s0002-9610(02)00878-4
更新日期：2002-07-01 00:00:00
