Abstract:
INTRODUCTION:We describe an institutional program (INR- Interval NSQIP Review), to augment NSQIP utility through structured, multidisciplinary review of surgical outcomes in order to create near 'real-time' adverse event (AE) monitoring and improve surgeon awareness. METHODS:INR is a monthly meeting of quality analysts, surgeons and nursing leadership initiated to validate AE with NSQIP criteria, review data in real-time, and perform in-depth case analyses. Occurrence classification concerns were referred for national NSQIP review. Monthly reports were distributed to surgeons with AE rates and case-specific details. RESULTS:Since implementation, 377/3,026 AE underwent in-depth review. Of those, 7 occurrences were referred for clarification by central NSQIP review. Overall 37 (1.2%) were not consistent with NSQIP-defined AE after INR. Time from occurrence to surgeon review decreased by 223 days (296 vs. 73 days, p = 0.006). DISCUSSION:Structured monthly institutional review of AE prior to submission can create greater transparency and confidence of NSQIP data, reduce time from occurrence to surgeon recognition, and improve stakeholder understanding of AE definitions. This approach can be tailored to institutional needs and should be evaluated for downstream improvement in patient outcomes.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Cunningham AJ,Howell B,Polites S,Krishnaswami S,Hughey E,Terry S,Fox J,Azarow Kdoi
10.1016/j.amjsurg.2020.02.057subject
Has Abstractpub_date
2020-05-01 00:00:00pages
865-868issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(20)30139-2journal_volume
219pub_type
杂志文章abstract::One hundred seventeen patients with threatened limb loss were evaluated. Seventy-three of these patients underwent vascular reconstruction. Diabetics had a significantly higher incidence of ischemic ulceration and gangrene when compared with nondiabetics. Nondiabetics typically presented with rest pain. The outcome of...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80534-8
更新日期:1988-12-01 00:00:00
abstract:BACKGROUND:The anastomotic leak and stricture formation after esophagectomy and cervical esophagogastric anastomosis deny patients with esophageal carcinoma the benefits of surgery. The present study was designed to ascertain whether a wide cross-sectional area at the site of anastomosis leads to lesser anastomotic com...
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/s0002-9610(01)00616-x
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:Restoration of the abdominal wall's integrity after postoperative wound dehiscence is frequently performed in a delayed fashion, necessitating a temporary dressing of the dehisced wound. METHODS:The Vacuum Assisted Closure (VAC) system (Kinetic Concepts, Inc., San Antonio, TX) was used in 21 patients with p...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.09.003
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:Methylene blue dye (MBD) is being used as an alternative to isosulfan blue dye in sentinel lymph node (SLN) biopsies for breast cancer patients. Complications using MBD for SLN localization have not previously been reported. METHODS:A retrospective study was conducted of 24 consecutive patients who received...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)00945-5
更新日期:2002-10-01 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:Five percent of patients who undergo fundoplication will require reoperation. The cause of this high failure rate and the best management for these patients remains poorly understood. The aim of this study was to identify patterns and causes of failure of primary antireflux procedures. METHODS:Retrospective...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2004.08.062
更新日期:2004-12-01 00:00:00
abstract::Gastroduodenal artery pseudoaneurysm is a rare but life threatening complication of pancreatitis. Diagnosis and management of it remain challenging. Surgical treatment was associated with a high mortality. Percutaneous transarterial embolization of bleeding artery has recently been advocated as a definitive therapy an...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.05.014
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine whether differing neoadjuvant chemotherapy (NAC) regimens for HER2 positive breast cancer (HER2+ BC) are associated with differing surgical complications. Our goal was to evaluate postoperative complications in HER2+ BC patients receiving NAC with Herceptin (trastuzumab...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.06.053
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:The role of sentinel lymph node status (SLNS) in thick melanoma is evolving. The purpose of this study was to determine the prognostic value of SLNS in thick melanoma. METHODS:A retrospective analysis of 120 prospectively collected clinically node-negative thick melanomas over 5 years was performed. Patient...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.12.022
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:We investigated whether or not interleukin-8 (IL-8) and granulocyte elastase (GE) can be associated with pulmonary complication after esophagectomy (the most common cause of postoperative death). METHODS:We measured serial changes in the IL-8 concentration and GE activity in the plasma and bronchoalveolar l...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00558-4
更新日期:2001-02-01 00:00:00
abstract::Several recent reviews have suggested that aggressive surgical intervention can reduce morbidity and mortality associated with intra-abdominal crises in AIDS patients. We reviewed our experience with 57 AIDS patients with 63 emergent laparotomies performed at 4 hospitals affiliated with the University of California in...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80194-1
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:This study was undertaken to evaluate the accuracy of touch preparation (touch prep) in the evaluation of sentinel lymph nodes (SLNs). METHODS:We performed a retrospective review of 402 breast cancer patients who underwent SLN biopsy. RESULTS:A SLN was identified in 381 patients. Of 61 patients with a true...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.06.020
更新日期:2010-06-01 00:00:00
abstract::Since its inception in 1994, the National Surgical Quality Improvement Program (NSQIP) has been used to compare the performance of all Veterans Administration (VA) hospitals offering major surgical procedures. The program's outcome data are used to identify areas of both excellent and poor performance. The data can al...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.10.004
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:Efforts to improve surgical safety are limited by several factors and no consensus exists regarding the most effective way to improve surgical quality. The use of ISO 9001 quality standards within healthcare is recognized but has not been widely applied for improving surgical outcomes. METHODS:A surgical qu...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.11.014
更新日期:2020-11-09 00:00:00
abstract:BACKGROUND:Glass tables can break and cause traumatic injury. This public health issue is avoidable by adequate regulatory measures. We describe the burden and characteristics of these injuries using the National Electronic Injury Surveillance System (NEISS) database and data from a level 1 trauma center. METHODS:NEIS...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.07.002
更新日期:2020-11-01 00:00:00
abstract::Between 1973 and 1989, 49 patients with gastrointestinal lymphomas were treated at the Virginia Mason Medical Center, Seattle, Washington, and followed in the tumor registry. The purpose of this review was to determine the influence of treatment on long-term survival of these patients. The mean age was 63 years (range...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90902-p
更新日期:1991-05-01 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::Our purpose in this study was to determine whether tumor DNA content is a prognostic factor independent of other standard clinical and histologic parameters in squamous cell carcinoma (SCC) of the head and neck region. Tumor DNA content was determined in 76 patients with primary resectable SCC of the oral cavity, lary...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80291-5
更新日期:1988-10-01 00:00:00
abstract:BACKGROUND:Increased surgical workforce diversity diminishes health disparities. METHODS:Researchers recruited and nonrandomly enrolled participants into intervention and comparison groups for a quasi-experimental study of the impact of a seminar course on student exposure to diverse mentorship and service through sur...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.07.031
更新日期:2020-06-01 00:00:00
abstract::The p53 tumor suppressor gene has been implicated in human esophageal tumorigenesis, and mutations are reported in primary esophageal adenocarcinomas and associated Barrett's epithelium. To evaluate the potential clinical significance of this molecular genetic marker in the progression of Barrett's epithelium to invas...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(94)90053-1
更新日期:1994-01-01 00:00:00
abstract::Over a 2 year period, 34 limbs were revascularized in 33 patients. The in situ saphenous vein technique was used. Improved instrumentation and patency rates have encouraged the use of this method. Eighteen patients were insulin-dependent diabetics. The indication for operation was limb salvage in 25 limbs (73 percent)...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90108-3
更新日期:1983-05-01 00:00:00
abstract:BACKGROUND:Aging of the population necessitates consideration of the increasing number of older adults requiring emergency care. The objective of this study was to compare outcomes and presentation of octogenarian and/or nonagenarian emergency general surgery (EGS) patients with younger adults. METHODS:Based on a stan...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.01.021
更新日期:2016-08-01 00:00:00
abstract::A review has been made of the records of 208 patients operated on for complications of diverticulitis of the colon. One hundred forty patients had emergency operations and 68, elective operations. Resection and anastomosis, with or without temporary diverting colostomy, practiced in the majority of emergency cases in ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(87)90605-2
更新日期:1987-03-01 00:00:00
abstract::Feeding gastrostomy and jejunostomy provide effective access for long-term enteral nutrition. Traditional operative techniques for the performance of these procedures requires laparotomy and often, general anesthesia. This report describes our experience with two relatively new methods, percutaneous endoscopic gastros...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80017-9
更新日期:1985-01-01 00:00:00
abstract::Between 1971 and 1976, ninety-three patients with a clinical diagnosis of pseudocyst confirmed by ultrasonography were identified from a group of 923 patients admitted for pancreatic disease. Uncertainties in diagnosis and/or rapid progression of underlying pancreatitis led to urgent laparotomy and drainage in eleven ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90024-2
更新日期:1979-01-01 00:00:00
abstract:BACKGROUND:Training future rural surgeons is critical, but training needs are unclear. We hypothesize perspectives on necessity of subspecialty training differ among rural surgeons by generational cohort. METHODS:An online survey was sent to ACS Rural Surgery Listserv subscribers. Closed-ended elements were analyzed u...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2018.11.026
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Hemoperfusion with PMX-F (polymyxin B covalently immobilized on fibers) has been reported to be safe and effective for patients with septic shock. However, the molecular mechanism of this usefulness is not yet clear. The purpose of this study was to evaluate whether the expression of CD14, human leukocyte an...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.12.067
更新日期:2004-08-01 00:00:00
abstract::Intracellular growth hormone has been demonstrated in human mammary carcinoma cells by using an unlabeled antibody enzyme technic with horseradish peroxidase and antihorseradish peroxidase complex. Intense reaction was seen in both male and female mammary carcinoma cells. Positive staining was observed in nuclei and c...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90102-2
更新日期:1978-02-01 00:00:00
abstract:BACKGROUND:Our aim was to determinate the prognostic value of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in primary operable patients with non-small cell lung cancer (NSCLC). METHODS:Six hundred seventy-eight NSCLC patients were enrolled in this study. The prognostic significance of both mar...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.03.022
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Invasion of the larynx by differentiated thyroid gland carcinoma is uncommon but causes serious morbidity and mortality when present. METHODS:The clinicopathologic characteristics of 5 patients in which a total laryngectomy had to be performed for differentiated thyroid carcinoma are analyzed. Special refer...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.04.009
更新日期:2005-07-01 00:00:00