Abstract：
BACKGROUND:Pancreatic cancer is a leading cause of financial insolvency and cancer related deaths in the United States. The risk of catastrophic health expenditure (CHE) was calculated for patients undergoing pancreatic resection at an academic institution. METHODS:Patients who underwent pancreatic resection between 2013 and 2017 were identified through an institutional cancer registry. A CHE was an out-of-pocket payment (OOP) > 10% of the estimated median household income. RESULTS:319 patients met inclusion criteria. Hospital median charge was $76,700. 99% of patients had insurance and hospital bill adjustments. As a result, 61% (n = 193) made no OOP. Only 3 patients risked CHE. For all tumors combined there were no differences in survival outcomes by OOP. CONCLUSION:This is the first study to use institutional financial data to calculate CHE risk for pancreatic resection patients. Insurance adjustments to hospital charges that accompany health insurance and voluntary hospital adjustments for the uninsured protect patients against CHE.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Okoroh JS,Weaver L,Heslin MJ,Vickers SM,Wang TN,Rose JB,Reddy Sdoi
10.1016/j.amjsurg.2020.11.040subject
Has Abstractpub_date
2020-11-20 00:00:00eissn
0002-9610issn
1879-1883pii
S0002-9610(20)30763-7pub_type
杂志文章abstract：:An analysis of 276 femoropopliteal bypass procedures performed in 264 patients at the Columbia-Presbyterian Medical Center over the past two decades showed a direct relationship of graft patency to preoperative popliteal artery runoff. Fuctional results were better than patency results. Sympathectomy and anticoagulati...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90279-8
更新日期：1976-07-01 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：:Twenty-five patients with ulcerative colitis were treated between 1959 and 1986 at the Mount Sinai Hospital, with severe gastrointestinal hemorrhage as their major complaint. Twenty-two patients required operation, while three patients were treated medically. Total proctocolectomy with ileostomy was carried out in 5 p...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(06)80064-4
更新日期：1990-06-01 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：BACKGROUND:Prospective evaluation of the percutaneous tracheostomy by the guide wire dilating forceps (GWDF) technique. METHODS:In 50 selected patients percutaneous tracheostomy with fiberscopic control was performed and evaluated. RESULTS:Most percutaneous tracheostomies were performed without any adverse effect. No...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-9610(99)00049-5
更新日期：1999-04-01 00:00:00
abstract：:Two courses of triple-agent chemotherapy were given to 47 patients with advanced head and neck cancer. All but one patient with a nasopharyngeal carcinoma had resectable stage III and IV squamous cell carcinoma. Eighty-eight percent of the patients responded to the chemotherapy with a 50 percent or greater decrease in...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90417-2
更新日期：1982-10-01 00:00:00
abstract：:The role of preoperative localization tests in patients undergoing initial neck exploration for hyperparathyroidism (HPT) is controversial. The use of parathyroid ultrasonography (US) in 46 patients (7 men, 39 women; mean age: 60 years) who underwent initial neck exploration for hypercalcemia and who had the diagnosis...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80900-6
更新日期：1992-10-01 00:00:00
abstract：:A case of massive air embolus secondary to use of an intravenous infusion pump is presented. The pump is unable to detect air entering the intravenous line if the air enters distal to the air detection device. A simple solution is presented. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90163-6
更新日期：1979-02-01 00:00:00
abstract：BACKGROUND:Predicting length of stay (LOS) is difficult for trauma and emergency general surgery (TEGS) patients. Our aim was to determine the accuracy of LOS predictions by TEGS team members and the NSQIP Risk Calculator and the patient factors associated with inaccurate predictions. METHODS:LOS for 200 TEGS patients...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.01.055
更新日期：2020-09-01 00:00:00
abstract：:Reoperation to remove an aortic graft was performed in 18 patients. The need for removal was infection in the majority. A changing flora was seen in aortic graft infection with gram-negative organisms predominating. Despite a standardized approach with total graft removal, aortic closure, and extraanatomic reconstruct...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90371-9
更新日期：1983-08-01 00:00:00
abstract：BACKGROUND:The morbidity and mortality conference (M&M) is a key component of the performance improvement process. The audience response system (ARS) has been shown to improve audience participation and promote more truthful responses in various settings. We implemented the ARS in our trauma M&M and evaluated the respo...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.05.015
更新日期：2009-06-01 00:00:00
abstract：:The accuracy of the hepatobiliary scan in the diagnosis of acute cholecystitis was determined at a major United States Army Medical Center. Forty-two patients with complete medical records were selected for the study. There was 18 positive findings and 24 negative findings. The accuracy rate for the positive findings ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90333-7
更新日期：1984-11-01 00:00:00
abstract：:Plasma fatty acid profiles of 33 critically ill surgical patients receiving fat-free parenteral nutrition were examined at weekly intervals up to 28 days. While plasma total fatty acid concentration remained relatively constant and within the normal range, marked compositional alterations were apparent. Levels of lino...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90326-3
更新日期：1981-12-01 00:00:00
abstract：:The relationship between platelet count and aggregability was serially evaluated after splenectomy in patients with normosplenism and hypersplenism, and the results were compared with those found in patients undergoing only upper abdominal surgery. The preoperative count and aggregability of platelets were significant...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90242-8
更新日期：1978-08-01 00:00:00
abstract：BACKGROUND:Venous thromboembolism is a common cause of morbidity. Guidelines recommend perioperative thromboprophylaxis, but clinicians remain cautious of bleeding after major oncologic resections. METHODS:Retrospective analysis of a single institution's prospective hepatopancreatobiliary database was performed for pa...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.08.012
更新日期：2014-12-01 00:00:00
abstract：INTRODUCTION:Despite the use of radiologic, endoscopic, and laparoscopic staging techniques, the rate of nontherapeutic laparotomies in patients with hilar cholangiocarcinoma remains high. This study evaluated the accuracy of preoperative high-resolution computed tomography (HRCT) to determine resectability in this set...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.10.024
更新日期：2007-06-01 00:00:00
abstract：:Following its introduction in 1993, the LAP-BAND (INAMED Health, Santa Barbara, CA) has been used extensively across the world for the treatment of obesity, and data on safety and effectiveness are now available. This review draws on the literature and our own clinical patient base to provide an overview of the early ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(02)01179-0
更新日期：2002-12-01 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：INTRODUCTION:While women represent approximately half of all medical students, only 38% of general surgery residents are women. The objective of this study is to explore how access to mentors and organizational support affects career choices. METHODS:In June of 2016, a survey was sent to medical students at a single i...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.07.005
更新日期：2017-10-01 00:00:00
abstract：:Patients who have undergone recent abdominal surgery and have generalized obliterative adhesions provide a major management problem if they require urgent ileostomy for sepsis or fistulization, particularly when there is an associated abdominal wall defect. This report describes a technique for creating an ileostomy t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00414-1
更新日期：2000-07-01 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：BACKGROUND:Fournier's gangrene is a fulminant and destructive inflammation of the scrotum, penis, and perineum. The objective of this study was to compare 2 different approaches to wound management after aggressive surgical debridement. METHODS:Data from 35 patients with Fournier's gangrene were prospectively collecte...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.07.053
更新日期：2009-02-01 00:00:00
abstract：:Vertebral arteriovenous fistulas are rare. A report of two cases is presented with problems related to diagnosis and therapy. An alternative approach to surgical management is given. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90320-9
更新日期：1979-12-01 00:00:00
abstract：BACKGROUND:The Estimation of Physiologic Ability and Surgical Stress (E-PASS) score was designed on the premise that the balance between the patient's physiologic reserve capacity and the surgical stress inflicted at operation was important in the occurrence of postoperative complications. The aim of this study was to ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.10.032
更新日期：2007-08-01 00:00:00
abstract：:A new catheter has been developed that can be accurately and precisely positioned using duplex ultrasonography alone. A piezoelectric transducer that functions as a passive, omnidirectional receiver is attached to the mid-balloon region of an angioplasty catheter. Integration to a standard duplex imaging system allows...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90171-9
更新日期：1991-08-01 00:00:00
abstract：BACKGROUND:Traumatic injuries during pregnancy are the leading cause of nonobstetric maternal mortality. We aimed to determine hospital charges for trauma activations during pregnancy. METHODS:We used the Illinois State Trauma Registry data from 1999 to 2003. Using STATA for bivariate and regression analyses, we compa...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.10.018
更新日期：2014-07-01 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：: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：BACKGROUND:Although the immunologic benefits of laparoscopic surgery have been established, effects from hand-assisted (HA) surgery have not been investigated thoroughly. We hypothesized that the HA approach maintains the immunologic advantage of laparoscopic surgery compared with the open (O) approach. METHODS:Six O,...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.09.026
更新日期：2011-07-01 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
