Abstract:
:This prospective study describes the current prognosis of patients in acute Organ System Failure (OSF). Objective definitions were developed for five OSFs, and then 5677 ICU admissions from 13 hospitals were monitored. The number and duration of OSF were linked to outcome at hospital discharge for each of the 2719 ICU patients (48%) who developed OSF. For all medical and most surgical admissions, a single OSF lasting more than 1 day resulted in a mortality rate approaching 40%. Among both medical and surgical patients, two OSFs for more than 1 day increased death rates to 60%. Advanced chronologic age increased both the probability of developing OSF and the probability of death once OSF occurred. Mortality for 99 patients with three or more OSFs persisting after 3 days was 98%. The two patients who survived were both young, in prior excellent health, and had severe but limited primary diseases. These results emphasize the high death rates associated with acute OSF and the rapidity with which mortality increases over time. The prognostic estimates provide reference data for physicians treating similar patients.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Knaus WA,Draper EA,Wagner DP,Zimmerman JEdoi
10.1097/00000658-198512000-00004subject
Has Abstractpub_date
1985-12-01 00:00:00pages
685-93issue
6eissn
0003-4932issn
1528-1140journal_volume
202pub_type
杂志文章abstract:OBJECTIVE:This study evaluates the effects of mechanical bowel preparation (MBP) on anastomosis below the peritoneal verge and questions the influence of MBP on anastomotic leakage in combination with a diverting ileostomy in lower colorectal surgery. SUMMARY BACKGROUND DATA:In a previous large multicenter randomized ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181c0e75c
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:To assess the authors' hypothesis that with modern techniques, the current risks of repair for both complete and partial atrioventricular canal (AVC) are equal. SUMMARY BACKGROUND DATA:Repair of complete AVC in infancy has traditionally carried a substantial mortality. In contrast, partial AVC has been consi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200210000-00014
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to determine whether prolonged air leak (PAL) is associated with postoperative morbidity and mortality following pulmonary resection after adjusting for differences in baseline characteristics using propensity score analysis. SUMMARY BACKGROUND DATA:Patients with PAL after lung resec...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003191
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Surgery is the criterion standard for the treatment of severe burns and of late sequels after ingestion of corrosive agents, but long-term outcome is unknown. METHODS:Patients who underwent surgery between 1987 and 2006, for the treatment of severe caustic burns (group I, n = 268) or of late sequels (group ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182583fb2
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVE:To describe causes of death in the first year after esophagectomy and determine the time frame that should be used for measurement of quality of surgery. A case-mix adjustment model was developed for the comparison between hospitals. BACKGROUND:The time period in which postoperative mortality should be measu...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000482
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:To assess the impact of a laparoscopic approach on female fecundity in ileoanal pouch surgery. BACKGROUND:Restorative proctocolectomy with ileal pouch anal anastomosis (IPAA) is associated with tubal factor infertility in female patients. Different studies showed less adhesion formation after laparoscopic co...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SLA.0b013e318250caa9
更新日期:2012-12-01 00:00:00
abstract::This study sought to minimize juxta-anastomotic neointimal hyperplasia (JNIH) following the use of polytetrafluorethylene (PTFE) conduits. PTFE anastomoses to canine carotid arteries (noncuff grafts) were compared with grafts with vein cuffs interposed proximally and distally between the graft and native artery. This ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198806000-00011
更新日期:1988-06-01 00:00:00
abstract:BACKGROUND:Minimal immunosuppression (IS) is desirable in organ transplantation to reduce side effects and to promote the process of tolerance induction. MATERIAL AND METHODS:Between February 2000 and September 2004, 156 adults (>15 years old) receiving a primary liver graft were enrolled in a prospective, randomized,...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e31819009c9
更新日期:2008-12-01 00:00:00
abstract:OBJECTIVE:To compare resection rates and outcome of patients subsequently referred with hepatic metastases whose initial colon cancers were resected by surgeons with different specialty interests. SUMMARY BACKGROUND DATA:Variation in practice among noncolorectal specialist surgeons has led to recommendations that colo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199912000-00004
更新日期:1999-12-01 00:00:00
abstract:OBJECTIVE:Cetuximab, a monoclonal antibody targeting epidermal growth factor receptor (EGFR), has been proven to be efficient in metastatic colorectal cancer (mCRC); however, the therapeutic response is variable and markers predictive of response are urgently required. This study was conducted to determinate the predic...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181bc9d96
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVE:We examined management strategies, overall survival (OS), and progression-free survival (PFS) among patients with PMNSGCTs undergoing resection and multidisciplinary management at a high-volume institution. SUMMARY OF BACKGROUND DATA:Outcomes after resection of PMNSGCTs are not well-characterized, with limit...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003754
更新日期:2020-01-21 00:00:00
abstract:OBJECTIVE:To determine whether the investment in postgraduate education and training places patients at risk for worse outcomes and higher costs than if medical and surgical care was delivered in nonteaching settings. SUMMARY BACKGROUND DATA:The Veterans Health Administration (VA) plays a major role in the training of...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200109000-00011
更新日期:2001-09-01 00:00:00
abstract::Three patients with Menetrier's disease and protein-losing gastropathy who were studied during a 12 year period have been presented. The characteristic findings which differentiate them from patients with hypertrophic hypersecretory gastropathy, including the Zollinger-Ellison syndrome, are: 1) hypertrophy of gastric ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197505000-00036
更新日期:1975-05-01 00:00:00
abstract::Of 915 resections for bronchogenic carcinoma over a 25-year period (1945-1969), 249 patients survived over 5 years; 127 of the patients eligible survived over 10 years, 61 over 15 years, and 22 over 20 years. The case material was divided into three time periods: 1945-49, 1950-59 and 1960-69, as well as by extent of r...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197609000-00010
更新日期:1976-09-01 00:00:00
abstract:OBJECTIVE:To assess the feasibility of developing a simulated ward environment in which to assess the ward-based care of surgical patients by clinicians of varying levels of experience (construct validation). BACKGROUND:Increasing evidence points to the importance of the postoperative or ward-based phase of surgical c...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318288e1d4
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:The objective of this prospective, nonrandomized study was to evaluate the immediate and long-term results of first-line chemotherapy and possible surgery in locally advanced, presumably T4 squamous cell esophageal cancer. SUMMARY BACKGROUND DATA:Locally advanced esophageal cancer is rarely operable and has ...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199712000-00008
更新日期:1997-12-01 00:00:00
abstract::Population based surgical rates for various common surgical procedures were analyzed on a regional basis by examining select uniform hospital discharge abstract data from Wisconsin hospitals. The surgical asbracts of nearly 64,000 procedures were compared to the supply of physicians and showed a significant variation ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197802000-00012
更新日期:1978-02-01 00:00:00
abstract:OBJECTIVE:To train surgeons in a standardized technique of sentinel lymph node biopsy and to prepare them for the requirements of a prospective randomized surgical trial. SUMMARY BACKGROUND DATA:The NSABP B32 trial opened to accrual in May 1999. A significant component of this trial was a prerandomization training pha...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.sla.0000149429.39656.94
更新日期:2005-01-01 00:00:00
abstract::Truncal vagotomy (TV) is known to increase the feeding stimulated acid output of Heidenhain pouches. A series of experiments were performed in dogs to see if proximal gastric vagotomy (PGV) also had this effect. Dogs were prepared with gastric fistulas (GF) and Heidenhain pouches (HP). Gastric function testing include...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197811000-00011
更新日期:1978-11-01 00:00:00
abstract:OBJECTIVE:Pancreatic mucinous cystic neoplasms (MCNs) provide a spectrum of neoplastic changes ranging from benign to malignant. The authors have correlated K-ras mutations and p53 overexpression with the evolution of these tumors. METHODS:Areas of mild, moderate, or severe dysplasia were microdissected from paraffin-...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199910000-00006
更新日期:1999-10-01 00:00:00
abstract::Forty-nine patients undergoing elective or emergent gastric surgery have been included in this study. Gastric needle aspiration was performed at the time of surgery in each case, followed by qualitative aerobic and anaerobic bacteriologic analysis. In 18 patients undergoing elective operation for chronic nonobstructin...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197511000-00004
更新日期:1975-11-01 00:00:00
abstract::A patient is reported whose symptoms and clinical features were interpreted as pulmonary embolism. However, the ultimate diagnosis was malignant fibrous histiocytoma of the pulmonary artery, which was made evident at operation. Although extremely rare in the early medical literature, primary sarcoma of the pulmonary a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198702000-00017
更新日期:1987-02-01 00:00:00
abstract:OBJECTIVE:Using a prospective randomized study to assess postoperative morbidity and pancreatic function after pancreaticoduodenectomy with pancreaticojejunostomy and duct occlusion without pancreaticojejunostomy. SUMMARY BACKGROUND DATA:Postoperative complications after pancreaticoduodenectomy are largely due to leak...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-200210000-00004
更新日期:2002-10-01 00:00:00
abstract::Fifty-one adult patients were referred for surgical treatment during the time period from July 1980 to November 1985. The average age was 59 +/- 6 years (19-70 years). All patients had symptomatic ventricular tachycardia that was refractory to standard or experimental drug therapy. On the basis of patient condition, s...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198606000-00013
更新日期:1986-06-01 00:00:00
abstract:OBJECTIVE:To assess clinical and surgical factors affecting local recurrence and survival in young breast cancer patients in the Prospective study of Outcomes in Sporadic versus Hereditary breast cancer (POSH). BACKGROUND:Emerging data suggest young age is a predictor of increased local recurrence. METHODS:POSH is a ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000001930
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVE:The authors evaluated the outcome and potential prognostic factors of 60 patients with surgically resected periampullary tumors. SUMMARY BACKGROUND DATA:Periampullary carcinomas exhibit different clinical behaviors according to their site of origin. There are no prognostic factors for deciding the type of su...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199511000-00005
更新日期:1995-11-01 00:00:00
abstract::This review brings the total number of biliary cysts reported in the world literature to 955. Eighty-one per cent of patients are females and 61% were discovered before age ten. The classical triad of right upper quadrant pain, right upper quandrant mass, and juandice is present in 38% of cases. The duration of sympto...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-197511000-00017
更新日期:1975-11-01 00:00:00
abstract:OBJECTIVE:To analyze the impact of a conservative strategy of management in patients with necrotizing pancreatitis, reserving intervention for patients with documented infection or the late complications of organized necrosis. SUMMARY BACKGROUND DATA:The role of surgery in patients with sterile pancreatic necrosis rem...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200110000-00016
更新日期:2001-10-01 00:00:00
abstract::The etiology of gastroesophageal reflux (GER) in infancy is related to developmental factors, and there is a high incidence of associated conditions such as neurologic syndromes and esophageal atresia (60%). This is different from the situation in adults. Experience with 18 consecutive children with peptic esophageal ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198210000-00008
更新日期:1982-10-01 00:00:00
abstract:OBJECTIVE:To familiarize surgeons with the specific complications of cutaneous, gastrointestinal, inhalation, and systemic infection with Bacillus Anthracis, which may require surgical treatment. SUMMARY BACKGROUND DATA:The recent cases of intentional exposure to Bacillus Anthracis in the United States make familiarit...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-200207000-00004
更新日期:2002-07-01 00:00:00