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Sarah B Bateni, Frederick J Meyers, Richard J Bold, Robert J Canter
BACKGROUND: The impact of surgery on end of life care for patients with disseminated malignancy (DMa) is incompletely characterized. The purpose of this study was to evaluate postoperative outcomes impacting quality of care among DMa patients, specifically prolonged length of hospital stay, readmission, and disposition. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for years 2011-2012. DMa patients were matched to non-DMa patients with comparable clinical characteristics and operation types...
2016: PloS One
Valentine Nfonsam, Hassan Aziz, Viraj Pandit, Mazhar Khalil, Jana Jandova, Bellal Joseph
INTRODUCTION: Optimization of surgical outcomes after colectomy continues to be actively studied, but most studies group right-sided and left-sided colectomies together. The aim of our study was to determine whether the complication rate differs between right-sided and left-sided colectomies for cancer. METHODS: We identified patients who underwent laparoscopic colectomy for colon cancer between 2005 and 2010 in the American College of Surgeons National Surgical Quality Improvement Program database and stratified cases by right and left side...
2016: Cancer Treatment Communications
Cigdem Benlice, Erman Aytac, Meagan Costedio, Hermann Kessler, Maher A Abbas, Feza H Remzi, Emre Gorgun
BACKGROUND: This study aimed to compare perioperative outcomes of patients undergoing robotic, laparoscopic, and open colectomy using a procedure-targeted database. METHODS: Retrospective review of patients undergoing elective colectomy in 2013 was conducted using the procedure-targeted database of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). Robotic, laparoscopic, and open groups were matched (1:1:1) based on age, gender, body mass index, surgical procedure, diagnosis and ASA classification...
October 21, 2016: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
David J Cote, Heloise M Dubois, Aditya V Karhade, Timothy R Smith
Background Patients who undergo craniotomy for brain tumor have an increased risk of developing venous thromboembolism (VTE). Using the National Surgical Quality Improvement Program (NSQIP) registry, patients undergoing craniotomy for brain tumor from 2006 and 2014 were analyzed to identify risk factors for postoperative VTE. Methods The study population, identified by Current Procedural Terminology codes, included all NSQIP-reported patients who underwent a craniotomy for brain tumor resection. Results There were 629 instances of VTE among 19,409 craniotomies for brain tumor (3...
October 20, 2016: Seminars in Thrombosis and Hemostasis
David A Etzioni, Cynthia L Lessow, Heather D Lucas, Amit Merchea, James A Madura, Raman Mahabir, Nitin Mishra, Nabil Wasif, Amit K Mathur, Yu-Hui H Chang, Robert R Cima, Elizabeth B Habermann
OBJECTIVE: To characterize reasons for discordance between administrative data and registry data in the determination of postoperative infectious complications. BACKGROUND: Data regarding the occurrence of postoperative surgical complications are identified through either administrative or registry data. Rates of complications vary significantly between these two types of data; the reasons for this are not well-understood. METHODS: The occurrence of 30-day inpatient infectious complications (pneumonia, sepsis, surgical site infection, and urinary tract infection) was compared between the NSQIP and administrative mechanisms at 4 academic hospitals between 2012 and 2014...
October 17, 2016: Annals of Surgery
Rachel S Bronheim, Eric K Oermann, Samuel K Cho, John M Caridi
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To identify associations between abnormal coagulation profile and postoperative morbidity and mortality in patients undergoing posterior lumbar fusion (PLF). SUMMARY OF BACKGROUND DATA: The literature suggests that abnormal coagulation profile is associated with postoperative complications, notably the need for blood transfusion. However, there is little research that directly addresses the influence of coagulation profile on postoperative complications following PLF...
October 17, 2016: Spine
John C Kubasiak, Mackenzie Landin, Scott Schimpke, Jennifer Poirier, Jonathan A Myers, Keith W Millikan, Minh B Luu
INTRODUCTION: Tobacco smoking is a known risk factor for complications after major surgical procedures. The full effect of tobacco use on these complications has not been studied over large populations for ventral hernia repairs. This effect is more important as the preoperative conditioning, and optimization of patients is adopted. We sought to use the prospectively collected ACS-NSQIP dataset to evaluate respiratory and infectious complications for patients undergoing both laparoscopic and open ventral hernia repairs...
October 17, 2016: Surgical Endoscopy
Jay A Harolds
Mainly due to the positive effect on quality and safety from the Veterans Health Administration National Surgical Quality Improvement Program (VASQIP), a National Surgical Quality Improvement Program (NSQIP) for private hospitals was begun, which is now under the auspices of the American College of Surgeons (ACS). More than 600 hospitals now participate in the ACS-NSQIP. The information gained by the institutions is typically utilized to initiate quality improvement activities. The ACS-NSQIP also shares information on how to get better results, has national meetings, and provides other support...
October 5, 2016: Clinical Nuclear Medicine
Chad M Hall, Daniel C Jupiter, Justin L Regner
BACKGROUND: Laparoscopic cholecystectomy (LC) is routinely performed as an outpatient operation. NSQIP tracks acute or symptomatic congestive heart failure (CHF) within 30 days of the index operation. This study aims to quantify adverse events after LC and determine if patients with CHF may benefit from pre-operative optimization or post-operative admission. MATERIALS AND METHODS: This is a retrospective NSQIP database review of all adults undergoing LC between 2008 and 2012...
October 11, 2016: International Journal of Surgery
Chaya Shwaartz, Adam C Fields, Jeffrey J Aalberg, Celia M Divino
BACKGROUND: The value of drain placement in hepatic surgery has not been conclusive. The aim of this study was to determine whether drain placement during major hepatectomy was associated with negative postoperative outcomes and whether its placement reduced the need for secondary procedures. METHODS: The American College of Surgeons National Surgical Quality Improvement Program Procedure-Targeted Hepatectomy Database was used to identify patients who underwent major hepatectomy...
October 13, 2016: World Journal of Surgery
Andrés M Bur, Jason A Brant, Carolyn L Mulvey, Elizabeth A Nicolli, Robert M Brody, John P Fischer, Steven B Cannady, Jason G Newman
Importance: Unplanned hospital readmission is costly and in recent years has become a focus of health care legislation intended to reduce health care expenditures. Greater understanding of which perioperative complications are associated with hospital readmission after surgery for head and neck cancer is needed to reduce unplanned readmissions. Objective: To determine which clinical risk factors and complications are associated with 30-day unplanned readmission after surgery for malignant neoplasms of the head and neck...
October 13, 2016: JAMA Otolaryngology—Head & Neck Surgery
Mohammad H Eslami, Denis V Rybin, Gheorghe Doros, Alik Farber
OBJECTIVE: Despite vast improvement in the field of vascular surgery, elective abdominal aortic aneurysm (AAA) repair still leads to perioperative death. Patients with asymptomatic AAAs, therefore, would benefit from an individual risk assessment to help with decisions regarding operative intervention. The purpose of this study was to describe such a 30-day postoperative (POD) risk prediction model using American College of Surgeons National Surgical Quality Improvement Project (NSQIP) data...
October 5, 2016: Journal of Vascular Surgery
Alvin C Kwok, Jayant P Agarwal
PURPOSE: We sought to use the NSQIP database to determine the national rate and predictors of free flap failure based upon flap sites and flap types. METHODS: Free flaps were identified using the 2005-2010 NSQIP database. We examined overall flap failure rates as well as failure rates based upon flap sites (head and neck, extremities, trunk, and breast) and flap types (muscle, fascial, skin, bone, and bowel flaps). Univariate and multivariate analyses were used to determine predictors of flap failure...
October 7, 2016: Microsurgery
Munyaradzi Chimukangara, Melissa C Helm, Matthew J Frelich, Matthew E Bosler, Lisa E Rein, Aniko Szabo, Jon C Gould
BACKGROUND: Frailty is a measure of physiologic reserve associated with increased vulnerability to adverse outcomes following surgery in older adults. The 'accumulating deficits' model of frailty has been applied to the NSQIP database, and an 11-item modified frailty index (mFI) has been validated. We developed a condensed 5-item frailty index and used this to assess the relationship between frailty and outcomes in patients undergoing paraesophageal hernia (PEH) repair. METHODS: The NSQIP database was queried for ICD-9 and CPT codes associated with PEH repair...
October 3, 2016: Surgical Endoscopy
Peter A Najjar, Arin L Madenci, Cheryl K Zogg, Eric B Schneider, Christian A Dankers, Marc T Pimentel, Amrita S Chabria, Joel E Goldberg, Gaurav Sharma, Gregory Piazza, Ronald Bleday, Dennis P Orgill, Allen Kachalia
BACKGROUND: Prophylactic anticoagulation is routinely used in the inpatient setting; however, the risk of VTE remains elevated after discharge. Extensive evidence and clinical guidelines suggest post-discharge VTE prophylaxis is critical in at-risk populations but it remains severely underutilized in practice. STUDY DESIGN: We performed a single institution retrospective, non-randomized, pre- and post-intervention analysis of a systematic post-discharge pharmacological prophylaxis program against the primary outcome, post-discharge symptomatic VTE...
September 27, 2016: Journal of the American College of Surgeons
Elliot G Arsoniadis, Yen-Yi Ho, Genevieve B Melton, Robert D Madoff, Chap Le, Mary R Kwaan
BACKGROUND: Previous reports on racial disparities in the treatment of Crohn's Disease (CD) in African American (AA) patients have shown differences in both medical and surgical treatments in this population. No study thus far has examined the effect of AA race on outcomes after surgery for CD. METHODS: Utilizing the National Surgical Quality Improvement Program (NSQIP) Participant User File (PUF) for years 2005-2013, we examined the effect of AA race on post-operative complications in patients with CD undergoing intestinal surgery...
September 28, 2016: Journal of Crohn's & Colitis
Aditya V Karhade, David J Cote, Alexandra M G Larsen, Timothy R Smith
No abstract text is available yet for this article.
September 23, 2016: World Neurosurgery
Seokchun Lim, Louanne M Carabini, Robert D Kim, Ryan Khanna, Nader S Dahdaleh, Zachary A Smith
BACKGROUND CONTEXT: Higher ASA classification is a known predictor of postoperative complication in diverse surgical settings. However, its predictive value is not established in single-level elective anterior cervical discectomy and fusion (SLE-ACDF). PURPOSE: To evaluate the predictive value of American Society of Anesthesiology (ASA) classification system on 30-day morbidity following SLE-ACDF STUDY DESIGN/SETTING: Patients who underwent SLE-ACDF between 2011-2013 were selected from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database...
September 23, 2016: Spine Journal: Official Journal of the North American Spine Society
Kari Kraemer, Mark E Cohen, Yaoming Liu, Douglas C Barnhart, Shawn J Rangel, Jacqueline M Saito, Karl Y Bilimoria, Clifford Y Ko, Bruce L Hall
BACKGROUND: There is an increased desire of patients and families to be involved in the surgical decision making process. A surgeon's ability to provide patients and families with patient-specific estimates of postoperative complications is critical for shared decision making and informed consent. Surgeons can also use patient-specific risk estimates to decide whether or not to operate and what options to give to patients. Our objective was to develop and evaluate a publicly available risk estimation tool that would cover many common pediatric surgical procedures across all specialties...
August 24, 2016: Journal of the American College of Surgeons
Bryan M Saltzman, Gregory L Cvetanovich, Daniel D Bohl, Brian J Cole, Bernard R Bach, Anthony A Romeo
BACKGROUND: There has been increased emphasis in orthopaedics on high-quality prospective research to provide evidence-based treatment guidelines, particularly in sports medicine/shoulder surgery. The external validity of these studies has not been established, and the generalizability of the results to clinical practice in the United States is unknown. HYPOTHESIS: Comparison of patient demographics in major prospective studies of arthroscopic sports and shoulder surgeries to patients undergoing the same procedures in the National Surgical Quality Improvement Program (NSQIP) database will show substantial differences to question the generalizability and external validity of those studies...
September 2016: Orthopaedic Journal of Sports Medicine
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