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https://www.readbyqxmd.com/read/29155341/outpatient-elective-posterior-lumbar-fusions-appear-to-be-safely-considered-for-appropriately-selected-patients
#1
Patawut Bovonratwet, Taylor D Ottesen, Raj J Gala, Daniel R Rubio, Nathaniel T Ondeck, Ryan P McLynn, Jonathan N Grauer
BACKGROUND CONTEXT: There has been growing interest in performing posterior lumbar fusions (PLFs) in the outpatient setting to optimize patient satisfaction and reduce cost. Although still done in only a small percentage of cases, this has been more possible due to advances in surgical techniques and anesthesia. However, data on the perioperative course of outpatient compared to inpatient PLF in a large sample size is scarce. PURPOSE: To compare perioperative complications between outpatient and inpatient PLF in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database...
November 16, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29155339/body-mass-index-predicts-risk-of-complications-in-lumbar-spine-surgery-based-on-surgical-invasiveness
#2
Olivia J Bono, Gregory W Poorman, Norah Foster, Cyrus M Jalai, Samantha R Horn, Jonathan Oren, Alexandra Soroceanu, Subaraman Ramachandran, Taylor E Purvis, Deeptee Jain, Shaleen Vira, Bassel G Diebo, Breton Line, Daniel M Sciubba, Themistocles S Protopsaltis, Aaron J Buckland, Thomas J Errico, Virginie Lafage, Shay Bess, Peter G Passias
BACKGROUND CONTEXT: Obesity as a comorbidity in spine pathology may increase the risk of complications following surgical treatment. The BMI threshold at which obesity becomes clinically relevant, and the exact nature of that effect, remains poorly understood. PURPOSE: Identify the body mass index (BMI) that independently predicts risk of postoperative complications following lumbar spine surgery. STUDY DESIGN/SETTING: Retrospective review of the National Surgery Quality Improvement Program (NSQIP) years 2011-2013...
November 16, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29155269/influence-of-time-to-appendectomy-and-operative-duration-on-hospital-cost-in-children-with-uncomplicated-appendicitis
#3
Stephanie K Serres, Dionne A Graham, Charity C Glass, Danielle B Cameron, Seema P Anandalwar, Shawn J Rangel
BACKGROUND: The goal of this study was to examine the influence of time to appendectomy (TTA) and operative duration (OD) on hospital cost as surrogate measures of perioperative efficiency. STUDY DESIGN: Retrospective cohort analysis of 2,116 children undergoing appendectomy for uncomplicated appendicitis at 16 children's hospitals from 1/2013 to 12/2014. TTA (emergency department presentation to incision) and OD were obtained from the NSQIP-Pediatric Appendectomy Pilot Database and merged with cost data from the Pediatric Health Information System Database...
November 16, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29155268/new-5-factor-modified-frailty-index-using-american-college-of-surgeons-nsqip-data
#4
Sneha Subramaniam, Jeffrey J Aalberg, Rainier P Soriano, Celia M Divino
BACKGROUND: The modified frailty index (mFI-11) is a NSQIP based 11-factor index that has been proven to adequately reflect frailty and predict mortality and morbidity. These 11 factors, made of 16 variables, map to the original 70 item Canada Study of Health and Aging Frailty Index. In the past years, certain NSQIP variables have been removed from the database; as of 2015, only 5 out of the original 11 factors remain. The predictive power and usefulness of these five factors in an index (mFI-5) have not been proven in past literature...
November 16, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29155116/the-effect-of-steroids-on-complications-readmission-and-reoperation-after-posterior-lumbar-fusion
#5
Michael B Cloney, Roxanna M Garcia, Zachary A Smith, Nader S Dahdaleh
BACKGROUND DATA: The effects of chronic corticosteroid therapy on complications, readmission, and reoperation after posterior lumbar fusion (PLF) remains under-investigated and was examined to determine differences in outcomes. METHODS: We analyzed patients from 2006 to 2013 using the National Surgery Quality Improvement Program database (NSQIP) undergoing PLF. Patients taking steroids for a chronic condition were compared to those not taking steroids. Multivariable regression identified factors independently associated with complications, readmission, and reoperation...
November 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29146612/derivation-and-validation-of-a-geriatric-sensitive-perioperative-cardiac-risk-index
#6
Rami Alrezk, Nicholas Jackson, Mohanad Al Rezk, Robert Elashoff, Nancy Weintraub, David Elashoff, Gregg C Fonarow
BACKGROUND: Surgical patients aged 65 and over face a higher risk of cardiac complications from noncardiac surgery. The Revised Cardiac Risk Index (RCRI) and the Gupta Myocardial Infarction or Cardiac Arrest (MICA) calculator are widely used to predict this risk, but they are not specifically designed to predict MICA in geriatric patients. Our hypothesis is that a new geriatric-sensitive index, derived from geriatric data, will capture this population's unique response to risk factors...
November 16, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29146432/predictors-of-hospital-length-of-stay-and-30-day-readmission-in-cervical-spondylotic-myelopathy-patients-an-analysis-of-3057-patients-using-the-acs-nsqip-database
#7
Peter G Passias, Cyrus M Jalai, Nancy Worley, Shaleen Vira, Saqib Hasan, Samantha R Horn, Frank A Segreto, Cole A Bortz, Andrew P White, Michael Gerling, Virginie LaFage, Thomas Errico
BACKGROUND: Hospital length of stay (LOS), 30-day readmission rate, and other metrics are increasingly being used to evaluate quality of surgical care. The factors most relevant to cervical spondylotic myelopathy (CSM) are not yet established. OBJECTIVE: To identify peri-operative factors associated with extended LOS and/or 30-day readmission following elective surgery for CSM. METHODS: Surgical CSM patients at institutions represented by the American-College-of-Surgeons-National-Surgical-Quality-Improvement-Program (ACS-NSQIP) from 2010-2012 were included...
November 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29135700/safety-outcomes-following-spine-and-cranial-neurosurgery-evidence-from-the-national-surgical-quality-improvement-program
#8
Andrew K Rock, Charles F Opalak, Kathryn G Workman, William C Broaddus
BACKGROUND: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) was used to establish predictors for 30-day postoperative complications following spine and cranial neurosurgery. MATERIALS AND METHODS: The ACS-NSQIP participant use files were queried for neurosurgical cases between 2005 and 2015. Prevalence of postoperative complications following neurosurgery was determined. Nested multivariable logistic regression analysis was used to identify demographic, comorbidity, and perioperative characteristics associated with any complication and mortality for spine and cranial surgery...
November 10, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29122621/simple-operating-room-bundle-reduces-superficial-surgical-site-infections-after-major-urologic-surgery
#9
Sarah C Vij, Ganesh Kartha, Venkatesh Krishnamurthi, Michelle Ponziano, Howard B Goldman
OBJECTIVE: To reduce our superficial surgical site infection rate (sSSI) following major urologic surgery by implementing a simple operating room bundle. METHODS: A simple operating room bundle was applied to all major urologic cases (cystectomy, nephrectomy and prostatectomy) at a single tertiary referral center. The bundle included allowing skin prep to dry appropriately, changing gloves prior to skin closure, irrigating the wound prior to skin closure and using a new separate sterile closing instrument set for skin closure...
November 6, 2017: Urology
https://www.readbyqxmd.com/read/29121786/perioperative-morbidity-of-open-versus-minimally-invasive-partial-nephrectomy-a-contemporary-analysis-of-the-national-surgical-quality-improvement-program-nsqip
#10
Jorge Francisco Pereira, Joseph Renzulli, Gyan Pareek, Daniel Moreira, Ruiting Guo, Zheng Zhang, Ali Amin, Anthony Mega, Dragan Golijanin, Boris Gershman
INTRODUCTION AND OBJECTIVES: In recent years, there has been a shift to minimally invasive partial nephrectomy (MIPN) with the dissemination of robotic-assisted technology. However, contemporary data on the comparative morbidity of open PN and MIPN are lacking. We therefore evaluated the perioperative morbidity of MIPN and OPN using a contemporary national cohort. METHODS: We identified 13,658 patients aged 18-89 who underwent PN from 2010-2015 in the National Surgical Quality Improvement Program (NSQIP) database, of whom 9,018 (66...
November 9, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29106849/the-association-of-hypoalbuminemia-with-early-perioperative-outcomes-a-comprehensive-assessment-across-16-major-procedures
#11
Christian P Meyer, Arturo J Rios-Diaz, Deepansh Dalela, Praful Ravi, Akshay Sood, Julian Hanske, Felix K H Chun, Adam S Kibel, Stuart R Lipsitz, Maxine Sun, Quoc-Dien Trinh
BACKGROUND: Poor nutritional status is thought to influence peri- and postoperative outcomes. We assessed the association of hypoalbuminemia, a surrogate for poor nutritional status, with perioperative outcomes in patients undergoing one of 16 major surgical procedures. METHODS: Patients undergoing one of 16 major surgeries were identified using the ACS-NSQIP (2005-2011). Risk-adjusted logistic regression models examined the association of hypoalbuminemia on perioperative outcomes...
November 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29106826/operating-at-night-does-not-increase-the-risk-of-intraoperative-adverse-events
#12
Trine G Eskesen, Thomas Peponis, Noelle Saillant, David R King, Peter J Fagenholz, George C Velmahos, Haytham M A Kaafarani
BACKGROUND: We sought to investigate the association between nighttime (NT) operating and the occurrence of intraoperative adverse events (iAEs). STUDY DESIGN: Our 2007-2012 institutional ACS-NSQIP and administrative databases were screened for iAEs using the ICD-9-CM-based Patient Safety Indicator "accidental puncture or laceration". Procedures were defined as AM (06.00-14.00 h), PM (14.00-22.00 h), or NT (22.00-06.00 h). Univariate and multivariable analyses were performed to investigate the association between PM and NT operating and the occurrence of iAEs...
October 21, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29102302/national-analysis-of-unplanned-readmissions-after-thoracoscopic-versus-open-lung-cancer-resection
#13
Rohun Bhagat, Michael R Bronsert, Austin N Ward, Jeremiah Martin, Elizabeth Juarez-Colunga, Natalia O Glebova, William G Henderson, David Fullerton, Michael J Weyant, John D Mitchell, Robert A Meguid
BACKGROUND: Hospital readmissions are viewed as a mark of inferior health care quality and are penalized. Unplanned postoperative readmission reason and timing after lung resection are not well understood. We examine related, unplanned readmissions after thoracoscopic versus open anatomic lung resections to identify opportunities to improve patient care. METHODS: We analyzed the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data set, 2012 to 2015, characterizing 30-day related, unplanned postoperative readmissions after anatomic lung resections for primary lung cancer...
November 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29101558/perioperative-bleeding-and-blood-transfusion-are-major-risk-factors-for-venous-thromboembolism-following-bariatric-surgery
#14
Alexander W Nielsen, Melissa C Helm, Tammy Kindel, Rana Higgins, Kathleen Lak, Zachary M Helmen, Jon C Gould
BACKGROUND: Morbidly obese patients are at increased risk for venous thromboembolism (VTE) after bariatric surgery. Perioperative chemoprophylaxis is used routinely with bariatric surgery to decrease the risk of VTE. When bleeding occurs, routine chemoprophylaxis is often withheld due to concerns about inciting another bleeding event. We sought to evaluate the relationship between perioperative bleeding and postoperative VTE in bariatric surgery. METHODS: The American College of Surgeons-National Surgical Quality Improvement Program (NSQIP) dataset between 2012 and 2014 was queried to identify patients who underwent bariatric surgery...
November 3, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29080956/validation-of-an-online-risk-calculator-for-the-prediction-of-anastomotic-leak-after-colon-cancer-surgery-and-preliminary-exploration-of-artificial-intelligence-based-analytics
#15
T Sammour, L Cohen, A I Karunatillake, M Lewis, M J Lawrence, A Hunter, J W Moore, M L Thomas
BACKGROUND: Recently published data support the use of a web-based risk calculator ( www.anastomoticleak.com ) for the prediction of anastomotic leak after colectomy. The aim of this study was to externally validate this calculator on a larger dataset. METHODS: Consecutive adult patients undergoing elective or emergency colectomy for colon cancer at a single institution over a 9-year period were identified using the Binational Colorectal Cancer Audit database. Patients with a rectosigmoid cancer, an R2 resection, or a diverting ostomy were excluded...
October 28, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29074118/an-update-on-the-incidence-of-perioperative-outcomes-after-carotid-endarterectomy-stratified-by-type-of-preprocedural-neurologic-symptom
#16
Alexander B Pothof, Emma S Zwanenburg, Sarah E Deery, Thomas F X O'Donnell, Gert J de Borst, Marc L Schermerhorn
OBJECTIVE: Perioperative complications after carotid endarterectomy (CEA) have decreased over time. Therefore, we aimed to provide an update on 30-day outcomes after CEA, stratified by type of preprocedural neurologic symptom. METHODS: We included all CEAs from the Targeted Vascular module of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP, 2011-2015) and stratified patients based on type of preprocedural neurologic symptom, that is, asymptomatic, ocular transient ischemic attack (TIA), hemispheric TIA, and stroke...
October 23, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29072987/can-surgical-site-infections-be-reduced-with-the-adoption-of-a-bundle-of-simultaneous-initiatives-the-use-of-nsqip-incidence-data-to-follow-multiple-quality-improvement-interventions
#17
Duncan Rozario
Surgical site infections (SSI) are a common complication after surgical procedures. To reduce the incidence of SSIs, Oakville Trafalgar Memorial Hospital decided to institute a bundle of initiatives to change multiple factors simultaneously based on best available evidence and the understanding of infection pathophysiology. We used National Surgical Quality Improvement Program data on the incidence of SSIs in our targeted and essentials, general surgery and orthopedic surgery cases before and after the implementation of an SSI reduction bundle...
October 26, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29072972/incision-classification-accuracy-do-residents-know-how-to-classify-them
#18
Jessica Goodwin, Pepper Womack, Billy Moore, J Laureano Phillips, Therese Duane
BACKGROUND: It is unclear whether surgical residents understand how to classify incisions, which may impact how closure is handled in the operating room. We hypothesized that surgical residents define incision class (IC) accurately compared with an attending NSQIP surgeon champion (SC). METHODS: We evaluated our NSQIP database from April 1, 2015, to December 31, 2016, including cases in which a resident was present and IC was documented. Cases in which the resident, circulator, or surgical clinical rater disagreed on the IC were then reviewed by a blinded SC...
November 2017: Surgical Infections
https://www.readbyqxmd.com/read/29072562/platelet-to-white-blood-cell-ratio-predicts-30-day-postoperative-infectious-complications-in-patients-undergoing-radical-nephrectomy-for-renal-malignancy
#19
Alaina Garbens, Christopher J D Wallis, Georg Bjarnason, Girish S Kulkarni, Avery B Nathens, Robert K Nam, Raj Satkunasivam
INTRODUCTION: We sought to examine the relationship between preoperative platelet to white blood cell ratio (PLT/WBC), a hematologic marker of the systemic inflammatory response, and postoperative infectious complications following radical nephrectomy for localized renal cell carcinoma. METHODS: We performed a retrospective cohort study of patients treated with radical nephrectomy for localized kidney cancer between January 1, 2005 and December 31, 2014 (n=6235) using the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database...
November 11, 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/29071496/a-matched-comparison-of-laparoscopic-versus-open-inguinal-hernia-repair-in-patients-with-liver-disease-using-propensity-score-matching
#20
K Y Pei, F Liu, Y Zhang
PURPOSE: Patients with liver cirrhosis may require inguinal hernia repair. It is unknown if surgical approach, laparoscopic or open, affects outcomes in this high-risk patient population. This study compares complications, deaths, and length of stay between open and laparoscopic inguinal hernias in patients with liver disease. METHODS: All patients (N = 145,780) who were diagnosed with inguinal hernia (ICD-9-codes: 550.00, 550.02, 550.10, 550.12, 550.90, and 550...
October 25, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
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