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https://www.readbyqxmd.com/read/29776643/review-of-risk-assessment-tools-to-predict-morbidity-and-mortality-in-elderly-surgical-patients
#1
REVIEW
Gilgamesh Eamer, Mohamed J H Al-Amoodi, Jayna Holroyd-Leduc, Darryl B Rolfson, Lindsey M Warkentin, Rachel G Khadaroo
BACKGROUND: Informed surgical consent requires accurate estimation of risks and benefits. Multiple risk assessment tools are available; however, most are not widely used or are specific to certain interventions. Assessing surgical risk is especially challenging in elderly patients because of their range of comorbidities, level of frailty, or severity of illness and a number of available surgical interventions. DATA SOURCES: We searched MEDLINE from January 2014 to July 2017 for studies that used risk assessment tools in studies on elderly surgical patients...
April 18, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29775552/right-colon-resection-for-colon-cancer-does-surgical-approach-matter
#2
Ivy N Haskins, Tammy Ju, Matthew Skancke, Xiangyu Kuang, Richard L Amdur, Fred Brody, Vincent Obias, Samir Agarwal
BACKGROUND: Surgical resection with curative intent remains the standard of care for colon cancer. This study aims to compare the 30-day outcomes and oncologic results following open, laparoscopic, and robot-assisted right colon resection for colon cancer using the Targeted Colectomy American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. MATERIALS AND METHODS: All patients undergoing elective, right colon resection with primary anastomosis were identified within the targeted colectomy ACS-NSQIP database...
May 18, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29761322/concurrent-risk-reduction-surgery-in-patients-with-increased-lifetime-risk-for-breast-and-ovarian-cancer-an-analysis-of-the-national-surgical-quality-improvement-program-nsqip-database
#3
Maryam Elmi, Arash Azin, Ahmad Elnahas, David R McCready, Tulin D Cil
BACKGROUND: Patients with genetic susceptibility to breast and ovarian cancer are eligible for risk-reduction surgery. Surgical morbidity of risk-reduction mastectomy (RRM) with concurrent bilateral salpingo-oophorectomy (BSO) is unknown. Outcomes in these patients were compared to patients undergoing RRM without BSO using a large multi-institutional database. METHODS: A retrospective cohort analysis was conducted using the American College of Surgeon's National Surgical Quality Improvement Program (NSQIP) 2007-2016 datasets, comparing postoperative morbidity between patients undergoing RRM with patients undergoing RRM with concurrent BSO...
May 14, 2018: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29749243/the-predictive-value-of-risk-indices-for-cardiac-complications-in-living-donor-liver-transplantation
#4
I P Canbolat, Y Erdogan, G Adali, O Kaplan, M Dayangac, Y Yuzer, Y Tokat
BACKGROUND AND AIMS: The American College of Surgeons' National Surgical Quality Improvement Program (NSQIP) risk tool and Revised Cardiac Risk Index (RCRI) are recommended tools for cardiovascular assessment before non-cardiac surgery to predict early postoperative cardiac morbidity and mortality. Their predictive value for postoperative cardiovascular morbidity and mortality after liver transplantation is unknown. We aimed to evaluate the validity of these two risk tools to predict early (30-day) cardiovascular complications and in-hospital all-cause mortality...
2018: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/29743805/outcomes-after-endoscopic-dilation-of-laryngotracheal-stenosis-an-analysis-of-acs-nsqip
#5
Avni Bavishi, Emily Boss, Rahul K Shah, Jennifer Lavin
Importance: Endoscopic management of pediatric subglottic stenosis (SGS) is common, however no multi-institutional studies have assessed its perioperative outcomes. The American College of Surgeon's National Surgical Quality Improvement Program - Pediatric (ACS-NSQIP-P) represents a source of such data. Design: Current procedural terminology (CPT) codes were queried for endoscopic or open airway reconstruction in the ACS-NSQIP-P Public Use File (PUF). Demographics and 30-day events were abstracted to compare open to endoscopic techniques and to assess for risk factors for varied outcomes after endoscopic dilation...
March 2018: Journal of Clinical Outcomes Management: JCOM
https://www.readbyqxmd.com/read/29732423/predicting-critical-care-unit-level-complications-after-long-segment-fusion-procedures-for-adult-spinal-deformity
#6
Rafael De la Garza-Ramos, Jonathan Nakhla, Yaroslav Gelfand, Murray Echt, Aleka N Scoco, Merritt D Kinon, Reza Yassari
Background: To identify predictive factors for critical care unit-level complications (CCU complication) after long-segment fusion procedures for adult spinal deformity (ASD). Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database [2010-2014] was reviewed. Only adult patients who underwent fusion of 7 or more spinal levels for ASD were included. CCU complications included intraoperative arrest/infarction, ventilation >48 hours, pulmonary embolism, renal failure requiring dialysis, cardiac arrest, myocardial infarction, unplanned intubation, septic shock, stroke, coma, or new neurological deficit...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29732419/complications-following-single-level-interbody-fusion-procedures-an-acs-nsqip-study
#7
Jamal N Shillingford, Joseph L Laratta, Joseph M Lombardi, John D Mueller, Meghan Cerpa, Hemant P Reddy, Comron Saifi, Charla R Fischer, Ronald A Lehman
Background: Controversy exists over the ability of various lumbar interbody fusion techniques to realign global and regional balance and their effect on patient outcomes. This is a retrospective cohort study to compare thirty-day postoperative outcomes between anterior and posterior interbody fusion techniques within a large national database. Methods: A retrospective cohort study utilizing the National Surgical Quality Improvement Program (NSQIP) database included 2,372 (29...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29732418/preoperative-steroids-do-not-improve-outcomes-for-intramedullary-spinal-tumors-a-nsqip-analysis-of-30-day-reoperation-and-readmission-rates
#8
Abhiraj D Bhimani, Morteza Sadeh, Darian R Esfahani, Gregory D Arnone, Steven Denyer, Jack Zakrzewski, Pouyan Kheirkhah, Tania M Aguilar, Kate Louise D Milan, Ankit I Mehta
Background: Intramedullary spinal cord tumors (IMSCTs) account for 8-10% of all spinal cord tumors and affect patients of all ages. Although uncommon, IMSCTs carry risk of neurological morbidity and mortality, with 5-year survival rates ranging from 50% to 80%. In this study, we utilize the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to determine the effect of steroid administration on 30-day outcomes following surgery for IMSCTs. Methods: ACS-NSQIP data for patients undergoing surgery for intramedullary tumors from 2005 to 2015 was reviewed...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29719874/reducing-the-rate-of-post-surgical-urinary-tract-infections-in-orthopedic-patients
#9
Amit Thakker, Natasha Briggs, Azusa Maeda, Julie Byrne, John Roderick Davey, Timothy D Jackson
Urinary tract infection (UTI) is the fourth leading cause of healthcare-associated infections, with approximately 70%-80% being attributed to the inappropriate use of indwelling catheters. In many cases, indwelling catheters are used inappropriately without any valid indication, creating potentially avoidable and significant patient distress, discomfort, pain and activity restrictions, together with substantial care burden, cost and hospitalisation. In the Division of Orthopedic Surgery at Toronto Western Hospital (TWH), we identified UTI rate reduction as a quality improvement priority...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29719063/diabetes-is-not-associated-with-increased-rates-of-free-flap-failure-analysis-of-outcomes-in-6030-patients-from-the-acs-nsqip-database
#10
Rami S Kantar, William J Rifkin, Joshua A David, Michael J Cammarata, J Rodrigo Diaz-Siso, Jamie P Levine, Alyssa R Golas, Daniel J Ceradini
BACKGROUND: Diabetes affects a significant proportion of the population in the United States. Microsurgical procedures are common in this patient population, and despite many conflicting reports in the literature, there are no large studies evaluating the direct association between diabetes and outcomes, specifically failure, following free flap reconstruction. In this study, we sought to determine the impact of diabetes on postoperative outcomes following free flap reconstruction using a national multi-institutional database...
May 2, 2018: Microsurgery
https://www.readbyqxmd.com/read/29717658/concurrent-inguinal-hernia-repair-in-patients-undergoing-minimally-invasive-radical-prostatectomy-a-national-surgical-quality-improvement-program-study
#11
Leilei Xia, Benjamin L Taylor, Neal Patel, Raju R Chelluri, Jay D Raman, Douglas Scherr, Thomas J Guzzo
OBJECTIVE: To compare perioperative 30-day outcomes between minimally-invasive radical prostatectomy (MIRP) with and without concurrent inguinal hernia repair (IHR) using a national database. METHODS: The National Surgical Quality Improvement Program database was queried for MIRP from 2012-2015. Concurrent IHR was identified using relevant Current Procedural Terminology codes. Primary outcomes were overall complications, reoperations, unplanned readmissions, and mortality within 30 days of MIRP...
May 2, 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29715572/risk-factors-for-perioperative-blood-transfusions-in-adult-spinal-deformity-surgery
#12
Samuel White, Zoe B Cheung, Ivan Ye, Kevin Phan, Joshua Xu, James Dowdell, Jun S Kim, Samuel K Cho
OBJECTIVE: Adult spinal deformity (ASD) surgery is associated with a high rate of perioperative blood transfusions and it is important to understand the risk factors for perioperative blood transfusions in order to implement strategies to reduce transfusions. The aim of this study was to identify independent risk factors of perioperative blood transfusions in patients undergoing surgery for ASD. METHODS: A retrospective cohort study was performed using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2010 to 2014...
April 28, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29713875/impact-of-synchronous-liver-resection-on-the-perioperative-outcomes-of-patients-undergoing-crs-hipec
#13
Jordan M Cloyd, Sherif Abdel-Misih, John Hays, Mary E Dillhoff, Timothy M Pawlik, Carl Schmidt
BACKGROUND: While liver resection (LR) and cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) are commonly performed for hepatic and peritoneal metastases, respectively, the safety of synchronous LR and CRS-HIPEC has not been established. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) databases from 2005 to 2016 were used to identify patients who underwent CRS-HIPEC. Demographic, clinical, and perioperative outcomes were compared among patients who underwent CRS-HIPEC with and without synchronous LR...
April 30, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29712598/association-of-increasing-frailty-with-detrimental-outcomes-after-pancreatic-resection
#14
Rodney Lane Guyton, Catalina Mosquera, Konstantinos Spaniolas, Timothy L Fitzgerald
An association between detrimental outcomes and frailty has been documented; however, the impact specific to pancreatic surgery is unknown. Using NSQIP data, patients were classified as non-, mildly, moderately, or severely frail. A total of 16,028 patients were included in the study; most of the patients were white (78.5%) and underwent pancreaticoduodenectomy (PD) (67%). Complications occurred in 17.6 per cent cases, and the median length of stay (LOS) was 11.89 days. Prolonged LOS and mortality occurred in 9...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29709469/effect-of-resident-involvement-on-morbidity-and-mortality-following-thoracic-endovascular-aortic-repair
#15
Derrick O Acheampong, Philip Paul, Shanice Guerrier, Percy Boateng, I Michael Leitman
OBJECTIVE: To evaluate the effect of resident involvement in thoracic endovascular aortic repair (TEVAR). SUMMARY OF BACKGROUND DATA: Although the influence of resident intraoperative involvement in several types of surgical procedures has been reported, the effect of resident participation in TEVAR is unknown. We evaluated patient outcomes in resident-involved TEVAR procedures. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was analyzed for TEVAR performed from 2010 to 2012...
April 27, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29707443/the-national-surgical-quality-improvement-program-30-day-challenge-microsurgical-breast-reconstruction-outcomes-reporting-reliability
#16
Austin D Chen, Parisa Kamali, Anmol S Chattha, Alexandra Bucknor, Justin B Cohen, Patrick P Bletsis, Renata Flecha-Hirsch, Adam M Tobias, Bernard T Lee, Samuel J Lin
Background: The aim was to assess reliability of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) 30-day perioperative outcomes and complications for immediate, free-tissue transfer breast reconstruction by direct comparisons with our 30-day and overall institutional data, and assessing those that occur after 30 days. Methods: Data were retrieved for consecutive immediate, free-tissue transfer breast reconstruction patients from a single-institution database (2010-2015) and the ACS-NSQIP (2011-2014)...
March 2018: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29697506/association-of-neuraxial-anesthesia-with-postoperative-venous-thromboembolism-after-noncardiac-surgery-a-propensity-matched-analysis-of-acs-nsqip-database
#17
Alparslan Turan, Gausan R Bajracharya, Steve Leung, Merve Yazici Kara, Guangmei Mao, Thomas Botsford, Kurt Ruetzler, Kamal Maheshwari, Wael Ali Sakr Esa, Hesham Elsharkawy, Daniel I Sessler
BACKGROUND: Neuraxial anesthesia improves components of the Virchow's triad (hypercoagulability, venous stasis, and endothelial injury) which are key pathogenic contributors to venous thrombosis in surgical patients. However, whether neuraxial anesthesia reduces the incidence of venous thromboembolism (VTE) remain unclear. We therefore tested the primary hypothesis that neuraxial anesthesia reduces the incidence of 30-day VTE in adults recovering from orthopedic surgery. Secondarily, we tested the hypotheses that neuraxial anesthesia reduces 30-day readmission, 30-day mortality, and the duration of postoperative hospitalization...
April 23, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29696572/comparison-of-early-morbidity-and-mortality-between-sleeve-gastrectomy-and-gastric-bypass-in-high-risk-patients-for-liver-disease-analysis-of-american-college-of-surgeons-national-surgical-quality-improvement-program
#18
Mohamad A Minhem, Sali F Sarkis, Bassem Y Safadi, Souha A Fares, Ramzi S Alami
INTRODUCTION: Chronic liver disease is prevalent in obese patients presenting for bariatric surgery and is associated with increased postoperative morbidity and mortality (M&M). There are no comparative studies on the safety of different types of bariatric operations in this subset of patients. OBJECTIVE: The aim of this study is to compare the 30-day postoperative M&M between laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-Y-gastric bypass (LRYGB) in the subset of patients with a model of end-stage liver disease (MELD) score ≥ 8...
April 25, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29696330/patient-frailty-should-be-used-to-individualize-treatment-decisions-in-primary-hyperparathyroidism
#19
Carolyn D Seib, Kathryn Chomsky-Higgins, Jessica E Gosnell, Wen T Shen, Insoo Suh, Quan-Yang Duh, Emily Finlayson
BACKGROUND: Primary hyperparathyroidism (PHPT) is a common endocrine disorder that predominantly affects patients >60 and is increasing in prevalence. Identifying risk factors for poor outcomes after parathyroidectomy in older adults will help tailor operative decision making. The impact of frailty on surgical outcomes in parathyroidectomy has not been established. METHODS: We performed a retrospective review of patients ≥40 years who underwent parathyroidectomy in the 2005-2010 ACS NSQIP...
April 25, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29689404/extended-length-of-stay-in-elderly-patients-after-anterior-cervical-discectomy-and-fusion-is-not-attributable-to-baseline-illness-severity-or-post-operative-complications
#20
Owoicho Adogwa, Daniel T Lilly, Victoria D Vuong, Shyam A Desai, Bichun Ouyang, Syed Khalid, Ryan Khanna, Carlos A Bagley, Joseph Cheng
BACKGROUND: Healthcare systems are increasing efforts to minimize postoperative hospital stays to improve resource use. Common explanations for extended postoperative stay are baseline patient sickness, postoperative complications, or physician practice differences. However, the degree extended length of stay (LOS) represents patient illness or postoperative complications remains unknown. The aim is to investigate the influence of postoperative complications and elderly patient comorbidities on extended LOS after anterior cervical discectomy and fusion (ACDF)...
April 21, 2018: World Neurosurgery
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