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Mini Kamboj, Teresa Childers, Jessica Sugalski, Donna Antonelli, Juliane Bingener-Casey, Jamie Cannon, Karie Cluff, Kimberly A Davis, E Patchen Dellinger, Sean C Dowdy, Kim Duncan, Julie Fedderson, Robert Glasgow, Bruce Hall, Marilyn Hirsch, Matthew Hutter, Lisa Kimbro, Boris Kuvshinoff, Martin Makary, Melanie Morris, Sharon Nehring, Sonia Ramamoorthy, Rebekah Scott, Mindy Sovel, Vivian Strong, Ashley Webster, Elizabeth Wick, Julio Garcia Aguilar, Robert Carlson, Kent Sepkowitz
BACKGROUND Surgical site infections (SSIs) following colorectal surgery (CRS) are among the most common healthcare-associated infections (HAIs). Reduction in colorectal SSI rates is an important goal for surgical quality improvement. OBJECTIVE To examine rates of SSI in patients with and without cancer and to identify potential predictors of SSI risk following CRS DESIGN American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data files for 2011-2013 from a sample of 12 National Comprehensive Cancer Network (NCCN) member institutions were combined...
March 19, 2018: Infection Control and Hospital Epidemiology
Mike Fruscione, Russell Kirks, Allyson Cochran, Keith Murphy, Erin H Baker, John B Martinie, David A Iannitti, Dionisios Vrochides
BACKGROUND: The American College of Surgeons NSQIP® Surgical Risk Calculator (SRC) was developed to estimate postoperative outcomes. Our goal was to develop and validate an institution-specific risk calculator for patients undergoing major hepatectomy at Carolinas Medical Center (CMC). METHODS: Outcomes generated by the SRC were recorded for 139 major hepatectomies performed at CMC (2008-2016). Novel predictive models for seven postoperative outcomes were constructed and probabilities calculated...
March 14, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Hemalkumar Mehta, Ayodele Osasona, Yong Shan, James S Goodwin, Ikenna C Okereke
OBJECTIVE: Video-assisted thoracoscopic surgery may be associated with less morbidity than open lobectomy/segmentectomy, but some studies have questioned the benefit of thoracoscopic surgery. The study aimed to determine trends and factors associated with patient's likelihood of undergoing thoracoscopic lobectomy/segmentectomy and to compare outcomes with each approach. METHODS: This retrospective study included adult patients undergoing pulmonary lobectomy/segmentectomy from the American College of Surgeons National Surgical Quality Improvement Project from 2007-2015 (n=14,717)...
March 13, 2018: Seminars in Thoracic and Cardiovascular Surgery
David Asuzu, Kevin Y Pei, Kimberly A Davis
BACKGROUND: Small bowel obstruction is common and often requires surgical management. Simple preoperative models are lacking to predict post-operative complications after surgical management of adhesive small bowel obstruction. METHODS: We retrospectively analyzed data from 15,036 patients who underwent open lysis of adhesions for small bowel obstruction from 2005 to 2013 using the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database...
March 6, 2018: American Journal of Surgery
Fernando A Angarita, Sergio A Acuna, Erin Cordeiro, Ahmad Elnahas, Subir Sutradhar, Timothy Jackson, Tulin D Cil
PURPOSE: Postoperative complication rates for elderly women undergoing breast cancer surgery have not been well studied. We describe the postoperative complication rates of elderly (≥ 70 years) women with breast cancer and compare them with young (40-69 years) women. METHODS: Data were extracted from the National Surgical Quality Improvement Program database (2004-2014). We included women with invasive breast cancer who underwent surgery. Outcomes were 30-day postoperative morbidity and mortality (complications), which were compared between young and elderly women...
March 15, 2018: Breast Cancer Research and Treatment
Kenneth C Cummings Iii, Nicole M Zimmerman, Kamal Maheshwari, Gregory S Cooper, Linda C Cummings
STUDY OBJECTIVE: Epidural analgesia may be associated with fewer postoperative complications and is associated with improved survival after colon cancer resection. This study used the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) to assess any association between epidural analgesia (versus non-epidural) and complications after colectomy. DESIGN: Retrospective cohort study. SETTING: 603 hospitals in the United States reporting data to NSQIP...
March 12, 2018: Journal of Clinical Anesthesia
Timothy Feeney, Manuel Castillo-Angeles, John W Scott, Stephanie L Nitzschke, Ali Salim, Adil H Haider, Joaquim M Havens
BACKGROUND: Emergency general surgery (EGS) is an independent risk factor for morbidity and mortality, and seven procedures account for 80% of the National burden of operative EGS. We aimed to characterize the excess morbidity and mortality attributable to these procedures based on the level of procedural risk. METHODS: Retrospective analysis of the ACS National Surgical Quality Improvement Project (ACS-NSQIP) database. (2005-2014). Seven EGS procedures were stratified as high risk and low risk...
March 7, 2018: American Journal of Surgery
Nicholas P McKenna, Amy E Glasgow, Robert R Cima, Elizabeth B Habermann
BACKGROUND: Organ space infection (OSI) after ileal pouch anal anastomosis (IPAA) is a devastating complication. The aim of this was study was to determine separately risk factors for OSI after total proctocolectomy (TPC) with IPAA and completion proctectomy (CP) with IPAA. METHODS: 4049 patients with a diagnosis of chronic ulcerative colitis undergoing TPC with IPAA or CP with IPAA between 2005 and 2015 were identified in the American College of Surgeons National Surgical Quality Improvement Program database...
March 6, 2018: American Journal of Surgery
Julie Hallet, Alyson L Mahar, Avery B Nathens, Melanie E Tsang, Kaitlyn A Beyfuss, Yulia Lin, Natalie G Coburn, Paul J Karanicolas
Background: Bleeding and need for red blood cell transfusions (RBCT) remain a significant concern with hepatectomy. RBCT carry risk of transfusion-related immunomodulation that may impact post-operative recovery. This study soughs to assess the association between RBCT and post-hepatectomy morbidity. Methods: Using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) registry, we identified all adult patients undergoing elective hepatectomy over 2007-2012...
February 2018: Hepatobiliary Surgery and Nutrition
Pelumi Adedayo, Kimberly Resnick, Sareena Singh
OBJECTIVE: Our objective was to examine the association of the modified frailty index (mFI) and non-home discharge in patients undergoing surgery for endometrial cancer (EMCA). METHODS: Patients who underwent surgery for EMCA from 2011 to 2012 were identified from the American College of Surgeons - Nastional Surigical Quality Improvement Project (ACS-NSQIP) database. Current Procedural Terminology (CPT) codes were used to identify surgical characteristics. We excluded patients who were already living in a non-home facility...
March 9, 2018: Journal of Geriatric Oncology
Nicholas A Bedard, Andrew J Pugely, Michael McHugh, Nathan Lux, Jesse E Otero, Kevin J Bozic, Yubo Gao, John J Callaghan
BACKGROUND: Use of large clinical and administrative databases for orthopaedic research has increased exponentially. Each database represents unique patient populations and varies in their methodology of data acquisition, which makes it possible that similar research questions posed to different databases might result in answers that differ in important ways. QUESTIONS/PURPOSES: (1) What are the differences in reported demographics, comorbidities, and complications for patients undergoing primary TKA among four databases commonly used in orthopaedic research? (2) How does the difference in reported complication rates vary depending on whether only inpatient data or 30-day postoperative data are analyzed? METHODS: Patients who underwent primary TKA during 2010 to 2012 were identified within the National Surgical Quality Improvement Programs (NSQIP), the Nationwide Inpatient Sample (NIS), the Medicare Standard Analytic Files (MED), and the Humana Administrative Claims database (HAC)...
January 2018: Clinical Orthopaedics and related Research
Ayòtúndé B Fadayomi, Gyulnara G Kasumova, Omidreza Tabatabaie, Susanna W L de Geus, Tara S Kent, Sing Chau Ng, A James Moser, Mark P Callery, Stanley W Ashley, Jennifer F Tseng
BACKGROUND: Surgical site infections (SSIs) are common following pancreatectomy and associated with significant morbidity and economic burden. We sought to identify distinct predictors for superficial versus deep/organ space SSIs and their effects on surgical outcomes. METHODS: ACS-NSQIP targeted pancreatectomy 2014 and 2015 databases were queried. Univariate and multivariate models were developed for both types of SSI, length of stay (LOS), and readmission. Costs were estimated based on Centers for Medicare & Medicaid Services (CMS) recommendations...
March 8, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Bryan D Haughom, Bryce A Basques, Michael D Hellman, Nicholas M Brown, Craig J Della Valle, Brett R Levine
BACKGROUND: Epidemiological estimates indicate a rising incidence of periprosthetic hip fractures. While native hip fractures are known to be a highly morbid condition, a significant body of research has led to improved outcomes and decreased complications following these injuries. Comparatively, little research has evaluated the relative morbidity and mortality of periprosthetic hip fractures. The purpose of this study was to compare the morbidity and mortality of periprosthetic vs native hip fractures...
February 1, 2018: Journal of Arthroplasty
Ruiyang Jiang, Steven Wolf, Muhammad H Alkazemi, Gina-Maria Pomann, J Todd Purves, John S Wiener, Jonathan C Routh
INTRODUCTION: The surgical comorbidity assessment is important for patient risk stratification, counseling, and research. In adults, risk assessment indices, such as the Charlson Co-morbidity Score (CCS) or Van Walraven Index (VWI), are well established. In pediatrics, however, risk assessment indices are scarce. Recently, a pediatric-specific risk assessment index, the Rhee index, was developed to discriminate mortality for pediatric general surgery patients. Currently, there is no validated risk assessment tool in pediatric urology...
February 26, 2018: Journal of Pediatric Urology
Andrew T Strong, Gautam Sharma, Chao Tu, Ali Aminian, James B Young, John Rodriguez, Matthew Kroh
BACKGROUND: Weight loss following bariatric surgery can improve cardiac function among patients with heart failure (HF). However, perioperative morbidity of bariatric surgery has not been evaluated in patients with HF. STUDY DESIGN: The National Surgical Quality Improvement Project (NSQIP) database for 2006-2014 was queried to identify patients undergoing adjustable gastric band, gastric bypass, sleeve gastrectomy, and biliopancreatic diversion-duodenal switch. Patients with HF were propensity matched to a control group without HF (1:5)...
March 6, 2018: Obesity Surgery
Kevin Y Pei, Yawei Zhang, Timur Sarac, Kimberly A Davis
OBJECTIVES: There is evidence to suggest outcomes may be related to surgeon experience or skill level. Lower extremity amputations are performed by both general surgeons (GS) and vascular surgeons (VS); however, the effect of specialty on post-operative outcome in below-knee amputation is not known. This retrospective study compares outcomes in below-knee amputations between VS and GS. METHODS: Patients who underwent below-knee amputations (BKA) between 2005 and 2014 were identified from the American College of Surgeons National Surgical Quality Improvement Project (NSQIP) database...
February 28, 2018: Annals of Vascular Surgery
Sara L Zettervall, Tammy Ju, Jeremy L Holzmacher, Lisbi Rivas, Paul P Lin, Khashayar Vaziri
BACKGROUND: Post-operative pancreatic fistulas remain a significant source of morbidity following pancreatic surgery. Few studies have evaluated the effect of neoadjuvant chemotherapy and radiation on this adverse outcome. This study aims to evaluate the effects of neoadjuvant therapy on 30-day morbidity and mortality following pancreaticoduodenectomy. STUDY DESIGN: A retrospective analysis was performed utilizing the targeted pancreas module of the National Surgical Quality Improvement Project (NSQIP) from 2014 to 2015 for patients undergoing pancreaticoduodenectomy with pancreaticojejunal reconstruction...
March 2, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Abdullah Alshehri, Kourosh Afshar, Julie Bedford, Graeme Hintz, Erik D Skarsgard
INTRODUCTION: Anthropometric measurements can be used to define pediatric malnutrition. Our study aims to: (1) characterize the preoperative nutritional status of children undergoing abdominal or thoracic surgery, and (2) describe the associations between WHO-defined acute (stunting) and chronic (wasting) undernutrition (Z-scores <-2) and obesity (BMI Z-scores >+2) with 30-day postoperative outcomes. METHODS: We queried the Pediatric NSQIP Participant Use File and extracted data on patients' age 29days to 18years who underwent abdominal or thoracic procedures...
February 7, 2018: Journal of Pediatric Surgery
Chandrew Rajakumar, Ranjeeta Mallick, Glenn Posner, David Schramm, Sukhbir Singh, Karine Lortie, Dante Pascali, Innie Chen
OBJECTIVES: Due to the rapid decline in vaginal hysterectomy cases in recent years, there is concern regarding gynecologic surgical training and proficiency for vaginal hysterectomy. The objective of this study is to determine the effect of surgical trainee involvement on surgical outcomes in vaginal hysterectomy cases performed for benign indications. DESIGN: Retrospective, multicenter, cohort study using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database...
February 26, 2018: Journal of Minimally Invasive Gynecology
Sai Yendamuri, Athar Battoo, Kris Attwood, Samjot Singh Dhillon, Grace K Dy, Mark Hennon, Anthony Picone, Chukwumere Nwogu, Todd Demmy, Elisabeth Dexter
BACKGROUND: Mediastinoscopy is considered the gold standard for preresectional staging of lung cancer. We sought to examine the effect of concomitant mediastinoscopy on postoperative pneumonia (POP) in patients undergoing lobectomy. METHODS: All patients in our institutional database (2008-2015) undergoing lobectomy who did not receive neoadjuvant therapy were included in our study. The relationship between mediastinoscopy and POP was examined using univariate (Chi square) and multivariate analyses (binary logistic regression)...
February 27, 2018: Annals of Surgical Oncology
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