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OBJECTIVEHospital readmission contributes substantial costs to the healthcare system. The purpose of this investigation was to create a predictive machine learning model to identify lumbar laminectomy patients at risk for postoperative hospital readmission.METHODSPatients who had undergone a lumbar laminectomy procedure in the period from 2011 to 2014 were isolated from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. Demographic characteristics and clinical factors, including complications, comorbidities, length of stay, age, and body mass index, were analyzed in relation to whether or not the patients had been readmitted to the hospital within 30 days after their procedure by utilizing independent-samples t-tests...
December 1, 2018: Journal of Neurosurgery. Spine
Sala Abdalla, Rosaria Scarpinata
The optimal timing of loop ileostomy reversal remains largely unknown, but evidence that delayed ileostomy closure may increase postoperative complication rates is increasing. PURPOSE: Retrospective research was conducted to compare outcomes between patients who had early (<6 months) or late (>6 months) loop ileostomy closure. METHODS: Records of patients >18 years of age who underwent circumstomal reversal of a loop ileostomy over a period of 5 years in 1 hospital's colorectal unit were abstracted and analyzed...
December 2018: Ostomy/wound Management
Diogo Torres, Amanika Kumar, Jamie N Bakkum-Gamez, Amy L Weaver, Michaela E McGree, Chen Wang, Carrie L Langstraat, William A Cliby
OBJECTIVE: To evaluate the contribution of molecular subtype to 30-day postoperative complications and 90-day mortality after primary debulking surgery (PDS) in advanced stage high-grade serous ovarian cancer (HGSOC). METHODS: Patients with stages III-IV HGSOC undergoing PDS from 1994 to 2011 with available molecular subtyping were included. Residual disease (RD) status was categorized as 0, 0.1-0.5, 0.6-1.0, or >1 cm. Surgical complexity scores were calculated as high, intermediate, or low as previously published...
November 28, 2018: Gynecologic Oncology
Erin Chang, Paul J Chung, Michael C Smith, Michael J Lee, Daniel J Gross, Elizabeth Kao, Gainosuke Sugiyama
BACKGROUND: With the population of octogenarians projected to increase fourfold by 2050, we sought to compare outcomes of laparoscopic versus open approach in octogenarians requiring surgery for adhesive small bowel obstruction (SBO). METHODS/MATERIALS AND METHODS: Using 2006-2015 American College of Surgeons National Surgical Quality Improvement Project, we identified patients aged ≥80 y who underwent emergency surgery within 1 d of admission for SBO. Risk variables of interest included age, sex, race, body mass index, preoperative sepsis, and American Society of Anesthesiologists (ASA) classification...
January 2019: Journal of Surgical Research
Amy Ahn, Kevin Phan, Zoe B Cheung, Samuel Jw White, Jun S Kim, Samuel K Cho
OBJECTIVE: To identify independent risk factors for non-home discharge in patients undergoing laminectomy for intradural extramedullary (IDEM) spinal tumors. METHODS: We performed a retrospective cohort analysis of data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) from 2011 to 2014. Adult patients undergoing laminectomy for the excision of IDEM spinal tumors were included and divided into 2 groups based on home or non-home discharge disposition...
November 27, 2018: World Neurosurgery
Danishta Ramdin, Arumugam Moorthy, Winston J Rennie
Spondyloarthritis (SpA) is a group of chronic inflammatory conditions which severely impact quality of life. Several criteria have been developed in the past to aid the diagnosis of SpA based on symptoms and radiographic changes during the course of the disease. However, it takes several years before structural changes manifest on conventional radiographs, leading to a diagnostic delay of 6 to 10 years. The use of MRI and its incorporation into the Assessment of Spondyloarthritis (ASAS) criteria, has radically changed the diagnosis of SpA in the last decade by allowing visualisation of both active and chronic inflammatory changes and enabling clinicians to recognise SpA during it's early stage and initiate treatment...
December 16, 2017: Journal of the Belgian Society of Radiology
Ivan Ye, Ray Tang, Samuel J White, Zoe B Cheung, Samuel K Cho
OBJECTIVE: The purpose of this study was to identify predictors of 30-day postoperative pulmonary complications following open reduction and internal fixation (ORIF) of vertebral fractures. METHODS: We performed a retrospective study using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2010 to 2014. Adult patients who underwent ORIF of vertebral fractures were included and divided into 2 groups based on the occurrence of 30-day postoperative pulmonary complications...
November 26, 2018: World Neurosurgery
Malek Meskawi, Pierre-Alain Hueber, Roger Valdivieso, Pierre I Karakiewicz, Benjamin Pradere, Vincent Misrai, Bilal Chughtai, Kevin C Zorn
PURPOSE: To examine the complications and functional outcomes of high-risk patients on antithrombotic therapy (ATT) treated with photoselective vaporization of the prostate (PVP) using the Greenlight (GL) XPS-180 system. METHODS: A retrospective analysis of prospectively maintained institutional database was performed. Men with symptomatic LUTS related to BPH were treated with 523-nm GL PVP using the XPS-180 W system. They were stratified according to ATT status: group 1 (control group), group 2 (acetylsalicylic acid), group 3 (antiplatelet agents other than acetylsalicylic acid) and group 4 (anticoagulation agents)...
November 26, 2018: World Journal of Urology
Rodolfo Pini, Enrico Gallitto, Gianluca Faggioli, Chiara Mascoli, Andrea Vacirca, Cecilia Fenelli, Mauro Gargiulo, Andrea Stella
OBJECTIVE: The appropriateness of endovascular aneurysm repair (EVAR) of uncomplicated abdominal aortic aneurysm depends on the risk-benefit ratio, particularly in elderly patients with short life expectancy. The aim of this study was to assess the efficacy of EVAR in >80-year-old patients by evaluating their postoperative survival and analyzing the possible predictors of late mortality. METHODS: All consecutive patients aged >80 years undergoing elective EVAR from 2006 to 2015 were prospectively evaluated...
November 23, 2018: Journal of Vascular Surgery
Melissa Medina, Shannon R Foiles, Matilde Francois, Carl V Asche, Jinma Ren, Dale K Mueller, Richard C Anderson
BACKGROUND: Thoracic Epidural has long been the most recommended treatment for postoperative pain management in general thoracic surgery. This study compares liposomal bupivacaine (LB) as an alternative method for pain control and compares it to the standard. METHODS: LB was compared to thoracic epidural bupivacaine hydrochloride (TE BH) in 387 patients who underwent video-assisted thoracoscopic pulmonary resection (VATS-R) at our institution. Patients received either continuous TE BH or intraoperative LB at a predetermined dose...
October 17, 2018: American Journal of Surgery
Andrew Nunno, Yan Li, Thomas A Pieters, James E Towner, Tyler Schmidt, Meichuanzi Shi, Kevin Walter, Yan Michael Li
OBJECTIVE: Patients undergoing surgical resection of meningioma are at increased risk for developing venous thromboembolism (VTE). The primary aim of this study was to assess the occurrence of VTE in patients who underwent surgery to remove their meningioma, and to determine the risk factors and associated complications with VTE. METHODS: The American College of Surgeons(ACS) National Surgical Quality Improvement Project (NSQIP) database from 2012-2015 was reviewed for patients who had undergone meningioma resection according to their primary Current Procedural Terminology codes and International Classification of Diseases, Ninth Revision...
November 20, 2018: World Neurosurgery
Eva J Lehtonen, Matthew C Hess, Gerald McGwin, Ashish Shah, Alexandre Leme Godoy-Santos, Sameer Naranje
Objective: To identify independent risk factors, complications and early hospital readmission following total knee arthroplasty. Methods: Using the ACS-NSQIP database, we identified patients who underwent primary TKA from 2012-2015. The primary outcome was early hospital readmission. Patient demographics, preoperative comorbidities, laboratory data, operative characteristics, and postoperative complications were compared between readmitted and non-readmitted patients...
2018: Acta Ortopedica Brasileira
Luis Fernando Moreira, Henrique Iahnke Garbin, Gabriella Richter Da-Natividade, Bernardo Volkweis Silveira, Thais Vicentine Xavier
OBJECTIVE: to evaluate the main risk factors for postoperative complications in patients undergoing appendectomy for acute appendicitis. METHODS: we retrospectively analyzed 1241 patients undergoing open or laparoscopic appendectomy. Patients were allocated to four groups: Group 1, without postoperative complications, and Groups 2, 3, and 4, with postoperative complications defined according to their severity, following Clavien-Dindo classification (I, II, and ≥III, respectively)...
November 14, 2018: Revista do Colégio Brasileiro de Cirurgiões
Danica Z Markovic, Tatjana Jevtovic-Stoimenov, Milena Stojanovic, Anita Z Vukovic, Vesna Dinic, Bojana Z Markovic-Zivkovic, Radmilo J Jankovic
BACKGROUND: Our previous research has shown American Society of Anaesthesiologists physical status classification (ASA) score and Americal College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) calculator to have the most accuracy in the prediction of postoperative mortality. AIMS: The aim of our research was to define the most reliable combination of cardiac biomarkers with ASA and ACS NSQIP. METHODS: We have included a total of 78 patients...
November 19, 2018: Aging Clinical and Experimental Research
David Myssiorek, Yasmina Ahmed, Afshin Parsikia, Maria Castaldi, John McNelis
BACKGROUND: Surgical Site Infection (SSI) is an uncommon but serious complication of thyroidectomy when encountered. STUDY DESIGN: NSQIP Participant Use File (PUF) from 2012 to 2015 were queried. Thyroidectomy was identified with CPT 60210, 12, 20, 25, 40, 52, 54, 60 in patients ≥18 years and clean (Wound Classification 1) wounds. Uni- and multivariate logistic regression testing were performed. A subgroup analysis for patients that underwent thyroidectomy for cancer was performed...
November 16, 2018: International Journal of Surgery
Wajid Arshad Abbasi, Amina Asif, Asa Ben-Hur, Fayyaz Ul Amir Afsar Minhas
BACKGROUND: Determining protein-protein interactions and their binding affinity are important in understanding cellular biological processes, discovery and design of novel therapeutics, protein engineering, and mutagenesis studies. Due to the time and effort required in wet lab experiments, computational prediction of binding affinity from sequence or structure is an important area of research. Structure-based methods, though more accurate than sequence-based techniques, are limited in their applicability due to limited availability of protein structure data...
November 15, 2018: BMC Bioinformatics
Alessandro De Cassai, Annalisa Boscolo, Tommaso Tonetti, Irina Ban, Carlo Ori
Background: The American Society of Anesthesiologists physical status (ASA-PS) is a grading system adopted worldwide by anesthesiologists to classify the overall health status of patients. Its importance is demonstrated not only by its routinely use in clinical practice, but also by its deployment in other healthcare-related environments. However, a weak/moderate inter-observer agreement for ASA-PS has been previously shown and, although definitions and clinical examples of each class were provided by ASA, doubts remain on the individual factors influencing the assignment to an ASA-PS class...
November 14, 2018: Korean Journal of Anesthesiology
Charles L Nelson, Atul F Kamath, Nabil M Elkassabany, Zhenggang Guo, Jiabin Liu
INTRODUCTION: Low serum albumin is associated with higher perioperative complications following total hip arthroplasty (THA). The distinct threshold for a significant rise in perioperative complications has not been defined for THA. The purpose of this study was to define the threshold at which perioperative complications rise after THA. METHODS: We analysed the American College of Surgeons NSQIP database from 2006 to 2013. Our study cohort included unilateral primary THA with reported preoperative albumin levels...
November 11, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Travis Markham, Robert Wegner, Nadia Hernandez, Jae W Lee, Warren Choi, Holger K Eltzschig, John Zaki
STUDY OBJECTIVE: To investigate the impact of utilizing a multimodal analgesia protocol to allow the implementation of Enhanced Recovery after Cardiac Surgery (ERACS) in patients requiring cardio-pulmonary bypass. DESIGN: Retrospective analysis of patients treated with the proposed ERACS bundle in comparison to matched controls. SETTING: Single-center study. PATIENTS: A total of 50 patients undergoing elective cardiac surgery limited to on pump coronary artery bypass graft...
November 5, 2018: Journal of Clinical Anesthesia
Xin Zhang, Da-Ke Tong, Fang Ji, Xu-Zhou Duan, Pei-Zhao Liu, Sheng Qin, Kai-Hang Xu, Xia-Ti Di-Li
To evaluate the risk factors for the development of postoperative delirium and design a predictive nomogram for the prevention of delirium in elderly patients with a hip fracture, we retrospectively studied 825 patients who sustained a femoral neck fracture from January 2005 to December 2015. Independent risk factors for developing delirium within 6 months of surgery were identified using multivariable logistic regression analyses. A predictive nomogram model was built based on the results, and the discrimination and calibration were determined by C-index and calibration plot...
October 30, 2018: Injury
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