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https://www.readbyqxmd.com/read/28438417/comparing-hospital-outcomes-between-open-and-closed-tibia-fractures-treated-with-intramedullary-fixation
#1
Evan J Smith, Xiangyu Kuang, Rajeev Pandarinath
INTRODUCTION: Tibial shaft fractures comprise a large portion of operatively treated long bone fractures, and present with the highest rate of open injuries. Intramedullary fixation has become the standard of care for both open and closed injuries. The rates of short term complications and hospital length of stay for open and closed fractures treated with intramedullary fixation is not fully known. Previous series on tibia fractures were performed at high volume centers, and data were not generalizable, further they did not report on length of stay and the impact of preoperative variables on infections, complications and reoperation...
March 30, 2017: Injury
https://www.readbyqxmd.com/read/28430052/predicting-complication-risk-in-spine-surgery-a-prospective-analysis-of-a-novel-risk-assessment-tool
#2
Anand Veeravagu, Amy Li, Christian Swinney, Lu Tian, Adrienne Moraff, Tej D Azad, Ivan Cheng, Todd Alamin, Serena S Hu, Robert L Anderson, Lawrence Shuer, Atman Desai, Jon Park, Richard A Olshen, John K Ratliff
OBJECTIVE The ability to assess the risk of adverse events based on known patient factors and comorbidities would provide more effective preoperative risk stratification. Present risk assessment in spine surgery is limited. An adverse event prediction tool was developed to predict the risk of complications after spine surgery and tested on a prospective patient cohort. METHODS The spinal Risk Assessment Tool (RAT), a novel instrument for the assessment of risk for patients undergoing spine surgery that was developed based on an administrative claims database, was prospectively applied to 246 patients undergoing 257 spinal procedures over a 3-month period...
April 21, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28427873/risk-factors-for-hospital-admission-after-anterior-cruciate-ligament-reconstruction
#3
Steven L Bokshan, Steven F DeFroda, Brett D Owens
PURPOSE: To determine patient and surgical risk factors for admission after anterior cruciate ligament reconstruction (ACLR) using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. METHODS: All instances of ACLR from 2005 to 2014 from the ACS NSQIP prospective database were analyzed. Both univariate analysis and binary logistic regression were performed to determine which patient demographics and medical comorbidities were associated with admission after surgery...
April 17, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28422908/the-emergency-surgery-score-ess-accurately-predicts-the-occurrence-of-postoperative-complications-in-emergency-surgery-patients
#4
Anirudh R Nandan, Jordan D Bohnen, Naveen F Sangji, Thomas Peponis, Kelsey Han, D Dante Yeh, Jarone Lee, Noelle Saillant, Marc De Moya, George C Velmahos, David C Chang, Haytham M A Kaafarani
BACKGROUND: The Emergency Surgery Score (ESS) was recently validated as a scoring system to predict mortality in emergency surgery (ES) patients. We sought to examine the ability of ESS to predict the occurrence of 30-day postoperative complications in ES. METHODS: The 2011-2012 American College of Surgeons National Surgical Quality.Improvement Program (ACS-NSQIP) database was screened for all surgical operations classified as "emergent". Thirty-day postoperative complications were defined as per ACS-NSQIP (e...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28421672/a-transplant-specific-quality-initiative-introducing-transqip-a-joint-effort-of-the-asts-and-acs
#5
Justin Parekh, Clifford Ko, Jacqueline Lappin, Stuart Greenstein, Ryutaro Hirose
In an attempt to improve surgical quality in the field of transplantation, the American College of Surgeons (ACS) and American Society and Transplant Surgeons have initiated a national quality improvement program in transplantation. This transplant specific quality improvement program, called TransQIP, has been built from the ground up by transplant surgeons and captures detailed information on donor and recipient factors as well as transplant specific outcomes. It is built upon the existing ACS/NSQIP infrastructure and is designed to capture 100% of liver and kidney transplants performed at participating sites...
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28409847/trends-in-immediate-breast-reconstruction-and-early-complication-rates-among-older-women-a-big-data-analysis
#6
Parisa Kamali, Daniel Curiel, Charlotte L van Veldhuisen, Alexandra E M Bucknor, Bernard T Lee, Hinne A Rakhorst, Samuel J Lin
BACKGROUND: Although approximately 57% of breast cancer (BC) diagnoses are in older patients (>60 years), only 4.1-14% receives breast reconstruction (BR). This has been attributed to physician concerns about operative complications. This paper aims to: 1) analyze the 30-day complication rates in the older patient population undergoing immediate breast reconstruction (IBR); and 2) analyze links between complication type and category of reconstruction. METHODS: Using the ACS-NSQIP database (2005-2014), all women older than 60 years of age diagnosed with BC and DCIS were identified...
April 13, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28408077/does-timing-of-gastroschisis-repair-matter-a-comparison-using-the-acs-nsqip-pediatric-database
#7
Lori A Gurien, Melvin S Dassinger, Jeffrey M Burford, Marie E Saylors, Samuel D Smith
BACKGROUND: There is no consensus on optimal timing of gastroschisis repair. The 2012-2014 ACS NSQIP Pediatric Participant Use Data File was used to compare outcomes of primary versus staged gastroschisis repair. METHODS: Cases were divided into primary repair (0-1day) and staged repair (4-14days). Baseline characteristics and outcomes were compared for primary versus staged closure using Fisher's exact tests for categorical variables and Wilcoxon rank-sum tests for continuous variables...
February 21, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28400189/predicting-complications-following-robot-assisted-partial-nephrectomy-with-the-acs-nsqip-universal-surgical-risk-calculator
#8
Jared S Winoker, David J Paulucci, Harry Anastos, Nikhil Waingankar, Ronney Abaza, Daniel D Eun, Akshay Bhandari, Ashok K Hemal, John P Sfakianos, Ketan K Badani
PURPOSE: We evaluated the predictive value of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) surgical risk calculator in a tertiary referral cohort of patients undergoing robot-assisted partial nephrectomy (RAPN). MATERIALS AND METHODS: We queried our prospectively maintained multi-institutional database of RAPN patients and input the preoperative details of 300 randomly selected patients into the calculator. Accuracy of the calculator was assessed by receiver-operator area under the curve (AUC) and also by Brier score (BS)...
April 8, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28400087/minimally-invasive-hepatopancreatobiliary-surgery-in-north-america-an-acs-nsqip-analysis-of-predictors-of-conversion-for-laparoscopic-and-robotic-pancreatectomy-and-hepatectomy
#9
Amer H Zureikat, Jeffrey Borrebach, Henry A Pitt, Douglas Mcgill, Melissa E Hogg, Vanessa Thompson, David J Bentrem, Bruce L Hall, Herbert J Zeh
BACKGROUND: Procedural conversion rates represent an important aspect of the feasibility of minimally invasive surgical (MIS) approaches. This study aimed to outline the rates and predictors of procedural completion/conversion for MIS hepatectomy and pancreatectomy. METHODS: All 2014 ACS-NSQIP laparoscopic and robotic hepatectomy and pancreatectomy procedures were identified and grouped into pure, open assist, or unplanned conversion to open. Risk adjusted multinomial logistic regression models were generated with completion (Pure) set as the primary outcome...
April 8, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28389289/pre-operative-risk-factors-predict-protracted-hospital-length-of-stay-after-elective-endovascular-abdominal-aortic-aneurysm-repair
#10
Elizabeth G King, Alik Farber, Denis Rybin, Gheorghe Doros, Jeffrey A Kalish, Mohammad H Eslami, Jeffrey J Siracuse
INTRODUCTION: One of the main advantages of endovascular abdominal aortic aneurysm repair (EVAR) is shorter post-operative hospital length of stay (LOS) compared to open repair. However, patients with pre-existing conditions may be predisposed to a protracted LOS. Our aim was to identify pre-operative risk factors for prolonged post-operative LOS after elective EVAR. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database (2005-2013) was used to analyze all patients undergoing elective EVAR without adjunctive procedures...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28385519/complications-and-readmission-after-lumbar-spine-surgery-in-elderly-patients-an-analysis-of-2-320-patients
#11
Ahmed Saleh, Caroline Thirukumaran, Addisu Mesfin, Robert W Molinari
BACKGROUND CONTEXT: There is a paucity of literature describing risk factors for adverse outcomes after geriatric lumbar spinal surgery. As the geriatric population increases, so does the number of lumbar spinal surgeries in this cohort. PURPOSE: The purpose of the study was to determine how safe lumbar surgery is in elderly patients. Does patient selection, type of surgery, length of surgery, and other comorbidities in the elderly patient affect complication and readmission rates after surgery? STUDY DESIGN/SETTING: This is a retrospective cohort study...
April 3, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28375886/unplanned-readmissions-following-outpatient-hand-and-elbow-surgery
#12
Mohamed Noureldin, Elizabeth B Habermann, Daniel S Ubl, Sanjeev Kakar
BACKGROUND: Unplanned readmission following surgery is a quality metric that helps surgeons assess initiatives targeted at improving patient care. We utilized the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to determine the rates, causes, and predictors of unplanned 30-day readmissions after outpatient elective hand and elbow surgery. METHODS: The ACS-NSQIP database was queried using hand-and-elbow-specific Current Procedural Terminology (CPT) codes to retrospectively identify patients who had undergone outpatient hand or elbow surgery in 2012 and 2013...
April 5, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28366299/unplanned-return-to-operating-room-after-lower-extremity-endovascular-intervention-is-an-independent-predictor-for-hospital-readmission
#13
Tarik Z Ali, Erik B Lehman, Faisal Aziz
OBJECTIVE: Hospital readmissions after surgical operations are preventable and are now counted as a quality metric. Patients with peripheral arterial disease often have several serious medical comorbidities. With advancements in endovascular technology and increasing comfort level of vascular surgeons, more and more patients with peripheral arterial disease are being treated with endovascular therapy. Most of these interventions are done as same-day operations. This study retrospectively reviewed the factors associated with hospital readmission after lower extremity endovascular interventions...
March 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28360496/drivers-of-hospital-length-of-stay-in-56-000-orthopaedic-trauma-patients-the-impact-of-postoperative-cardiac-events
#14
Diana G Douleh, Mahesh Yarlagadda, Michelle S Shen, Gerard Williams, Idine Mousavi, Manish K Sethi
PURPOSE: To determine whether postoperative cardiac complications following orthopaedic trauma treatment are associated with longer lengths of stay. METHODS: This was a retrospective cohort study. We analyzed orthopaedic trauma patients in the United States for whom data was collected in the ACS-NSQIP database between the years of 2006 and 2013. The patient population included 56,217 orthopaedic trauma patients meeting any 1 of the 89 CPT codes selected in the ACS-NSQIP database...
January 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28342028/disparities-in-knee-and-hip-arthroplasty-outcomes-an-observational-analysis-of-the-acs-nsqip-clinical-registry
#15
Peter Cram, Gillian Hawker, John Matelski, Bheeshma Ravi, Andrew Pugely, Rajiv Gandhi, Timothy Jackson
BACKGROUND: Disparities in total joint arthroplasty (TJA) have largely been studied in single center studies and using administrative data. Our objective was to investigate differences in TJA outcomes in white men, black men, white women, and black women using a large international registry. METHODS: We used 2010-2013 data from the ACS-NSQIP to identify four groups of adults (white men, black men, white women, black women) who underwent primary total knee arthroplasty (TKA) or total hip arthroplasty (THA)...
March 24, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28334436/impact-of-neoadjuvant-chemoradiation-on-perioperative-outcomes-in-patients-with-rectal-cancer
#16
Brandon C Chapman, Patrick Hosokawa, William Henderson, Alessandro Paniccia, Douglas M Overbey, Wells Messersmith, Christopher Lieu, Greg V Stiegmann, Richard D Schulick, Csaba Gajdos
BACKGROUND AND OBJECTIVES: Neoadjuvant chemoradiation for rectal cancer is associated with lower local recurrence rates. The objective of this study is to assess the impact of neoadjuvant therapy on perioperative complications in patients with rectal cancer. METHODS: Using the ACS-NSQIP database (2005-2012), a propensity score was used to match 3592 patients with rectal cancer receiving neoadjuvant therapy to 3592 patients undergoing surgery alone. The association between neoadjuvant chemoradiation and perioperative outcomes was evaluated...
March 23, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28328681/predictors-of-mortality-following-emergency-general-surgery-an-american-college-of-surgeons-national-surgical-quality-improvement-program-risk-calculator
#17
Ivy N Haskins, Patrick J Maluso, Mary E Schroeder, Richard L Amdur, Khashayar Vaziri, Samir Agarwal, Babak Sarani
BACKGROUND: The complex nature of current morbidity and mortality predictor models do not lend themselves to clinical application at the bedside of patients undergoing emergency general surgery (EGS). Our aim was to develop a simplified risk calculator for prediction of early postoperative mortality following EGS. STUDY DESIGN: EGS cases other than appendectomy and cholecystectomy were identified within the American College of Surgeons National Surgery Quality Improvement Program (ACS-NSQIP) database from 2005-2014...
March 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28300677/wound-disruption-after-lower-extremity-bypass-surgery-is-a-predictor-of-subsequent-development-of-wound-infection
#18
Faisal Aziz, Tiffany Bohr, Erik B Lehman
OBJECTIVES: Despite advances in endovascular surgery, lower extremity arterial bypass (LEB) remains the gold standard treatment for severe, symptomatic Peripheral Arterial Disease (PAD). With recent changes in healthcare, there has been an increasing emphasis on reducing the hospital length of stay (LOS). The purpose of this study is to identify the postoperative complications, which occur after discharge from hospital, and to find risk factors for developing such complications. METHODS: The 2013 lower extremity revascularization -targeted American College of Surgeons (ACS-NSQIP) database and generalized 2013 general and vascular surgery ACS-NSQIP PUF were used for this study...
March 11, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28296288/effect-of-diabetes-mellitus-on-postoperative-endoscopic-sinus-surgery-outcomes
#19
Andrey Filimonov, Sei Yeon Chung, Anni Wong, Jacob S Brady, Soly Baredes, Jean Anderson Eloy
BACKGROUND: Endoscopic sinus surgery (ESS) has become the treatment of choice for a variety of nasal conditions. The purpose of this study was to analyze the effect of diabetes mellitus (DM) on postoperative outcomes in ESS. METHODS: Data on endoscopic sinus surgery performed from 2005 to 2013 were collected from the American College of Surgeons National Surgical Quality Improvement (ACS-NSQIP) database. Two groups were created, based on the presence of a DM diagnosis, and were analyzed for preoperative variables, comorbidities, and postoperative complications using SPSS statistical software...
March 10, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28290954/improving-surgical-complications-and-patient-safety-at-the-nation-s-largest-military-hospital-an-analysis-of-national-surgical-quality-improvement-program-data
#20
Steve Maturo, Charlotte Hughes, George Kallingal, Stephen Silvey, A J Johnson, Douglas Soderdahl, Evan Renz, Joseph Brennan
INTRODUCTION: The U.S. Military Health System cares for over 9 million patients and encompasses 63 hospitals and 413 clinics worldwide. Military medicine balances the simultaneous tasks of caring for those patients wounded in military engagements, treating large numbers of families of service men and women, and training the next generation of health care providers and ancillary staff. Similar to civilian health care delivery in the United States, military medicine has also seen increased scrutiny in the areas of cost and quality...
March 2017: Military Medicine
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