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https://www.readbyqxmd.com/read/29135700/safety-outcomes-following-spine-and-cranial-neurosurgery-evidence-from-the-national-surgical-quality-improvement-program
#1
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/29106849/the-association-of-hypoalbuminemia-with-early-perioperative-outcomes-a-comprehensive-assessment-across-16-major-procedures
#2
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
#3
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
#4
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/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
#5
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
#6
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/29071496/a-matched-comparison-of-laparoscopic-versus-open-inguinal-hernia-repair-in-patients-with-liver-disease-using-propensity-score-matching
#7
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
https://www.readbyqxmd.com/read/29069040/predictive-validity-of-the-acs-nsqip-surgical-risk-calculator-in-geriatric-patients-undergoing-lumbar-surgery
#8
Xiao Wang, Yanting Hu, Binjiang Zhao, Yue Su
The risk calculator of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) has been shown to be useful in predicting postoperative complications. In this study, we aimed to evaluate the predictive value of the ACS-NSQIP calculator in geriatric patients undergoing lumbar surgery.A total of 242 geriatric patients who underwent lumbar surgery between January 2014 and December 2016 were included. Preoperative clinical information was retrospectively reviewed and entered into the ACS-NSQIP calculator...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29068873/expanding-the-scope-of-quality-measurement-in-surgery-to-include-nonoperative-care-results-from-the-american-college-of-surgeons-national-surgical-quality-improvement-program-emergency-general-surgery-pilot
#9
Michael W Wandling, Clifford Y Ko, Paul E Bankey, Chris Cribari, H Gill Cryer, Jose J Diaz, Therese M Duane, S Morad Hameed, Matthew M Hutter, Michael H Metzler, Justin L Regner, Patrick M Reilly, H David Reines, Jason L Sperry, Kristan L Staudenmayer, Garth H Utter, Marie L Crandall, Karl Y Bilimoria, Avery B Nathens
BACKGROUND: Patients managed nonoperatively have been excluded from risk-adjusted benchmarking programs, including the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP). Consequently, optimal performance evaluation is not possible for specialties like emergency general surgery (EGS) where nonoperative management is common. We developed a multi-institutional EGS clinical data registry within ACS NSQIP that includes patients managed nonoperatively to evaluate variability in nonoperative care across hospitals and identify gaps in performance assessment that occur when only operative cases are considered...
November 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29064902/the-role-of-bowel-preparation-in-colorectal-surgery-results-of-the-2012-2015-acs-nsqip-data
#10
Aaron L Klinger, Heather Green, Dominique J Monlezun, David Beck, Brian Kann, Herschel D Vargas, Charles Whitlow, David Margolin
OBJECTIVE: To analyze potential benefits with regards to infectious complications with combined use of mechanical bowel preparation (MBP) and ABP in elective colorectal resections. BACKGROUND: Despite recent literature suggesting that MBP does not reduce infection rate, it still is commonly used. The use of oral antibiotic bowel preparation (ABP) has been practiced for decades but its use is also controversial. METHODS: Patients undergoing elective colorectal resection in the 2012 to 2015 American College of Surgeons National Surgical Quality Improvement Program cohorts were selected...
October 23, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29064899/variation-in-drain-management-after-pancreatoduodenectomy-early-versus-delayed-removal
#11
Joal D Beane, Michael G House, Eugene P Ceppa, Scott C Dolejs, Henry A Pitt
OBJECTIVE: The objectives are to report practice patterns and management of operatively placed drains and to compare outcomes in patients with early versus delayed drain removal after pancreatoduodenectomy. BACKGROUND: Early drain removal after pancreatoduodenectomy, when guided by postoperative day (POD) 1 drain fluid amylase (DFA-1), is associated with reduced rates of clinically relevant postoperative pancreatic fistula (CR-POPF). However, whether surgeons have altered their management based on this strategy is unknown...
October 23, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29061269/comparison-of-percutaneous-versus-open-femoral-cutdown-access-for-endovascular-repair-of-ruptured-abdominal-aortic-aneurysms
#12
COMPARATIVE STUDY
Samuel L Chen, Nii-Kabu Kabutey, Matthew D Whealon, Isabella J Kuo, Roy M Fujitani
OBJECTIVE: Ruptured endovascular aortic aneurysm repair (REVAR) is being increasingly used to treat ruptured abdominal aortic aneurysms (rAAAs). However, the comparison between totally percutaneous (pREVAR) vs femoral cutdown (cREVAR) access for REVAR has not been studied. We used a national surgical database to evaluate the 30-day outcomes in patients undergoing pREVAR vs cREVAR. METHODS: Patients who underwent EVAR for rAAA between 2011 and 2014, inclusively, were studied in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) targeted vascular database...
November 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29055738/the-utility-of-preoperative-labs-in-predicting-postoperative-complications-following-posterolateral-lumbar-fusion
#13
Nikita Lakomkin, Vadim Goz, Joseph S Cheng, Darrel S Brodke, William Ryan Spiker
BACKGROUND CONTEXT: Several studies have suggested that lab results have minimal impact on clinical decision-making in surgery. Despite the widespread use of preoperative testing in spine surgery and the large volume of posterolateral lumbar fusions (PLFs) being performed each year, no study has assessed the ability of preoperative labs to predict adverse events following PLF. PURPOSE: The purpose of this study was to explore the relationship between commonly obtained preoperative lab results and postoperative complications following 1-2 level PLF...
October 18, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29054389/optimizing-surgical-quality-datasets-to-care-for-older-adults-lessons-from-the-american-college-of-surgeons-nsqip-geriatric-surgery-pilot
#14
Julia R Berian, Lynn Zhou, Melissa A Hornor, Marcia M Russell, Mark E Cohen, Emily Finlayson, Clifford Y Ko, Thomas N Robinson, Ronnie A Rosenthal
BACKGROUND: Surgical quality datasets can be better tailored toward older adults. The American College of Surgeons (ACS) NSQIP Geriatric Surgery Pilot collected risk factors and outcomes in 4 geriatric-specific domains: cognition, decision-making, function, and mobility. This study evaluated the contributions of geriatric-specific factors to risk adjustment in modeling 30-day outcomes and geriatric-specific outcomes (postoperative delirium, new mobility aid use, functional decline, and pressure ulcers)...
September 28, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29050896/intraoperative-pedicle-screw-navigation-does-not-significantly-affect-complication-rates-after-spine-surgery
#15
Scott C Wagner, Patrick B Morrissey, Ian D Kaye, Arjun Sebastian, Joseph S Butler, Christopher K Kepler
Various forms of intraoperative computer-assisted navigation technologies exist, and have consistently been shown to improve pedicle screw accuracy. However, the overall clinical effects of inaccurate pedicle screw placement have been debated. We examined the clinical effects of improved pedicle screw accuracy with computer navigation technology in reducing complication rates in patients undergoing multi-level spinal fusion. We retrospectively reviewed the ACS-NSQIP registry utilizing Current Procedural Terminology (CPT) codes 22843 + 22844 to identify patients undergoing spinal instrumentation of greater than 7 levels, as well as the CPT code 61783 to denote the use of intraoperative computer-assisted navigation...
October 16, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29045025/do-pre-operative-oral-antibiotics-increase-clostridium-difficile-infection-rates-an-analysis-of-13-959-colectomy-patients
#16
Muralidharan Parthasarathy, David Bowers, Thomas Groot-Wassink
AIM: The aim of this study was to determine whether or not preoperative oral antibiotic preparation (POAP) increases the rate of Clostridium difficile colitis (CDC) in patients undergoing colectomy. METHOD: In 2015, data for colectomies had been collected prospectively and recorded in the targeted colectomy option of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). This was available for retrospective analysis. Data available for analysis included elective and emergency status, POAP, surgical approach, primary anastomosis and CDC status...
October 16, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29042076/perioperative-outcomes-after-reoperative-carotid-endarterectomy-are-worse-than-expected
#17
Brianna M Krafcik, Thomas W Cheng, Alik Farber, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
OBJECTIVE: Reoperative carotid endarterectomy (CEA) can be technically challenging because of significant scarring as a consequence of the initial CEA procedure. There are limited data that describe outcomes after reoperative CEA, and as such, our goal was to determine the effect of reoperative CEA on perioperative outcomes. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database was queried for patients undergoing index and reoperative CEA between 2005 and 2014...
October 14, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29038044/readmission-rates-following-same-day-discharge-compared-to-postoperative-day-one-discharge-after-benign-laparoscopic-hysterectomy
#18
David Sheyn, Sherif El-Nashar, Megan Billow, Sangeeta Mahajan, Mary Duarte, Robert Pollard
STUDY OBJECTIVE: To determine if there is a difference in readmission rates after same day discharge compared to postoperative day one (POD#1) discharges following laparoscopic hysterectomy. DESIGN: Retrospective cohort study with 1:2 propensity score matching (Canadian Task Force Classification II-2). SETTING: American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. PATIENTS: Women undergoing benign laparoscopic total or supra-cervical hysterectomy or laparoscopic assisted vaginal hysterectomy with or without adnexal surgery, between the years 2010 to 2015...
October 13, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29033195/national-surgical-quality-improvement-program-surgical-risk-calculator-poorly-predicts-complications-in-patients-undergoing-radical-cystectomy-with-urinary-diversion
#19
Shay Golan, Melanie A Adamsky, Scott C Johnson, Nimrod S Barashi, Zachary L Smith, Maria V Rodriguez, Chuanhong Liao, Norm D Smith, Gary D Steinberg, Arieh L Shalhav
PURPOSE: To evaluate the accuracy of the American College of Surgeons National Surgical Quality Improvement Programs (ACS-NSQIP) surgical risk calculator in patients undergoing radical cystectomy (RC) with urinary diversion. MATERIALS AND METHODS: Preoperative characteristics of patients who underwent RC with ileal conduit or orthotropic neobladder (ONB) between 2007 and 2016 were entered into the proprietary online ACS-NSQIP calculator to generate 30-day predicted risk profiles...
October 12, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/29028760/the-impact-of-metastatic-spinal-tumor-location-on-30-day-perioperative-mortality-and-morbidity-after-surgical-decompression
#20
Awais K Hussain, Khushdeep S Vig, Zoe B Cheung, Kevin Phan, Mauricio C Lima, Jun S Kim, Deepak A Kaji, Varun Arvind, Samuel Kang-Wook Cho
STUDY DESIGN: A retrospective cohort study from 2011 to 2014 was performed using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. OBJECTIVE: The purpose of this study was to assess the impact of tumor location in the cervical, thoracic, or lumbosacral spine on 30-day perioperative mortality and morbidity after surgical decompression of metastatic extradural spinal tumors. SUMMARY OF BACKGROUND DATA: Operative treatment of metastatic spinal tumors involves extensive procedures that are associated with significant complication rates and healthcare costs...
October 12, 2017: Spine
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