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https://www.readbyqxmd.com/read/28100157/characterization-of-planned-and-unplanned-30-day-readmissions-following-vascular-surgical-procedures
#1
Georges Tahhan, Alik Farber, Nishant K Shah, Brianna M Krafcik, Teviah E Sachs, Jeffrey A Kalish, Matthew R Peacock, Jeffrey J Siracuse
OBJECTIVE: Thirty-day readmission is increasingly used as a quality of care indicator. Patients undergoing vascular surgery have historically been at high risk for readmission. We analyzed hospital readmission details to identify patients at high risk for readmission in order to better understand these readmissions and improve resource utilization in this patient population. METHODS: A retrospective review and analysis of our medical center's admission and discharge data were conducted from October 2012 to March 2015...
January 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28088597/phase-ii-randomized-trial-of-negative-pressure-wound-therapy-to-decrease-surgical-site-infection-in-patients-undergoing-laparotomy-for-gastrointestinal-pancreatic-and-peritoneal-surface-malignancies
#2
Perry Shen, Aaron Blackham, Stacey Lewis, Clancy Clark, Russell Howerton, Harveshp Mogal, Rebecca Dodson, Gregory B Russell, Edward A Levine
BACKGROUND: Surgical site infections (SSI) remain a major source of morbidity and cost after resection of intra-abdominal malignancies. Negative pressure wound therapy (NPWT) has been reported to significantly reduce SSI when applied to the closed laparotomy incision. This paper reports results of a randomized clinical trial examining the effect of NPWT on SSI rates in surgical oncology patients with increased risk for infectious complications. STUDY DESIGN: From 2012-2016, 265 patients underwent open resection of intra-abdominal neoplasms stratified into three groups: gastrointestinal (n=57), pancreas (n=73), and peritoneal surface malignancy (n=135)...
January 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28086864/direct-detection-of-falciparum-and-non-falciparum-malaria-dna-from-a-drop-of-blood-with-high-sensitivity-by-the-dried-lamp-system
#3
Kyoko Hayashida, Kiichi Kajino, Humphrey Simukoko, Martin Simuunza, Joseph Ndebe, Amos Chota, Boniface Namangala, Chihiro Sugimoto
BACKGROUND: Because of the low sensitivity of conventional rapid diagnostic tests (RDTs) for malaria infections, the actual prevalence of the diseases, especially those caused by non-Plasmodium falciparum (non-Pf) species, in asymptomatic populations remain less defined in countries lacking in well-equipped facilities for accurate diagnoses. Our direct blood dry LAMP system (CZC-LAMP) was applied to the diagnosis of malaria as simple, rapid and highly sensitive method as an alternative for conventional RDTs in malaria endemic areas where laboratory resources are limited...
January 13, 2017: Parasites & Vectors
https://www.readbyqxmd.com/read/28069525/utilization-of-the-nsqip-pediatric-database-in-development-and-validation-of-a-new-predictive-model-of-pediatric-postoperative-wound-complications
#4
Ilan I Maizlin, David T Redden, Elizabeth A Beierle, Mike K Chen, Robert T Russell
BACKGROUND: Surgical wound classification, introduced in 1964, stratifies the risk of surgical site infection (SSI) based on a clinical estimate of the inoculum of bacteria encountered during the procedure. Recent literature has questioned the accuracy of predicting SSI risk based on wound classification. We hypothesized that a more specific model founded on specific patient and perioperative factors would more accurately predict the risk of SSI. STUDY DESIGN: Using all observations from the 2012 to 2014 pediatric National Quality Surgical Improvement-Pediatric (NSQIP-P) Participant Use File, patients were randomized into model creation and model verification datasets...
January 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28069031/diagnostic-accuracy-of-the-postoperative-ratio-of-c-reactive-protein-to-albumin-for-complications-after-colorectal-surgery
#5
Xiaolong Ge, Yu Cao, Hongkan Wang, Chao Ding, Hongliang Tian, Xueying Zhang, Jianfeng Gong, Weiming Zhu, Ning Li
BACKGROUND: The ratio of C-reactive protein to albumin, as a novel inflammation-based prognostic score, is associated with outcomes in cancer and septic patients. The diagnostic accuracy of the CRP/albumin ratio has not been assessed in colorectal surgery for postoperative complications. METHODS: A total of 359 patients undergoing major colorectal surgery between 2012 and 2015 were eligible for this study. Uni- and multivariate analyses were performed to identify risk factors for postoperative complications...
January 10, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28067937/incidence-of-surgical-site-infections-in-children-active-surveillance-in-an-italian-academic-children-s-hospital
#6
M L Ciofi Degli Atti, L Serino, S Piga, A E Tozzi, M Raponi
BACKGROUND: Surgical Site Infections (SSIs) account for 16-34% of all health-care associated infections. This study aimed to assess the incidence rate of SSIs in children who underwent surgical procedures in an academic children's hospital in Italy. STUDY DESIGN: Prospective cohort study. METHODS: We actively followed-up 0-17 year old children at 30 days of surgical procedures without implants conducted during one index week per quarter, from the second quarter of 2014, to the first quarter of 2016 (8 index weeks in total)...
January 2017: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/28067749/association-between-obesity-and-perioperative-morbidity-in-open-versus-laparoscopic-sacrocolpopexy
#7
Gabriela E Halder, Jason L Salemi, Stuart Hart, Emad Mikhail
OBJECTIVES: The aim of this study was to compare differences in 30-day perioperative morbidity and mortality for women undergoing open sacrocolpopexy (OSCP) versus laparoscopic sacrocolpopexy (LSCP) across all body mass index (BMI) groups and between patients of ideal versus elevated BMI (includes overweight, obese, and morbidly obese). MATERIALS AND METHODS: Data for this retrospective review were obtained from the American College of Surgeons-National Surgical Quality Improvement Project database using current procedural terminology...
January 6, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28067747/readmission-and-reoperation-after-surgery-for-pelvic-organ-prolapse
#8
Erik D Hokenstad, Amy E Glasgow, Elizabeth B Habermann, John A Occhino
OBJECTIVES: We aimed to determine the rates of readmission and reoperation for patients undergoing surgery for pelvic organ prolapse (POP). METHODS: The American College of Surgeons National Surgical Quality Improvement Program Participant User File was used to select all surgeries performed for POP from 2012 through 2014. The cohort was then reviewed for unplanned readmissions and unplanned reoperations within 30 days of POP surgery. Patient and procedural factors associated with readmission or reoperation were compared using χ analyses and Student t test...
January 6, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28066911/outcomes-of-microvascular-free-tissue-transfer-in-twice-irradiated-patients
#9
Kate Clancy, Sami Melki, Musaddiq Awan, Shawn Li, Pierre Lavertu, Nicole Fowler, Min Yao, Rod Rezaee, Chad A Zender
BACKGROUND: Patients may require microvascular free tissue transfer (MFTT) following re-irradiation for recurrent cancer or radiation complications. The objective of this study was to describe the indications for and outcomes of free flaps performed in twice-radiated patients. METHODS: A retrospective chart review identified the indications for and outcomes of 36 free flaps performed on 29 twice-irradiated patients. RESULTS: The free flap success rate was 92%...
January 9, 2017: Microsurgery
https://www.readbyqxmd.com/read/28065868/clinical-impact-of-positive-propionibacterium-acnes-cultures-in-orthopedic-surgery
#10
Valery Lavergne, Michel Malo, Cinzia Gaudelli, Michelle Laprade, Stéphane Leduc, Pierre Laflamme, Dominique M Rouleau
BACKGROUND: The clinical significance of a positive culture to Propionibacterium acnes in orthopedic specimens remains unclear, whether about its role as a contaminant or a pathogen, or its impact as a coinfectant. Therefore we performed a retrospective study to provide a more accurate description of the clinical impact of P.acnes in an orthopedic population aiming to determine: 1) if there is a clinical difference between P.acnes infection and contamination? 2) if there is a clinical difference between P...
January 5, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28061321/effect-of-subcutaneous-sterile-vitamin-e-ointment-on-incisional-surgical-site-infection-after-elective-laparoscopic-colorectal-cancer-surgery
#11
David Alias, Jaime Ruiz-Tovar, Ana Moreno, Belen Manso, Gustavo Diaz, Manuel Duran, Damian Garcia-Olmo
BACKGROUND: Despite several interventions having been adopted to reduce the incidence of incisional surgical site infection (SSI), it still remains a challenge for surgeons, because incisional SSI is a common cause of health-care-associated infection, leading to increased morbidity, prolonged hospital stay, patient discomfort, and increased sanitary costs. The aim of this study was to evaluate the effect on incisional SSI of vitamin E ointment in the subcutaneous tissue of patients undergoing a laparoscopic colorectal surgical procedure...
January 6, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28060226/barriers-to-care-and-1-year-mortality-among-newly-diagnosed-hiv-infected-people-in-durban-south-africa
#12
Ingrid V Bassett, Sharon M Coleman, Janet Giddy, MFamMed, Laura M Bogart, Christine E Chaisson, Douglas Ross, Moses J E Flash, Tessa Govender, Rochelle P Walensky, Kenneth A Freedberg, Elena Losina
BACKGROUND: Prompt entry into HIV care is often hindered by personal and structural barriers. Our objective was to evaluate the impact of self-perceived barriers to healthcare on 1-year mortality among newly diagnosed HIV-infected individuals in Durban, South Africa. METHODS: Prior to HIV testing at four outpatient sites, adults (≥18y) were surveyed regarding perceived barriers to care including: 1) service delivery; 2) financial; 3) personal health perception; 4) logistical; and 5) structural...
December 30, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28059961/use-of-quantile-regression-to-determine-the-impact-on-total-health-care-costs-of-surgical-site-infections-following-common-ambulatory-procedures
#13
Margaret A Olsen, Fang Tian, Anna E Wallace, Katelin B Nickel, David K Warren, Victoria J Fraser, Nandini Selvam, Barton H Hamilton
OBJECTIVE: To determine the impact of surgical site infections (SSIs) on health care costs following common ambulatory surgical procedures throughout the cost distribution. BACKGROUND: Data on costs of SSIs following ambulatory surgery are sparse, particularly variation beyond just mean costs. METHODS: We performed a retrospective cohort study of persons undergoing cholecystectomy, breast-conserving surgery, anterior cruciate ligament reconstruction, and hernia repair from December 31, 2004 to December 31, 2010 using commercial insurer claims data...
February 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28059918/quality-improvement-initiatives-in-colorectal-surgery-value-of-physician-feedback
#14
Joshua A Waters, Todd Francone, Peter W Marcello, Patricia L Roberts, David J Schoetz, Thomas E Read, Caitlin Stafford, Rocco Ricciardi
BACKGROUND: The impact of process improvement through surgeon feedback on outcomes is unclear. OBJECTIVE: We sought to evaluate the effect of biannual surgeon-specific feedback on outcomes and adherence to departmental and Surgical Care Improvement Project process measures on colorectal surgery outcomes. DESIGN: This was a retrospective analysis of prospectively collected 100% capture surgical quality improvement data. SETTING: This study was conducted at the department of colorectal surgery at a tertiary care teaching hospital from January 2008 through December 2013...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28059916/does-hospital-transfer-impact-outcomes-after-colorectal-surgery
#15
Christopher J Chow, Wolfgang B Gaertner, Christine C Jensen, Bradford Sklow, Robert D Madoff, Mary R Kwaan
BACKGROUND: With increasing public reporting of outcomes and bundled payments, hospitals and providers are scrutinized for morbidity and mortality. The impact of patient transfer before colorectal surgery has not been well characterized in a risk-adjusted fashion. OBJECTIVE: We hypothesized that hospital-to-hospital transfer would independently predict morbidity and mortality beyond traditional predictor variables. DESIGN: We constructed a retrospective cohort of 158,446 patients who underwent colorectal surgery using the 2009-2013 American College of Surgeons National Surgical Quality Improvement Program database...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28059679/perioperative-outcomes-for-pediatric-neurosurgical-procedures-analysis-of-the-national-surgical-quality-improvement-program-pediatrics
#16
Benjamin J Kuo, Joao Ricardo N Vissoci, Joseph R Egger, Emily R Smith, Gerald A Grant, Michael M Haglund, Henry E Rice
OBJECTIVE Existing studies have shown a high overall rate of adverse events (AEs) following pediatric neurosurgical procedures. However, little is known regarding the morbidity of specific procedures or the association with risk factors to help guide quality improvement (QI) initiatives. The goal of this study was to describe the 30-day mortality and AE rates for pediatric neurosurgical procedures by using the American College of Surgeons (ACS) National Surgical Quality Improvement Program-Pediatrics (NSQIP-Peds) database platform...
January 6, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28058471/a-comparative-study-of-outcomes-between-single-site-robotic-and-multi-port-laparoscopic-cholecystectomy-an-experience-from-a-tertiary-care-center
#17
Banujan Balachandran, Theadore A Hufford, Taha Mustafa, Kunal Kochar, Suela Sulo, Joubin Khorsand
BACKGROUND: The aim of this study was to compare the outcomes of single-site robotic cholecystectomy with multi-port laparoscopic cholecystectomy within a high-volume tertiary health care center. METHODS: A retrospective analysis of prospectively maintained data was conducted on patients undergoing single-site robotic cholecystectomy or multi-port laparoscopic cholecystectomy between October 2011 and July 2014. A single surgeon performed all the surgeries included in the study...
January 5, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28057476/operative-treatment-of-early-infection-after-internal-fixation-of-limb-fractures-exclusive-of-severe-open-fractures
#18
REVIEW
P Bonnevialle
Early infection after open reduction and internal fixation (ORIF) of a limb bone is defined as bacteriologically documented, deep and/or superficial surgical-site infection (SSI) diagnosed within 6months after the surgical procedure. This interval is arbitrarily considered sufficient to obtain fracture healing. The treatment of early infection after ORIF should be decided by a multidisciplinary team. The principles are the same as for revision arthroplasty. Superficial SSIs should be differentiated from deep SSIs, based on the results of bacteriological specimens collected using flawless technique...
January 2, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28057022/long-term-follow-up-on-recovery-return-to-use-and-sporting-activity-a-retrospective-study-of-236-operated-colic-horses-in-finland-2006-2012
#19
Isa Anna Maria Immonen, Ninja Karikoski, Anna Mykkänen, Tytti Niemelä, Jouni Junnila, Riitta-Mari Tulamo
BACKGROUND: Surgical treatment of colic is expensive and complications may occur. Information on the prognosis and the use of the horse after surgery for colic is important for surgeons and owners. Current literature on return to athletic function after celiotomy is limited. The present study reviewed surgical cases of the Veterinary Teaching Hospital, Helsinki, Finland for 2006-2012. The aim was to follow the population of horses of different breeds for surgical findings, postsurgical complications, long-term recovery and prognosis...
January 5, 2017: Acta Veterinaria Scandinavica
https://www.readbyqxmd.com/read/28054168/minimally-invasive-surgery-for-complicated-diverticulitis
#20
Najjia N Mahmoud, Elijah W Riddle
Recent guidelines recommend an individualized approach to recurrent uncomplicated diverticulitis, reflecting research showing that non-operative treatment is safe. Thus, the majority of operations for diverticulitis in the future may be for complicated indications. A laparoscopic approach may be used for both acute and chronic complicated diverticulitis in appropriate patients, as described in the American and European guidelines. However, a safe approach to minimally invasive surgery requires recognition when conditions deteriorate or are not suited to laparoscopy as well as knowledge of a variety of technical maneuvers that elucidate difficult anatomy and facilitate resection...
January 4, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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