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National Surgical Quality Improvement Program

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https://www.readbyqxmd.com/read/28089474/what-happened-to-the-complication-the-importance-of-acs-nsqip-pediatric-in-optimizing-quality-improvement-initiatives-for-resident-education
#1
Bennett W Calder, Joseph V Sakran, Christian J Streck, Robert A Cina
OBJECTIVE: Morbidity and Mortality (M&M) conference is considered the golden hour of surgical education. Most training programs lack standardized methods to evaluate self-reported outcomes and contributions to resident education. The purpose of this study was to determine whether residents underreport pediatric postoperative complications thereby limiting a comprehensive educational opportunity and the ability to adequately perform quality improvement during M&M conference. DESIGN: A retrospective analysis of resident reports submitted to the M&M committee at an academic medical center was conducted over 1 year...
January 12, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28089186/predictors-of-same-day-discharge-in-primary-total-joint-arthroplasty-patients-and-risk-factors-for-post-discharge-complications
#2
Alex Sher, Aakash Keswani, Dong-Han Yao, Michael Anderson, Karl Koenig, Calin S Moucha
BACKGROUND: Same-day (<24 h) discharge total joint arthroplasty (TJA) may be a safe and effective option for certain patients with end-stage osteoarthritis. Given the growing pressure to improve quality and lower TJA episode costs, surgeons must identify which TJA patients can be appropriately discharged home quickly and safely. This study identifies characteristics associated with same-day discharge post-TJA as well as assesses risk factors for complications in this select patient population...
December 22, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28072654/adverse-events-following-vestibular-schwannoma-surgery-a-comparison-of-surgical-approach
#3
Anthony M Tolisano, Philip D Littlefield
OBJECTIVE: Compare complications of vestibular schwannoma (VS) resection by surgical approach. STUDY DESIGN: Retrospective cohort. SETTING: The 2008 to 2013 American College of Surgeons-National Surgical Quality Improvement Program. PATIENTS: Adult patients with VS resection by an otolaryngologist. INTERVENTIONS: VS resection via transtemporal (TT), retrosigmoid (RS), or middle cranial fossa (MCF) approaches...
January 9, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28067747/readmission-and-reoperation-after-surgery-for-pelvic-organ-prolapse
#4
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/28067697/national-administrative-databases-in-adult-spinal-deformity-surgery-a-cautionary-tale
#5
Aaron J Buckland, Gregory Poorman, Robert Freitag, Cyrus Jalai, Eric O Klineberg, Michael Kelly, Peter G Passias
STUDY DESIGN: Comparison between national administrative databases and a prospective multicenter physician managed database. OBJECTIVES: This study aims to assess the applicability of National Administrative Databases (NADs) in Adult Spinal Deformity (ASD). Our hypothesis is that NADs do not include comparable patients as in a physician-managed database (PMD) for surgical outcomes in adult spinal deformity. SUMMARY OF BACKGROUND DATA: NADs such as National Inpatient Sample (NIS) and National Surgical Quality Improvement Program (NSQIP) provide large numbers of publications owing to ease of data access and lack of IRB approval requirement...
January 6, 2017: Spine
https://www.readbyqxmd.com/read/28065622/is-outpatient-total-hip-arthroplasty-safe
#6
Stephen J Nelson, Matthew L Webb, Adam M Lukasiewicz, Arya G Varthi, Andre M Samuel, Jonathan N Grauer
BACKGROUND: Safety data for outpatient total hip arthroplasty (THA) remains scarce. METHODS: The present study retrospectively reviews prospectively collected data from the 2005-2014 American College of Surgeons National Surgical Quality Improvement Program Database. Patients who underwent THA were categorized by day of hospital discharge to be outpatient (length of stay [LOS] 0 days) or inpatient (LOS 1-5 days). Those with extended LOS beyond 5 days were excluded...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28059917/characterization-of-readmission-by-day-of-rehospitalization-after-colorectal-surgery
#7
Ahmed M Al-Mazrou, Kunal Suradkar, Christine M Mauro, Ravi P Kiran
BACKGROUND: Factors associated with readmission stratified by the day of postdischarge rehospitalization after colorectal surgery have not been characterized previously. OBJECTIVE: The purpose of this study was to identify factors leading to readmission on a day-to-day basis after discharge from colorectal surgery. DESIGN: This was a retrospective analysis of patients readmitted within 30-days after colorectal surgery. Reasons and factors associated with readmission each day after discharge were evaluated...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28059916/does-hospital-transfer-impact-outcomes-after-colorectal-surgery
#8
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
#9
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/28058551/modified-frailty-index-predicts-morbidity-and-mortality-after-pancreaticoduodenectomy
#10
Harveshp Mogal, Sarah A Vermilion, Rebecca Dodson, Fang-Chi Hsu, Russell Howerton, Perry Shen, Clancy J Clark
BACKGROUND: Pancreatic cancer is a disease of older adults, who may present with limited physiologic reserve. The authors hypothesized that a frailty index can predict postoperative outcomes after pancreaticoduodenectomy (PD). METHODS: All patients who underwent PD were identified in the 2005-2012 NSQIP Participant Use File. Patients undergoing emergency procedures, those with an American Society of Anesthesiologists (ASA) classification of five, and those with a diagnosis of preoperative sepsis were excluded from the study...
January 5, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28057294/an-institutional-analysis-of-unplanned-return-to-the-operating-room-to-identify-areas-for-quality-improvement
#11
Yihan Lin, Robert A Meguid, Patrick W Hosokawa, William G Henderson, Karl E Hammermeister, Richard D Schulick, Ryan C Shelstad, Trevor T Wild, Robert C McIntyre
BACKGROUND: Unplanned return to the operating room (uROR) has been suggested as a hospital quality indicator. The purpose of this study was to determine reasons for uROR to identify opportunities for patient care improvement. METHODS: uROR reported by our institution's American College of Surgeons National Surgical Quality Improvement Program underwent secondary review. RESULTS: The uROR rate reported by clinical reviewers was 4.3%. Secondary review re-categorized 64...
December 13, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28054326/what-is-the-timing-of-general-health-adverse-events-that-occur-after-total-joint-arthroplasty
#12
Daniel D Bohl, Nathaniel T Ondeck, Bryce A Basques, Brett R Levine, Jonathan N Grauer
BACKGROUND: Despite extensive research regarding risk factors for adverse events after total joint arthroplasty (TJA), there are few publications describing the timing at which such adverse events occur. QUESTIONS/PURPOSES: (1) On which postoperative day do certain adverse events occur? (2) What adverse events occur earlier after TKA than after THA? (3) For each adverse event, what proportion occurred after hospital discharge? METHODS: We screened the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) to identify all patients undergoing primary THA and primary TKA between 2005 and 2013, resulting in a study population of 124,657 patients evaluated as part of this retrospective database analysis...
January 4, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28041949/comparison-of-early-adverse-events-after-operative-treatment-of-bimalleolar-and-trimalleolar-fractures-versus-pilon-fractures
#13
Karim Z Masrouha, Hani Tamim, Assad Taha, Abdel Majid Sheikh Taha, Racha Abi-Melhem, Muhyeddine Al-Taki
Ankle fractures requiring open reduction and internal fixation vary in severity from unimalleolar fractures to bimalleolar/trimalleolar (BT) fractures to pilon fractures. Consequently, the postoperative outcomes with these surgeries can vary. Most previous studies of these injuries had small sample sizes, studied a single risk factor or adverse event, or did not compare different injuries by severity. The purpose of the present study was to describe and compare the patient characteristics and postoperative outcomes of 2 high-energy ankle fractures: BT and pilon fractures...
December 29, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28040399/operative-time-affects-short-term-complications-in-total-joint-arthroplasty
#14
Kyle R Duchman, Andrew J Pugely, Christopher T Martin, Yubo Gao, Nicholas A Bedard, John J Callaghan
BACKGROUND: Increased operative time has been associated with increased complications after total joint arthroplasty (TJA). The purpose of the present study was to investigate the effect of operative time on short-term complications after TJA while also identifying patient and operative factors associated with prolonged operative times. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2011-2013 to identify all patients who underwent primary total hip or knee arthroplasty...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28040258/hypoalbuminaemia-a-marker-of-malnutrition-and-predictor-of-postoperative-complications-and-mortality-after-hip-fractures
#15
Sultan Aldebeyan, Anas Nooh, Ahmed Aoude, Michael H Weber, Edward J Harvey
OBJECTIVE: Our aim was to determine the effect of hypoalbuminaemia as a marker of malnutrition on the 30-day postoperative complication rate and mortality in patients receiving surgical treatment for hip fractures using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. METHODS: We analyzed all patients admitted with hip fractures receiving surgical treatment from 2011 to 2013. Patients were dichotomized based on their albumin levels; hypoalbuminaemia (albumin <3...
December 23, 2016: Injury
https://www.readbyqxmd.com/read/28038967/pancreatoduodenectomy-with-venous-or-arterial-resection-a-nsqip-propensity-score-analysis
#16
Joal D Beane, Michael G House, Susan C Pitt, Ben Zarzaur, E Molly Kilbane, Bruce L Hall, Taylor S Riall, Henry A Pitt
INTRODUCTION: Vascular resection during pancreatoduodenectomy (PD) is being performed more frequently. Our aim was to analyze the outcomes of PD with and without vascular resection in a large, multicenter cohort. METHODS: Patient data were gathered from 43 institutions as part of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) Pancreatectomy Demonstration Project. Over a 14-month period, 1414 patients underwent PD without (82...
December 27, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28034608/risk-factors-for-urinary-tract-infection-following-midurethral-sling-surgery
#17
H R Vigil, R Mallick, V W Nitti, L T Lavallée, R H Breau, D R Hickling
PURPOSE: Midurethral sling surgery is common. Post-operative urinary tract infection rates vary in the literature and independent risk factors for urinary tract infection are not well defined. We sought to determine the incidence of and risk factors for urinary tract infection following midurethral sling surgery. MATERIAL AND METHODS: A retrospective cohort of females who underwent sling surgery was captured from the National Surgical Quality Improvement Program (NSQIP) database 2006-2014...
December 27, 2016: Journal of Urology
https://www.readbyqxmd.com/read/28034584/percutaneous-endovascular-aneurysm-repair-in-morbidly-obese-patients
#18
Jason A Chin, Laura Skrip, Bauer E Sumpio, Jonathan A Cardella, Jeffrey E Indes, Timur P Sarac, Alan Dardik, Cassius I Ochoa Chaar
OBJECTIVE: Endovascular aneurysm repair (EVAR) with percutaneous femoral access (PEVAR) has several potential advantages. Morbidly obese (MO) patients present unique anatomical challenges and have not been specifically studied. This study examines the trends in the use of PEVAR and its surgical outcomes compared with open femoral cutdown (CEVAR) in MO patients. METHODS: The American College of Surgeons National Surgical Quality Improvement Program files for the years 2005 to 2013 were reviewed...
December 26, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28034481/complications-following-outpatient-total-joint-arthroplasty-an-analysis-of-a-national-database
#19
P Maxwell Courtney, Anthony J Boniello, Richard A Berger
BACKGROUND: As outpatient total hip (THA) and knee arthroplasties (TKA) increase in popularity, concerns exist about the safety of discharging patients home the same day. The purpose of this study is to determine the complications associated with outpatient total joint arthroplasty (TJA) and to identify high-risk patients who should be excluded from these protocols. METHODS: We queried the American College of Surgeons-National Surgical Quality Improvement Program database for all patients who underwent primary TKA or THA from 2011 to 2014...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28034412/does-adoption-of-electronic-health-records-improve-organizational-performances-of-hospital-surgical-units-results-from-the-french-e-si-preps-sips-study
#20
Morgane Plantier, Nathalie Havet, Thierry Durand, Nicolas Caquot, Camille Amaz, Irène Philip, Pierre Biron, Lionel Perrier
BACKGROUND: Electronic health records (EHR) are increasingly being adopted by healthcare systems worldwide. In France, the "Hôpital numérique 2012-2017" program was implemented as part of a strategic plan to modernize health information technology (HIT), including promotion of widespread EHR use. With significant upfront investment costs as well as ongoing operational expenses, it is important to assess this system in terms of its ability to result in improvements in hospital performances...
February 2017: International Journal of Medical Informatics
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