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National Surgical Quality Improvement Program

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https://www.readbyqxmd.com/read/27896677/results-of-database-studies-in-spine-surgery-can-be-influenced-by-missing-data
#1
Bryce A Basques, Ryan P McLynn, Michael P Fice, Andre M Samuel, Adam M Lukasiewicz, Daniel D Bohl, Junyoung Ahn, Kern Singh, Jonathan N Grauer
BACKGROUND: National databases are increasingly being used for research in spine surgery; however, one limitation of such databases that has received sparse mention is the frequency of missing data. Studies using these databases often do not emphasize the percentage of missing data for each variable used and do not specify how patients with missing data are incorporated into analyses. This study uses the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to examine whether different treatments of missing data can influence the results of spine studies...
November 28, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27896654/bowel-preparation-is-associated-with-reduced-morbidity-in-elderly-patients-undergoing-elective-colectomy
#2
Scott C Dolejs, Michael J Guzman, Alyssa D Fajardo, Bruce W Robb, Bryan K Holcomb, Ben L Zarzaur, Joshua A Waters
BACKGROUND: Bowel preparation in elderly patients is associated with physiologic derangements that may result in postoperative complications. The aim of this study is to determine the impact of bowel preparation on postoperative outcomes in elderly patients. METHODS: Patients age 75 years and older who underwent elective colectomy were identified from the 2012-2014 American College of National Surgical Quality Improvement Program (ACS-NSQIP database). Patients were grouped into no bowel preparation, mechanical bowel preparation (MBP), oral antibiotic preparation (OABP), or combined MBP + OABP...
November 28, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27896407/mixed-methods-assessment-of-trauma-and-acute-care-surgical-quality-improvement-programs-in-peru
#3
Lacey N LaGrone, Amy K Fuhs, Eduardo Huaman Egoavil, Manuel J A Rodriguez Castro, Roberto Valderrama, Leah N Isquith-Dicker, Jaime Herrera-Matta, Charles N Mock
BACKGROUND: Evidence for the positive impact of quality improvement (QI) programs on morbidity, mortality, patient satisfaction, and cost is strong. Data regarding the status of QI programs in low- and middle-income countries, as well as in-depth examination of barriers and facilitators to their implementation, are limited. METHODS: This cross-sectional, descriptive study employed a mixed-methods design, including distribution of an anonymous quantitative survey and individual interviews with healthcare providers who participate in the care of the injured at ten large hospitals in Lima, Peru...
November 28, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27894758/the-impact-of-cardiac-risk-factors-on-short-term-outcomes-for-children-undergoing-a-ladd-procedure
#4
Luke R Putnam, Kathryn T Anderson, KuoJen Tsao, Lillian S Kao, Jane A Lugo, Kevin P Lally, Akemi L Kawaguchi
BACKGROUND/PURPOSE: The purpose of this study was to describe the outcomes of children with and without congenital heart disease who undergo a Ladd procedure. METHODS: The 2012-2014 National Surgical Quality Improvement Program Pediatric (NSQIP-P) data were queried for patients undergoing a Ladd procedure. Utilizing NSQIP-P definitions, patients were categorized into four cardiac risk groups (none, minor, major, severe) based on severity of cardiac anomalies, previous cardiac procedure(s), and ongoing cardiac dysfunction...
October 21, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27890683/the-effect-of-obesity-on-perioperative-outcomes-for-open-and-minimally-invasive-prostatectomy
#5
Scott C Johnson, Vignesh T Packiam, Shay Golan, Andrew J Cohen, Charles U Nottingham, Norm D Smith
OBJECTIVES: To compare the impact of obesity on perioperative outcomes between open radical prostatectomy (ORP) and minimally invasive prostatectomy (MIP). METHODS: Using the National Surgical Quality Improvement Program (NSQIP) public use files for 2008-2013, we identified patients undergoing prostatectomy using current procedural terminology codes. Those without BMI or comorbidity information were excluded. BMI was treated as a categorical variable according to the World Health Organization classification...
November 24, 2016: Urology
https://www.readbyqxmd.com/read/27890331/the-safety-of-same-day-breast-reconstructive-surgery-an-analysis-of-short-term-outcomes
#6
Erin Cordeiro, Toni Zhong, Timothy Jackson, Tulin Cil
BACKGROUND: We sought to examine the safety of same-day breast reconstructive (BR) surgery. METHODS: An analysis of the American College of Surgeons, National Surgical Quality Improvement Program (ACS-NSQIP) files was performed. Patients undergoing BR for breast cancer were examined, excluding those with high-risk co-morbidities or concurrent surgery. A propensity score was calculated and a multivariable logistic regression analysis was used to calculate the difference in 30-day complications between those undergoing SDS versus longer hospital stay...
November 12, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27887932/assessing-national-provision-of-care-variability-in-bariatric-clinical-care-pathways
#7
Dana A Telem, Saniea F Majid, Kinga Powers, Eric DeMaria, John Morton, Daniel B Jones
BACKGROUND: The American Society for Metabolic and Bariatric Surgery (ASMBS) Quality Improvement and Patient Safety (QIPS) Committee hypothesized that collecting and sharing clinical pathways could provide a valuable resource to new and existing bariatric programs. OBJECTIVE: To shed light on the variability in practice patterns across the country by analyzing pathways. SETTING: United States Centers of Excellence METHODS: From June 2014 to April 2015, clinical pathways pertaining to preoperative, intraoperative, and postoperative management of bariatric patients were solicited from the ASMBS executive council (EC), QIPS committee members, and state chapter presidents...
August 3, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27879589/abdominal-contouring-can-the-american-society-of-anesthesiologists-classification-system-help-determine-when-to-say-no
#8
Olatomide T Familusi, Matthew Doscher, Oscar J Manrique, Joseph Shin, Teresa Benacquista
BACKGROUND: The purpose of this study was to determine whether the American Society of Anesthesiologists classification system could be used preoperatively to identify patients at high risk for complications after abdominal contouring. METHODS: Using the National Surgical Quality Improvement Program database from 2007 to 2012, patients undergoing abdominal contouring procedures were identified and stratified by American Society of Anesthesiologists class. The primary outcome was any complication within 30 days...
December 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27879581/matching-procedures-at-the-time-of-immediate-breast-reconstruction-an-american-college-of-surgeons-national-surgical-quality-improvement-program-study-of-24-191-patients
#9
Carisa M Cooney, Mohamad E Sebai, Onyebuchi Ogbuagu, Chris Devulapalli, Michele A Manahan, Gedge D Rosson
BACKGROUND: The purpose of this study was to assess for compounded risk of postoperative morbidity with the addition of a simultaneous contralateral breast matching procedure at the time of mastectomy and immediate breast reconstruction. METHODS: 2005 to 2012 American College of Surgeons National Surgical Quality Improvement Program databases were used to identify cases of mastectomy and immediate breast reconstruction with and without simultaneous contralateral breast matching procedures...
December 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27876522/relative-value-unit-based-compensation-incentivization-in-an-academic-vascular-practice-improves-productivity-with-no-early-adverse-impact-on-quality
#10
Nadia Awad, Francis J Caputo, Jeffrey P Carpenter, James B Alexander, José L Trani, Joseph V Lombardi
OBJECTIVE: Given the increased pressure from governmental programs to restructure reimbursements to reflect quality metrics achieved by physicians, review of current reimbursement schemes is necessary to ensure sustainability of the physician's performance while maintaining and ultimately improving patient outcomes. This study reviewed the impact of reimbursement incentives on evidence-based care outcomes within a vascular surgical program at an academic tertiary care center. METHODS: Data for patients with a confirmed 30-day follow-up for the vascular surgery subset of our institution's National Surgical Quality Improvement Program submission for the years 2013 and 2014 were reviewed...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27875102/obesity-increases-operative-time-in-children-undergoing-laparoscopic-cholecystectomy
#11
T K Pandian, Daniel S Ubl, Elizabeth B Habermann, Christopher R Moir, Michael B Ishitani
INTRODUCTION: Few studies have assessed the impact of obesity on laparoscopic cholecystectomy (LC) in pediatric patients. MATERIALS AND METHODS: Children who underwent LC were identified from the 2012 to 2013 American College of Surgeons' National Surgical Quality Improvement Program Pediatrics data. Patient characteristics, operative details, and outcomes were compared. Multivariable logistic regression was utilized to identify predictors of increased operative time (OT) and duration of anesthesia (DOAn)...
November 22, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27873183/interdisciplinary-oncology-education-a-national-survey-of-trainees-and-program-directors-in-the-united-states
#12
Adil S Akthar, Christopher D Hellekson, Sabha Ganai, Olwen M Hahn, Ronald J Maggiore, Ezra E Cohen, Mitchell C Posner, Steven J Chmura, Andrew R Howard, Daniel W Golden
Oncologists must have a strong understanding of collaborating specialties in order to deliver optimal cancer care. The objective of this study was to quantify current interdisciplinary oncology education among oncology training programs across the USA, identify effective teaching modalities, and assess communication skills training. Web-based surveys were sent to oncology trainees and program directors (PDs) across the USA on April 1, 2013 and October 8, 2013, respectively. Question responses were Yes/No, five-point Likert scales (1 = not at all, 2 = somewhat, 3 = moderately, 4 = quite, 5 = extremely), or free response...
November 21, 2016: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/27870806/outpatientanterior-cervical-discectomy-and-fusion-is-associated-with-fewer-short-term-complications-inone-and-two-level-cases-a-propensity-adjusted-analysis
#13
Michael C Fu, Jordan A Gruskay, Andre M Samuel, Evan D Sheha, Peter B Derman, Sravisht Iyer, Jonathan N Grauer, Todd J Albert
STUDY DESIGN: Retrospective cohort study of prospectively-collected data from the National Surgical Quality Improvement Program (NSQIP) database. OBJECTIVE: To determine the postoperative morbidity of one-level and two-level outpatient anterior cervical discectomy and fusion (ACDF) relative to inpatient cases, and risk factors for post-discharge complications. SUMMARY OF BACKGROUND DATA: ACDF is increasingly performed as an outpatient procedure, with evidence demonstrating outpatient one-level ACDF to be associated with fewer postoperative complications than inpatients...
November 18, 2016: Spine
https://www.readbyqxmd.com/read/27870741/relationship-between-preoperative-anemia-and-in-hospital-mortality-in-children-undergoing-noncardiac-surgery
#14
David Faraoni, James A DiNardo, Susan M Goobie
BACKGROUND: The relationship between preoperative anemia and in-hospital mortality has not been investigated in the pediatric surgical population. We hypothesized that children with preoperative anemia undergoing noncardiac surgery may have an increased risk of in-hospital mortality. METHODS: We identified all children between 1 and 18 years of age with a recorded preoperative hematocrit (HCT) in the 2012, 2013, and 2014 American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) pediatric databases...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27867917/health-related-quality-of-life-in-brain-tumor-patients-treated-with-surgery-preliminary-result-of-a-single-institution
#15
Chang-Wook Kim, Jin-Deok Joo, Young-Hoon Kim, Jung Ho Han, Chae-Yong Kim
BACKGROUND: Alongside the extent of removal and patients' survival in the management of brain tumors, health-related quality of life (HRQOL) has become an important consideration. The purpose of this study is to evaluate the change of HRQOL in brain tumor patients before and after surgery and to assess the associated factors that contribute to the change of HRQOL. METHODS: A total of 258 patients who underwent surgical treatment were enrolled in this study. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30 (EORTC QLQ-C30) and the 20-item EORTC QLQ-Brain Neoplasm (QLQ-BN20) were used to assess HRQOL...
October 2016: Brain Tumor Research and Treatment
https://www.readbyqxmd.com/read/27865568/home-discharge-after-primary-elective-total-joint-arthroplasty-postdischarge-complication-timing-and-risk-factor-analysis
#16
Dong-Han Yao, Aakash Keswani, Chirag K Shah, Alex Sher, Karl M Koenig, Calin S Moucha
BACKGROUND: Bundled payment programs for primary total joint arthroplasty (TJA) have identified reducing nonhome discharge as a major area of cost savings. Health care providers must therefore identify, risk stratify, and appropriately care for home-discharged TJA patients. This study aimed to analyze risk factors and timing of postdischarge complications among home-discharged primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients and risk stratify them to identify those who would benefit from higher level care...
August 27, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27864707/impact-of-operative-length-on-post-operative-complications-in-meningioma-surgery-a-nsqip-analysis
#17
Aditya V Karhade, Luis Fandino, Saksham Gupta, David J Cote, Julian B Iorgulescu, Marike L Broekman, Linda S Aglio, Ian F Dunn, Timothy R Smith
Many studies have implicated operative length as a predictor of post-operative complications, including venous thromboembolism [deep vein thrombosis (DVT) and pulmonary embolism (PE)]. We analyzed the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database from 2006 to 2014, to evaluate whether length of operation had a statistically significant effect on post-operative complications in patients undergoing surgical resection of meningioma. Patients were included for this study if they had a post-operative diagnosis of meningioma...
November 18, 2016: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/27863971/systemic-inaccuracies-in-the-national-surgical-quality-improvement-program-database-implications-for-accuracy-and-validity-for-neurosurgery-outcomes-research
#18
John D Rolston, Seunggu J Han, Edward F Chang
The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) provides a rich database of North American surgical procedures and their complications. Yet no external source has validated the accuracy of the information within this database. Using records from the 2006 to 2013 NSQIP database, we used two methods to identify errors: (1) mismatches between the Current Procedural Terminology (CPT) code that was used to identify the surgical procedure, and the International Classification of Diseases (ICD-9) post-operative diagnosis: i...
November 15, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27858534/lumbar-decompression-in-the-elderly-increased-age-as-a-risk-factor-for-complications-and-nonhome-discharge
#19
Meghan E Murphy, Hannah Gilder, Patrick R Maloney, Brandon A McCutcheon, Lorenzo Rinaldo, Daniel Shepherd, Panagiotis Kerezoudis, Daniel S Ubl, Cynthia S Crowson, William E Krauss, Elizabeth B Habermann, Mohamad Bydon
OBJECTIVE With improving medical therapies for chronic conditions, elderly patients increasingly present as candidates for operative intervention for degenerative diseases of the spine. To date, there is a paucity of studies examining complications in lumbar decompression, without fusion, that include patients older than 80 years. Using a multicenter national database, the authors of this study evaluated lumbar decompression in the elderly, including octogenarians, to evaluate for associations between age and patient outcomes...
November 18, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27857495/the-impact-of-resident-involvement-on-outcomes-in-orthopedic-trauma-an-analysis-of-20-090-cases
#20
Phillip M Mitchell, Svetlana A Gavrilova, Ashley C Dodd, Basem Attum, William T Obremskey, Manish K Sethi
BACKGROUND: Involvement in patient care is critical in training orthopedic surgery residents for independent practice. As the focus on outcomes and quality measures intensifies, the impact of resident intraoperative involvement on patient outcomes will be increasingly scrutinized. We sought to determine the impact of residents' intraoperative participation on 30-day post-operative outcomes in the orthopedic trauma population. METHODS: A total of 20,090 patients from the American College of Surgeons National Surgical Quality Improvement Program database from 2006 to 2013 were identified...
October 2016: Journal of Clinical Orthopaedics and Trauma
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