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"Acute care surgery"

Lena M Napolitano, Thomas W Biester, Gregory J Jurkovich, Jo Buyske, Mark A Malangoni, Frank R Lewis
BACKGROUND: There are no specific Accreditation Council for Graduate Medical Education General Surgery Residency Program Requirements for rotations in surgical critical care (SCC), trauma, and burn. We sought to determine the experience of general surgery residents in SCC, trauma, and burn rotations. METHODS: Data analysis of surgical rotations of American Board of Surgery general surgery resident applicants (n = 7,299) for the last 8 years (2006 to 2013, inclusive) was performed through electronic applications to the American Board of Surgery Qualifying Examination...
October 2016: American Journal of Surgery
Greg Hambright, Vaidehi Agrawal, Phillip L Sladek, Suzanne M Slonim, Michael S Truitt
BACKGROUND: Acute care surgeons (ACS) often care for patients with limited access to health care. They may not participate in preventative screenings and interventions (PSIs) such as mammography, colonoscopy, or pneumococcal vaccinations (VAs). We sought to identify barriers to compliance and determine if ACS have an opportunity to facilitate PSI participation. METHODS: All patients evaluated by an ACS were considered for inclusion in the study. Patients meeting national PSI inclusion criteria were enrolled...
August 3, 2016: American Journal of Surgery
Joseph D Forrester, Thomas G Weiser, Paul Maggio, Timothy Browder, Lakshika Tennakoon, David Spain, Kristan Staudenmayer
BACKGROUND: Trauma patients with vascular injuries have historically been within a general surgeon's operative ability. Changes in training and decline in operative trauma have decreased trainees' exposure to these injuries. We sought to determine how frequently vascular procedures are performed at US trauma centers to quantify the need for general surgeons trained to manage vascular injuries. METHODS: We conducted a retrospective analysis of the National Trauma Data Base (NTDB) from 2012 compared with 2002...
September 2016: Journal of Surgical Research
John Mayberry
No abstract text is available yet for this article.
August 17, 2016: American Journal of Surgery
Yi-Hsuan Hu, Chien-Ying Wang, Mu-Shun Huang, Chen-Hsen Lee, Yi-Szu Wen
BACKGROUND: This study investigated surgery-related medical disputes and analyzed disease etiologies and the main causes of disputes in order to identify key points for the purpose of improving the quality of surgical patient care in Taiwan. METHODS: Reports on all surgery-related cases appraised by the Taiwan Witness Examiner Committee of the Department of Health between 2004 and 2008 were reviewed retrospectively by three senior physicians from the emergency department who specialize in both trauma and emergency general surgery...
August 28, 2016: Journal of the Chinese Medical Association: JCMA
Saad Y Salim, Pang Y Young, Thomas A Churchill, Rachel G Khadaroo
BACKGROUND: Acute mesenteric ischemia (AMI) has a high morbidity and mortality and often presents as a diagnostic challenge. Currently, there is no blood, urine, or radiologic tests that provide a definitive diagnosis of AMI. The aim of this study was to evaluate the clinical accuracy of urine intestinal fatty acid-binding protein (I-FABP) to diagnosis AMI. MATERIALS AND METHODS: Twenty patients referred to the Acute Care Surgery service at University of Alberta Hospital with suspected AMI taken to the operating room for definitive diagnosis were recruited...
July 16, 2016: Journal of Surgical Research
Hsin-I Tsai, Peter Chi-Ho Chung, Chao-Wei Lee, Huang-Ping Yu
INTRODUCTION: The technology near infrared spectroscopy (NIRS) has been utilized extensively in several clinical settings and one of which is in cerebral oximetry. This review will provide information on the technology, clinical applications and algorithm to follow when desaturation occurs. AREAS COVERED: The review will cover the technology of near infrared spectroscopy, cerebral oximetry and the utilization of cerebral oximetry in each clinical setting. Expert commentary: Cerebral oximetry provides a noninvasive measure of cerebral oxygenation, which when persistently declining, can serve as a warning sign of hemodynamic or metabolic compromise intraoperatively or a predictor of postoperative cognitive dysfunction...
September 2016: Expert Review of Medical Devices
Sachin Mathur, Tiong Thye Goo, T'zu Jen Tan, Kok Yang Tan, Kenneth Seck Wai Mak
The last 15 years have seen changing patterns of injury in emergency surgery and trauma patients. The ability to diagnose, treat and manage these patients nonoperatively has led to a decline in interest in trauma surgery as a career. In addition, healthcare systems face multiple challenges, including limited resources, an ageing population and increasing subspecialisation of medical care, while maintaining government-directed standards and managing public expectations. In the West, these challenges have led to the emergence of a new subspecialty, 'acute care surgery', with some models of care providing dedicated acute surgical units or separating acute and elective streams with the existing manpower resources...
June 2016: Singapore Medical Journal
Ramesh Wijaya, Hui Min Gloria Cheng, Chee Keong Chong
INTRODUCTION: Massive transfusion protocol (MTP) is increasingly used in civilian trauma cases to achieve better haemostatic resuscitation in patients requiring massive blood transfusions (MTs), with improved survival outcomes. However, in non-trauma patients, evidence for MTP is lacking. This study aims to assess the outcomes of a newly established MTP in a civilian setting, for both trauma and non-trauma patients, in an acute surgical care unit. METHODS: A retrospective cohort analysis was performed on 46 patients for whom MTP was activated in Changi General Hospital, Singapore...
May 2016: Singapore Medical Journal
E W Stranch, B L Zarzaur, S A Savage
INTRODUCTION: Penetrating cardiac injuries are infrequent but highly lethal. To address these injuries, cardiopulmonary bypass and cardiothoracic surgery availability are required for Level I trauma center verification. However, acute care surgeons are more readily available for this time-sensitive injury. The purpose of this study was to review an acute care surgery-based experience with penetrating cardiac trauma at an urban Level 1 trauma center. Our hypothesis was that care provided solely by acute care surgeons was both safe and effective for this patient population...
May 18, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Joseph J DuBose, Thomas M Scalea, Megan Brenner, Dimitra Skiada, Kenji Inaba, Jeremy Cannon, Laura Moore, John Holcomb, David Turay, Cassra N Arbabi, Andrew Kirkpatrick, James Xiao, David Skarupa, Nathaniel Poulin
INTRODUCTION: Aortic occlusion (AO) for resuscitation in traumatic shock remains controversial. Resuscitative endovascular balloon occlusion of the aorta (REBOA) offers an emerging alternative. METHODS: The American Association for the Surgery of Trauma Aortic Occlusion for Resuscitation in Trauma and Acute Care Surgery registry prospectively identified trauma patients requiring AO from eight ACS Level 1 centers. Presentation, intervention, and outcome variables were collected and analyzed to compare REBOA and open AO...
September 2016: Journal of Trauma and Acute Care Surgery
Ben L Zarzaur, Nakul Valsangkar, David F Feliciano, Leonidas G Koniaris
BACKGROUND: More than 75% of respondents to an Eastern Association for the Surgery of Trauma survey felt that barriers to research had increased and that acute care surgeon (ACS) academic productivity had decreased. Recent data confirm this impression and show lower academic productivity of junior ACS faculty compared with peers in other general surgical fields. The purpose of this study was to determine if early career acute care surgery research scholarships are associated with improved ACS academic productivity...
July 2016: Journal of Trauma and Acute Care Surgery
Mayur Narayan, Ronald Tesoriero, Brandon R Bruns, Elena N Klyushnenkova, Hegang Chen, Jose J Diaz
BACKGROUND: Trauma centers (TCs) have been shown to provide lifesaving, but more expensive, care when compared with non-TCs (NTC). Limited data exist about the economic impact of emergency general surgery (EGS) patients on health care systems. We hypothesized that the economic burden would be higher for EGS patients managed at TCs vs NTCs. METHODS: The Maryland Health Services Cost Review Commission database was queried from 2009 to 2013. The American Association for the Surgery of Trauma EGS ICD-9 codes were used to define the top 10 EGS diagnoses...
April 2016: Journal of the American College of Surgeons
Elliot C Dickerson, Hasan B Alam, Richard K J Brown, Jadranka Stojanovska, Matthew S Davenport
PURPOSE: The aim of this study was to determine if direct in-person communication between an acute care surgical team and radiologists alters surgical decision making. METHODS: Informed consent was waived for this institutional review board-exempt, HIPAA-compliant, prospective quality improvement study. From January 29, 2015 to December 10, 2015, semiweekly rounds lasting approximately 60 min were held between the on-call acute care surgery team (attending surgeon, chief resident, and residents) and one of three expert abdominal radiologists...
August 2016: Journal of the American College of Radiology: JACR
Patrick B Murphy, Kelly N Vogt, Tina S Mele, S Morad Hameed, Chad G Ball, Neil G Parry
No abstract text is available yet for this article.
March 14, 2016: Annals of Surgery
Cheryl K Zogg, Wei Jiang, Muhammad Ali Chaudhary, John W Scott, Adil A Shah, Stuart R Lipsitz, Joel S Weissman, Zara Cooper, Ali Salim, Stephanie L Nitzschke, Louis L Nguyen, Lorens A Helmchen, Linda Kimsey, Samuel T Olaiya, Peter A Learn, Adil H Haider
BACKGROUND: Racial disparities in surgical care are well described. As many minority patients are also uninsured, increasing access to care is thought to be a viable solution to mitigate inequities. The objectives of this study were to determine whether racial disparities in 30-/90-/180- day outcomes exist within a universally insured population of military-/civilian-dependent emergency general surgery (EGS) patients and ascertain whether differences in outcomes differentially persist in care received at military versus civilian hospitals and among sponsors who are enlisted service members versus officers...
May 2016: Journal of Trauma and Acute Care Surgery
Brandon Robert Bruns, Ronald B Tesoriero, Mayur Narayan, Lindsay OʼMeara, Margaret H Lauerman, Barbara Eaton, Anthony V Herrera, Thomas Michael Scalea, Jose J Diaz
INTRODUCTION: The formation of Acute Care Surgery services leads to decreased time to treatment and improved outcomes for emergency general surgery (EGS) patients. However, minimal work has focused on the ideal care delivery system and team structure. We hypothesize that the implementation of a dedicated EGS team (separate from trauma and surgical critical care), with EGS-specific protocols and dedicated operating room (OR) time, will increase productivity and improve mortality. METHODS: This is a retrospective review of financial and EGS registry data from fiscal year (FY) 12 to FY15...
July 2016: Journal of Trauma and Acute Care Surgery
Thomas L Sutton, Etienne E Pracht, David J Ciesla
BACKGROUND: Acute appendicitis (AA) is often studied as a surrogate for acute care surgery. Previous studies have shown differences in outcomes based on insurance status, but associated costs to health care systems are in need of further study. The purpose of the present study was to investigate how treatment, outcomes, and health care resource utilization differ between the uninsured and commercially insured in the setting of AA. METHODS: Patients with AA were identified by International Classification of Diseases, ninth edition, codes using the Agency for Health Care Administration Florida Hospital inpatient discharge data sets for 2002-2011...
March 2016: Journal of Surgical Research
Prem Chana, Elaine M Burns, Sonal Arora, Ara W Darzi, Omar D Faiz
OBJECTIVE: This review aims to assess the impact of implementing dedicated emergency surgical services, in particular acute care surgery, on clinical outcomes. BACKGROUND: The optimal model for delivering high-quality emergency surgical care remains unknown. Acute Care Surgery (ACS) is a health care model combining emergency general surgery, trauma, and critical care. It has been adopted across the United States in the management of surgical emergencies. METHOD: A systematic review was performed after PRISMA recommendations using the MEDLINE, Embase, and Psych-Info databases...
January 2016: Annals of Surgery
Kathleen M Casey, Alexander A Hannenberg
No abstract text is available yet for this article.
June 1, 2016: JAMA Surgery
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