Early Experiences With Bundled Payments for Care Improvement for Major Bowel Surgery
CONCLUSIONS: Patients undergoing major bowel surgery are a heterogeneous population. Physicians are ideally positioned to deliver high-value, patient-centered care and are crucial to the success of a BP model. The post-acute care setting is a key component of improving efficiency and quality of care.PMID:38523411 | DOI:10.1177/00031348241241618 (Source: The American Surgeon)
Source: The American Surgeon - March 25, 2024 Category: Surgery Authors: Udai S Sibia John R Klune Said Saiolghalam Anton Bilchik Source Type: research
Delayed Diagnosis of Inflammatory Breast Cancer Presenting as Acute Mastitis in a Patient One Month Postpartum
Am Surg. 2024 Mar 24:31348241241736. doi: 10.1177/00031348241241736. Online ahead of print.ABSTRACTInflammatory breast cancer (IBC) is a rare yet aggressive form of invasive ductal carcinoma, with a poor prognosis and decreased 5-year survival rates. Characteristic findings for IBC include rapid onset of breast edema, peau d'orange appearance, and involvement of the breast skin. Additionally, diagnosis is confirmed with a skin punch biopsy. With such nonspecific features, IBC can be mistaken for benign etiologies, causing delays in diagnosis and treatment. This patient is a 44-year-old woman presenting with left breast swe...
Source: The American Surgeon - March 25, 2024 Category: Surgery Authors: Ananya Seth Eliza M Slama Source Type: research
Factors Associated With Respiratory Failure After Open Ventral Hernia Repair: An Evaluation of the NSQIP Database
Am Surg. 2024 Mar 24:31348241241731. doi: 10.1177/00031348241241731. Online ahead of print.ABSTRACTAn analysis of ACS-NSQIP open ventral hernia repair (OVHR) data (2017-2019) was performed. Respiratory failure (RF) occurred in 643 patients (1%) and not in 63,213 (99%) (nRF). Respiratory failure patients were older (63.7 vs 57 years, P < .001) and more comorbid: insulin-dependent diabetes (14.7% vs 5.8%, P < .001), COPD (19.4% vs 5.2%, P < .001), BMI (36.0 vs 32.8, P < .001), and current tobacco use (24.9% vs 17.6%, P < .001). Respiratory failure patients had greater ASA scores (ASA 3: 63.3% vs 47.8%, P < ...
Source: The American Surgeon - March 25, 2024 Category: Surgery Authors: William R Lorenz Alexis M Holland Brittany S Mead Gregory T Scarola Vedra A Augenstein B Todd Heniford Source Type: research
The Importance of Early Femoral Access When REBOA Catheter Must Be Removed Prior to Hemorrhage Control
We describe a case where the REBOA Catheter needed to be removed prior to hemorrhage control. The patient is a 40-year-old man that presented following motor vehicle collision. A REBOA Catheter was placed via the right common femoral artery (CFA). CT scan demonstrated extravasation from the left inferior epigastric artery. The Interventional Radiology (IR) team would only be able to perform angioembolization via contralateral access where the REBOA Catheter was in place. Prior to removing the REBOA Catheter on the right, left CFA access was obtained in the event a new catheter needed to be deployed. Ultimately, IR performe...
Source: The American Surgeon - March 25, 2024 Category: Surgery Authors: Michele N Fiorentino Michael C Smith Stephen P Gondek Source Type: research
Accuracy of Trauma Surgeons Prospective Estimation of the Injury Severity Score: A Pilot Study
This study aimed to determine accuracy of ISS estimation at time of admission. Attending trauma surgeons assessed the Abbreviated Injury Scale of each body region for patients admitted during their call, from which estimated ISS (eISS) was calculated. The eISS was considered concordant to abstracted ISS (aISS) if both were in the same category: mild (<9), moderate (9-15), severe (16-25), or critical (>25). Ten surgeons completed 132 surveys. Overall ISS concordance was 52.2%; 87.5%, 30.8%, 34.8%, and 61.7% for patients with mild, moderate, severe, and critical aISS, respectively; unweighted k = .36, weighted k = .69....
Source: The American Surgeon - March 25, 2024 Category: Surgery Authors: Eli Mlaver Courtney H Meyer Jesse A Codner Gina Solomon Jyotirmay Sharma Morgan Krause W Matthew Vassy Christopher J Dente S Rob Todd Patricia Ayoung-Chee Source Type: research
Pediatric Peripheral Vascular Trauma: Incidence and Outcomes
Am Surg. 2024 Mar 25:31348241241623. doi: 10.1177/00031348241241623. Online ahead of print.ABSTRACTPeripheral vascular trauma (PVT) is rare in children, with an incidence estimated below 1%. We studied pediatric PVT and risk factors for major amputation by accessing the 2019 National Trauma Data Bank (NTDB). Demographics, injury type and location, trauma center capability, injury severity score (ISS), length of stay (LOS), and major amputation rates were evaluated. Statistical analysis included chi-square testing for categorical variables and t-tests for continuous variables. Of 130,554 pediatric trauma patients, 1196 (.9%...
Source: The American Surgeon - March 25, 2024 Category: Surgery Authors: Candice L Dunn Sathyaprasad Burjonrappa Source Type: research
Prevalence, Risk Factors, and Metabolic Characteristics of Metabolically Healthy Obesity in Patients Seeking Bariatric Surgery: A Cohort Study
CONCLUSION: Approximately 1 in 8 individuals referred for bariatric surgery displayed the phenotype of MHO. Despite being metabolically healthy based on certain criteria, a significant proportion of individuals with MHO still exhibited metabolic abnormalities, such as fatty liver, hyperuricemia, elevated lipid levels, and abnormal lipoprotein levels, highlighting the importance of thorough metabolic evaluation in this population.PMID:38525950 | DOI:10.1177/00031348241241621 (Source: The American Surgeon)
Source: The American Surgeon - March 25, 2024 Category: Surgery Authors: Xuejing Zheng Chenxu Tian Guangzhong Xu Dexiao Du Nengwei Zhang Jing Wang Qing Sang Qiqige Wuyun Weijian Chen Dongbo Lian Dezhong Wang Buhe Amin Liang Wang Source Type: research
Risk Factors for Venous Thromboembolism and Eventual Amputation in Traumatic Femoral and Iliac Vein Injuries: A Trauma Quality Improvement Program Analysis
CONCLUSION: Venous restoration was not an independent predictor of VTE. Venous ligation on index operation was the only modifiable independent predictor of amputation identified on regression analysis.PMID:38527489 | DOI:10.1177/00031348241241645 (Source: The American Surgeon)
Source: The American Surgeon - March 25, 2024 Category: Surgery Authors: Allison K Falcon Ladd M Caballero Dina M Filiberto Emily K Lenart Thomas S Easterday Maunil N Bhatt Erica L Mitchell Saskya Byerly Source Type: research
Rural Vascular Trauma: Time to Care
This study is the first of its kind within the last two decades to comprehensively review rural vascular trauma. Our research showed clinical decline in SIR associated with prolonged time to care and will allow us to optimize pre-hospital care and transport in regions with prolonged arrival times.PMID:38527493 | DOI:10.1177/00031348241241684 (Source: The American Surgeon)
Source: The American Surgeon - March 25, 2024 Category: Surgery Authors: Kirran Bakhshi Heather Rhodes-Lyons Ayman Ahmed Source Type: research
Advances in Hernia Care State of the Art
Am Surg. 2024 Mar 25:31348241241717. doi: 10.1177/00031348241241717. Online ahead of print.ABSTRACTThe field of hernia surgery has seen many recent advances and continues to evolve. Care of the hernia patient begins preoperatively by ensuring adequate preparation for surgery with surgeons now having the opportunity to accurately predict risk which can aid with informed consent. Imaging studies can now help surgeons diagnose and plan hernia surgery on an individual level based on hernia characteristics as well as abdominal wall musculature. In the operating room, new technology and surgical techniques have allowed surgeons ...
Source: The American Surgeon - March 25, 2024 Category: Surgery Authors: William W Hope Source Type: research
Surgical Resident Education and Performance in Extended Focused Abdominal Sonography for Trauma
Am Surg. 2024 Mar 24:31348241241747. doi: 10.1177/00031348241241747. Online ahead of print.ABSTRACTExtended focused assessment with sonography for trauma (eFAST) is a rapid triage tool aiding the detection of life-threatening injuries. In academic settings, residents perform most eFAST; however, the ACGME has no recommendations for eFAST training standards. We surveyed general surgery programs (GSPs) regarding eFAST training and established a baseline for sensitivity, specificity, and positive and negative predictive values for resident-performed eFAST. US GSP eFAST surveys were conducted by email and phone. We prospective...
Source: The American Surgeon - March 25, 2024 Category: Surgery Authors: Hannah Tan Cassidy L Pham Ramsey N Regen Noah R Rutherford Landon R Armstrong Lou M Smith Robert E Heidel Source Type: research
Early Experiences With Bundled Payments for Care Improvement for Major Bowel Surgery
CONCLUSIONS: Patients undergoing major bowel surgery are a heterogeneous population. Physicians are ideally positioned to deliver high-value, patient-centered care and are crucial to the success of a BP model. The post-acute care setting is a key component of improving efficiency and quality of care.PMID:38523411 | DOI:10.1177/00031348241241618 (Source: The American Surgeon)
Source: The American Surgeon - March 25, 2024 Category: Surgery Authors: Udai S Sibia John R Klune Said Saiolghalam Anton Bilchik Source Type: research
Delayed Diagnosis of Inflammatory Breast Cancer Presenting as Acute Mastitis in a Patient One Month Postpartum
Am Surg. 2024 Mar 24:31348241241736. doi: 10.1177/00031348241241736. Online ahead of print.ABSTRACTInflammatory breast cancer (IBC) is a rare yet aggressive form of invasive ductal carcinoma, with a poor prognosis and decreased 5-year survival rates. Characteristic findings for IBC include rapid onset of breast edema, peau d'orange appearance, and involvement of the breast skin. Additionally, diagnosis is confirmed with a skin punch biopsy. With such nonspecific features, IBC can be mistaken for benign etiologies, causing delays in diagnosis and treatment. This patient is a 44-year-old woman presenting with left breast swe...
Source: The American Surgeon - March 25, 2024 Category: Surgery Authors: Ananya Seth Eliza M Slama Source Type: research
Factors Associated With Respiratory Failure After Open Ventral Hernia Repair: An Evaluation of the NSQIP Database
Am Surg. 2024 Mar 24:31348241241731. doi: 10.1177/00031348241241731. Online ahead of print.ABSTRACTAn analysis of ACS-NSQIP open ventral hernia repair (OVHR) data (2017-2019) was performed. Respiratory failure (RF) occurred in 643 patients (1%) and not in 63,213 (99%) (nRF). Respiratory failure patients were older (63.7 vs 57 years, P < .001) and more comorbid: insulin-dependent diabetes (14.7% vs 5.8%, P < .001), COPD (19.4% vs 5.2%, P < .001), BMI (36.0 vs 32.8, P < .001), and current tobacco use (24.9% vs 17.6%, P < .001). Respiratory failure patients had greater ASA scores (ASA 3: 63.3% vs 47.8%, P < ...
Source: The American Surgeon - March 25, 2024 Category: Surgery Authors: William R Lorenz Alexis M Holland Brittany S Mead Gregory T Scarola Vedra A Augenstein B Todd Heniford Source Type: research
The Importance of Early Femoral Access When REBOA Catheter Must Be Removed Prior to Hemorrhage Control
We describe a case where the REBOA Catheter needed to be removed prior to hemorrhage control. The patient is a 40-year-old man that presented following motor vehicle collision. A REBOA Catheter was placed via the right common femoral artery (CFA). CT scan demonstrated extravasation from the left inferior epigastric artery. The Interventional Radiology (IR) team would only be able to perform angioembolization via contralateral access where the REBOA Catheter was in place. Prior to removing the REBOA Catheter on the right, left CFA access was obtained in the event a new catheter needed to be deployed. Ultimately, IR performe...
Source: The American Surgeon - March 25, 2024 Category: Surgery Authors: Michele N Fiorentino Michael C Smith Stephen P Gondek Source Type: research
