A nationwide study published in JACS found that critically ill children can now undergo liver transplantation and achieve similar survival benefits as stable children. Survival rates have improved significantly since pediatric critical care was recognized as a specialty area of medicine, with one-year survival increasing from 66% to 92%.
The American College of Surgeons has launched a new initiative funded by the Agency for Healthcare Research and Quality (AHRQ) to implement Enhanced Recovery After Surgery (ERAS) protocols in 750 hospitals. ERAS practices have been shown to lower costs, improve safety, and shorten recovery times for surgical patients.
A new study published in the Journal of the American College of Surgeons found that laparoscopic anti-reflux operations for gastroesophageal reflux disease (GERD) result in faster recovery, fewer postoperative complications, and lower healthcare costs compared to traditional open operations.
A new study from the University of Tennessee Health Science Center found that advances in imaging technology have led to a six-fold increase in the diagnosis of blunt cerebrovascular injuries in trauma patients. This has resulted in a significant decline in stroke and related death rates over the past 30 years.
Research suggests that high-volume medical centers can recover significantly more organs from deceased donors than low-volume centers. On average, these hospitals have an organ yield rate of 0.4 higher than low-volume centers. This could lead to recovering an additional 3,000 vital organs yearly.
The new guidelines aim to reduce SSI risk through patient education, lifestyle changes, and improved hospital management. Target blood glucose levels are set at 110-150 mg/dL for all patients before surgery, while smoking cessation and weight loss are encouraged.
A study published in the Journal of the American College of Surgeons has identified obesity-induced lymphedema as the cause of massive localized lymphedema. A new probability scale can help physicians identify patients at greatest risk for this condition, recommending weight loss as the preferred initial treatment.
Residents selectively extend work shifts to facilitate care transitions, stabilize critically ill patients, and perform routine responsibilities. However, senior residents reported more frequent duty hour violations, with junior residents having the highest rate of frequent violations.
A study of 12,703 patients found that same-day discharge after laparoscopic appendectomy resulted in similar postoperative complications and lower readmission rates compared to overnight hospital stays. This approach can lead to significant cost savings, with an estimated annual healthcare savings of $921,500,000 in the US.
A national survey of US general surgery residents found that 86% preferred flexible duty hour policies over standard schedules, with a stronger preference among senior residents. The study also showed that flexible hours improved patient safety and continuity of care, and reduced resident dissatisfaction.
Trauma patients who receive intensive physical, occupational, and cognitive therapy at acute care inpatient rehabilitation facilities are more likely to go home and survive a year after discharge. The study found that these patients experienced significant improvements in functional outcome and had a lower risk of death after a year.
The study, involving 1,531 women, found that breast reconstruction following mastectomy for breast cancer yields similar benefits for all age groups, with no significant increase in complication risk. The procedure is generally successful and should not be disqualifying based on age alone.
Researchers developed a nomogram to predict early ICU readmission for surgical patients using seven common variables. The tool helps clinicians identify high-risk patients and prevent unnecessary readmissions by assessing their readiness to leave the SICU.
For patients with suspicious papillary thyroid cancer, lobectomy is associated with better outcomes and lower costs compared to total thyroidectomy. The study used a Markov model to determine the effectiveness of each procedure in terms of quality-adjusted life years.
A new study found that nearly three-fourths of patients who sustain major trauma and receive an opiate prescription discontinue use by one month after hospital discharge. Only a few factors, including older age, lower socioeconomic status, and longer hospital stays, increased the chance for prolonged opiate use.
A study found that nearly 30% of women with breast cancer are not getting the recommended annual mammogram and surveillance imaging. Factors such as younger age, black race, and lack of insurance are associated with underutilization of breast imaging.
Contralateral prophylactic mastectomy (CPM) is being performed at a rate more than double what it was 10 years ago, with fear of recurrence as the leading reason. Studies found that patients are misinformed about CPM being the best treatment for breast cancer, which may be driving its increased popularity.
Studies show that websites for pancreatic cancer treatment differ in their presentation of information. Researchers found that non-profit organizations' websites were more easily understood and recommended by patients. The study suggests that website usability and visuals play a significant role in patient recommendations.
A multicenter study of 1,015 major liver resections found that minimally invasive surgery (MIS) had significantly lower odds of serious morbidity and death in the short term compared to open operations. Risk of complications such as bile leak and readmission were similar between the two procedures.
Obese women who receive bariatric surgery before becoming pregnant have lower rates of cesarean sections and larger babies compared to those who don't. The study found a significant decrease in cesarean deliveries among women who underwent bariatric operations, with only 1% vs 38% in obese women without the procedure.
Trauma centers treating high proportions of uninsured patients would see significant gains in financial margins from Medicaid expansion, according to a nationwide study. The simulation model found nearly three times as many patients would gain health insurance through Medicaid in expansion states than non-expansion states.
A study using wearable activity trackers found that monitoring patients' postoperative functional recovery correlates strongly with reported complications, showing a median of 1,247 steps on day seven compared to preoperative daily steps.
A nationwide study found that infants from families with no health insurance or low income have a higher risk of death from sepsis. Those with severe illness and low birth weight were at the highest risk, with odds ratios as high as 36.1 and 4.8, respectively.
The study found that implementing a telephone postoperative clinic reduced in-person clinic visits by 44% while maintaining satisfactory patient outcomes. The clinic also increased access to care for patients with long travel distances, improving their overall experience.
A new study found that starting blood-thinning medications within 72 hours of hospital arrival significantly reduces the likelihood of life-threatening blood clots in patients with traumatic brain injury. The study also showed no increase in risk of bleeding complications or death.
A Canadian hospital implemented strategies to reduce operating room traffic, which led to a significant decrease in orthopedic surgical site infections. The hospital reduced door openings from 42-70 to 3.2 per case, resulting in a 1.7% decrease in SSIs.
An automated communication system has been shown to improve surgical patient engagement in preventing SSIs, with a high degree of patient acceptance. The system's two-pronged approach reminds patients to follow antibiotic protocols and reports signs of infection, reducing the risk of rehospitalization and treatment costs.
Researchers at Vanderbilt University Medical Center implemented blood utilization practice guidelines, resulting in a 30% reduction in blood transfusions and $2 million savings. The new guidelines also reduced blood wastage by 75%, from 300 to 80 units, improving patient outcomes and optimizing the use of this limited resource.
Patients undergoing bariatric surgery at accredited centers have lower risks of serious complications, including death, and experience lower hospital charges. The American College of Surgeons review study analyzed over 1 million patients and found significant benefits of accreditation.
A new study reveals that only 8% of patients with large, apparently benign polyps have cancer, suggesting advanced endoscopic treatments like EMR and ESD as viable options. This finding could improve patient outcomes, reduce complications, and lower healthcare costs.
A new study found that readmission rates after complex cancer operations are higher in hospitals serving vulnerable populations, such as those with high Medicaid patients or serving as safety nets. The study suggests that payment penalties tied to readmissions may create unintended consequences on financially strained institutions.
A free colonoscopy program for uninsured patients has been shown to detect cancer at an earlier stage and appears to be cost-neutral. The program, which was expanded to all hospitals in Louisville, is being hailed as a model for statewide implementation in Kentucky.
A new study has confirmed the accuracy of the ACS NSQIP Surgical Risk Calculator, which estimates a patient's risk of postoperative complications. The calculator will undergo recalibration to improve its performance, addressing minor distortions in estimating risk for low- and high-risk patients.
The Occupant Transportation Decision Algorithm (OTDA) helps emergency responders and hospitals evaluate a crash victim's need for trauma care by analyzing data from electronic data recorders on board vehicles. The algorithm can aid in triage, reducing overtriage and undertriage rates.
A simple 20-second arm test has been developed to rapidly and accurately identify physiological frailty in older adults, using wearable technology. The test showed high agreement with the gold standard frailty index, making it a valuable tool for surgeons to assess risk of postoperative complications.
A study found that a quality improvement initiative by the Centers for Medicare and Medicaid Services increased the removal of liver transplant candidates from the waiting list. The analysis of nationwide transplant data showed that over 4,300 Americans were delisted between 2007 and 2012 due to deteriorating illness.
The ACS-Military Health System Partnership is developing a pre-deployment course for military surgeons to prepare them for combat and disaster scenarios. The goal is to ensure the military's trauma system remains intact between conflicts, building on the successful Joint Trauma Theater System.
A study found that the number of open cholecystectomies performed by general surgery residents has decreased significantly since laparoscopic cholecystectomy was introduced 30 years ago. This decline is raising concerns about whether surgeons will have enough technical experience to perform traditional open cholecystectomy procedures.
A survey of program directors found that flexible work hour schedules improve the continuity of patient care without compromising patient safety. Directors also believed that flexible duty hours would positively affect patient safety, continuity of care, quality of resident education, and resident well-being.
The Memorial Sloan Kettering Cancer Center fellowship program successfully trains international surgeons to return home and perform cancer operations, addressing a significant gap in low- and middle-income countries.
The study found that trauma surgeons working with geriatricians improved multidisciplinary care for elderly accident victims, leading to reduced short-term mortality rates and ICU readmissions. The program increased referrals for cognitive evaluation and advanced directives, demonstrating the benefits of comprehensive clinical pathways.
A new process of moving donor management out of hospitals to freestanding facilities has been shown to be more efficient and cost-effective. This approach results in a higher number of suitable organs being recovered for transplant, with an average increase of 3.4 organs per donor.
The Critical Care Resuscitation Unit (CCRU) at the University of Maryland Medical Center has seen a significant increase in transfers of critically ill surgical patients, with median arrival times cut by nearly half and median time to surgery reduced by over two-thirds. This faster intake and treatment strategy has led to improved outc...
A new study suggests that patients with resectable pancreatic cancer should receive at least 6 months of adjuvant chemotherapy to reduce distant disease recurrences and improve overall survival. Chemotherapy, but not chemoradiotherapy, significantly reduces the incidence of distant recurrence.
A national multicenter randomized trial found that extending surgical trainees' shifts does not compromise patient safety. The study showed flexible duty hour policies reduced handoffs and increased residents' satisfaction with their training. The findings provide high-level evidence to inform resident duty hour policies.
A new study found that nearly two-thirds of women aged 70 and older with stage I breast cancer who are eligible to safely omit subsequent radiation therapy do not receive it. Despite guidelines recommending against radiation therapy for this group, the study suggests a lack of compliance or poor awareness among healthcare providers.
Researchers found that a 56-day interval after chemoradiotherapy is the best timeframe for overall survival and tumor downstaging. The study analyzed data from nearly 12,000 patients with advanced stage localized rectal cancer.
Expectant mothers treated at trauma centers experience better outcomes than those treated at non-trauma hospitals, with a 40% lower risk of preterm labor. The study also found decreased odds of premature birth, low birth weight, and meconium at delivery among neonates.
Enhanced recovery after surgery (ERAS) programs can save hospitals money by reducing patient lengths of stay and direct variable costs. Implementing ERAS protocols requires significant upfront investments, but the model shows that these costs are more than offset by savings.
A new collaborative best practices guideline has been released for optimal care of older adults before, during, and after surgical operations. The guideline provides expert recommendations for surgeons, anesthesiologists, and allied health care professionals to address postoperative complications and prolonged recovery in older patients.