JAMA surgery
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Multicenter Study Observational Study
Postoperative Behavioral Variables and Weight Change 3 Years After Bariatric Surgery.
Severe obesity (body mass index ≥35 [calculated as weight in kilograms divided by height in meters squared]) is associated with significant medical comorbidity and increased mortality. Bariatric surgery induces weight loss, the extent of which can vary. Postoperative predictors of weight loss have not been adequately examined. ⋯ The results suggest the importance of assessing behaviors related to eating behavior, eating problems, weight control practices, and the problematic use of alcohol, smoking, and illegal drugs in bariatric surgery candidates and patients who have undergone bariatric surgery, and they suggest that the utility of programs to modify problematic eating behaviors and eating patterns should be addressed in research.
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Reduction of postoperative readmissions has been identified as an opportunity for containment of health care costs. To date, the effect of index hospitalization costs on subsequent readmissions, however, has not been examined. ⋯ Thirty-day readmission rates among patients undergoing major abdominal surgery vary significantly. Higher index hospitalization costs did not translate into lower readmission rates.
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The number of practicing pediatric surgeons has increased rapidly in the past 4 decades, without a significant increase in the incidence of rare diseases specific to the field. Maintenance of competency in the index procedures for these rare diseases is essential to the future of the profession. ⋯ Practicing pediatric surgeons receive limited exposure to index cases after training. With regard to maintaining competency in an era in which health care outcomes have become increasingly important, these results are concerning.
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Total hip replacement is a commonly performed orthopedic procedure for the treatment of painful arthritis, osteonecrosis, or fracture. ⋯ Data derived from patients in the New York and California State Inpatient Database were reliably able to explain readmission variability for patients in the Florida and Washington State Inpatient Database at a rate of 89.1% based on known preoperative risk factors. Risk-stratification models, such as the Readmission After Total Hip Replacement Risk Scale, can identify high-risk patients for readmission and permit implementation of patient-specific readmission-reduction strategies to reduce readmissions and health care expenditures.