American journal of surgery
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Comparative Study
Availability of acute care surgeons improves outcomes in patients requiring emergent colon surgery.
The need for emergent colon surgery is a common cause of severe sepsis/septic shock and mortality among surgical patients. We wanted to benchmark our outcomes against those of the National Surgical Quality Improvement Program (NSQIP). We hypothesized that having acute care surgeons to provide comprehensive perioperative care and rapid source control surgery would improve outcome. ⋯ Patients with severe sepsis/septic shock requiring emergent colon surgery have a high mortality rate. Delivery of comprehensive emergency surgical care by acute care surgeons appears to improve survival.
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Comparative Study
Gender influences outcomes in trauma patients with elevated systolic blood pressure.
This analysis explored the association between gender and systolic blood pressure (SBP) in trauma patients and then established how gender influenced outcomes in those with elevated SBP. ⋯ In this retrospective review of trauma registry data, men presented with higher SBP. In patients with TBI, regardless of gender, increased SBP was associated with increased pneumonia, and in men with TBI increased SBP was associated with increased mortality. The cause and relevance of these epidemiological findings require further investigation.
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It has been suggested that specific cervical spine fractures (CSfx) (location at upper cervical spine [CS], subluxation, or involvement of the transverse foramen) are predictive of blunt cerebrovascular injury (BCVI). We sought to determine the incidence of BCVI with CSfx in the absence of high-risk injury patterns. ⋯ We propose that all CS fracture patterns warrant screening for BCVI.
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The aim of this study was to analyze national trends in minimally invasive and open cases of all graduating residents in general surgery. ⋯ The results of this study demonstrate that general surgery residents in the United States are performing a greater number of minimally invasive and fewer open procedures for common surgical conditions.
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Comparative Study
What is the likelihood of requiring contralateral inguinal hernia repair after unilateral repair?
Factors that predispose patients to the development of inguinal hernias will persist after repair. This study aimed to determine the incidence of future contralateral hernia repair. ⋯ Despite a reported 8% to 22% incidence of clinically unsuspected contralateral inguinal hernia, the likelihood of undergoing contralateral repair within 10 years is low at 3.8%.