American journal of surgery
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Few studies have assessed the impact of pre-existing medical comorbidities on long-term survival after major trauma. This study investigated the influence of comorbidities as measured by the Charlson Comorbidity Index (CCI) on the 1-year mortality after major traumatic injury. ⋯ Comorbid illnesses have an important influence on long-term outcomes after major trauma. Whether this represents an inherent risk for adverse outcome or an opportunity for enhanced medical co-management remains to be defined.
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The national incidence of postoperative urinary retention (POUR), its risk factors, and associated outcomes are not well understood. ⋯ Patients at risk for POUR can be identified, and they may benefit from interventions to prevent POUR.
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The standard paradigm for acutely injured patients involves evaluation in an emergency department (ED). Our center has employed a policy for bypassing the ED and proceeding directly to the operating room (OR) based on prehospital criteria. ⋯ Our DOR protocol identified a severely injured cohort at high risk for requiring surgery with improved observed survival. High-yield triage criteria for DOR admission include a penetrating truncal injury, hypotension, and a severely altered mental status.
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Randomized Controlled Trial
Is double-gloving really protective? A comparison between the glove perforation rate among perioperative nurses with single and double gloves during surgery.
Surgical teams rely on surgical gloves as a barrier to protect themselves against blood-borne pathogenic infections during surgery. Double-gloving is adopted by surgeons to tackle the problem of glove perforation. Nevertheless, double-gloving is not practiced commonly by operating room nurses and there are only limited studies about double-gloving that targets only perioperative nurses. The aim of this research was to assess the effectiveness of double-gloving in protecting perioperative nurses by comparing the frequency of glove perforation between single-gloving and double-gloving groups. ⋯ Based on the findings of the study, double-gloving is indeed effective in protecting operating room nurses against blood-borne pathogen exposure. It should be introduced as a routine practice.
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Multicenter Study
Assessment for frailty is useful for predicting morbidity in elderly patients undergoing colorectal cancer resection whose comorbidities are already optimized.
The clinical syndrome of frailty identified through the assessment of weight loss, gait speed, grip strength, physical activity, and physical exhaustion has been used to identify patients with reduced reserves. We hypothesized that frailty is useful in predicting adverse outcomes in optimized elective elderly colorectal surgery patients. ⋯ Preliminary findings show that frailty is a potent adjunctive tool of predicting postoperative morbidity. Frailty can be used to identify elderly patients needing further optimization before major surgery.