American journal of surgery
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Randomized Controlled Trial
Use of ketorolac is associated with decreased pneumonia following rib fractures.
The effectiveness of the nonsteroidal anti-inflammatory drug ketorolac in reducing pulmonary morbidity after rib fractures remains largely unknown. ⋯ Early administration of ketorolac to patients with rib fractures is associated with a decreased likelihood of pneumonia, without apparent risks.
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Comparative Study
Interhospital transfer of blunt multiply injured patients to a level 1 trauma center does not adversely affect outcome.
Stops at nontrauma centers for severely injured patients are thought to increase deaths and costs, potentially because of unnecessary imaging and indecisive/delayed care of traumatic brain injuries (TBIs). ⋯ Interhospital transfer does not affect the outcome of blunt trauma patients. However, the unnecessarily prolonged stay of low GCS patients in hospitals lacking neurosurgical care is inappropriate.
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Multicenter Study Comparative Study
Abdominal wall reconstruction in the obese: an assessment of complications from the National Surgical Quality Improvement Program datasets.
This study utilizes the American College of Surgeons National Surgical Quality Improvement Program database to better understand the impact of obesity on perioperative surgical morbidity in abdominal wall reconstruction (AWR). ⋯ Although the incidence of complications increased with obesity, obesity itself does not appear to increase the odds of perioperative morbidity. Specific care should be given to VTE prophylaxis and to preventing renal complications.
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The aim of this study was to characterize patients readmitted following inpatient general surgery procedures. We hypothesized that a decreased length of stay would increase risk for readmission. ⋯ Contributors to postoperative readmissions are multifactorial. Perioperative factors predict risk for readmission and may help determine a target length of stay. Prevention of postoperative complications may reduce readmission rates.