American journal of surgery
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Hospital ranking systems are often used by individuals to inform choice around which healthcare system may be best equipped to manage their care. ⋯ Rank position among hospitals within the USNWR "honor roll" was not associated with differences in patient outcomes following surgical intervention. Patients and hospitals need to exercise caution when placing weight on rank-position among hospitals as a means to discriminate clinical outcomes and quality of actual patient care.
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The preoperative and intraoperative factors that could predict a higher risk of anastomotic/staple line leak for gastric cancer patients has not been accurately defined. ⋯ In a large single-institutional study, POCs were associated with decreased survival in patients undergoing surgery for gastric adenocarcinoma. Optimizing these patients post-operatively with limited anastomotic stress and enteral feeding tube may allow for a less complicated course.
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Comparative Study
Comparison of prescribing patterns before and after implementation of evidence-based opioid prescribing guidelines for the postoperative urologic surgery patient.
We developed evidence-based guidelines for postoperative opioid prescribing after urologic surgery and assessed changes in prescribing after implementation. ⋯ Fewer opioids were prescribed after implementing a prescribing guideline. Additional study is required to assess patient opioid utilization.
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Injuries are a leading cause of preventable morbidity and mortality in children. Mechanisms of injuries and presentations are diverse in pediatric injuries and require special attention. Dedicated pediatric trauma care centers are ideal for management of children with injuries simultaneously serving as sources of research data. The objective of the current study was to identify changes in injury mechanisms, modifiable risk factors, and outcomes independently associated with admissions at a large pediatric trauma center in Tampa, Florida. ⋯ Significant reductions in LOS, ICU stay, and complications were temporally observed despite an increase in admissions with higher use of helicopter transport. These results can most likely be attributed to dedicated pediatric trauma experts and resources available at an integrated pediatric trauma center.
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Editorial Historical Article
Surgeons, plague, and leadership: A historical mantle to carry forward.