Journal of the American College of Surgeons
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Multicenter Study Observational Study
Multicenter Observational Study Examining the Implementation of Enhanced Recovery within the Virginia Surgical Quality Collaborative in Patients Undergoing Elective Colectomy.
The American College of Surgeons (ACS) NSQIP Virginia Surgical Quality Collaborative (VSQC) exists to improve surgical outcomes through multi-institutional collaboration. Enhanced recovery (ER) protocols improve morbidity and reduce length of stay (LOS) after elective surgery. We hypothesized implementation of ER through VSQC would reduce postoperative complications and LOS in patients undergoing elective colectomy. Our objective was to evaluate whether standardization of care based on evidenced-based practices in healthcare settings across multiple institutions improved outcomes. ⋯ Implementation of ER across VSQC was associated with reduction in LOS and complications in patients undergoing elective laparoscopic colectomy.
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Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been increasingly used as part of damage control resuscitation for patients with non-compressible truncal hemorrhage. We hypothesized that there might be a select group of patients that could have benefited from prehospital placement of the REBOA. ⋯ Our data suggest that >10% of trauma patients who presented with cardiac arrest could have benefited from prehospital REBOA. Additional prospective studies are warranted to validate the use of field vital signs in selecting candidates.