Annals of surgery
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To assess the impact of obesity on morbidity and mortality in severely burned patients. ⋯ Overall, obesity was not associated with increased morbidity and mortality. Subgroup analysis revealed that patients with mild obesity have the best survival, whereas morbidly obese patients have the highest mortality. (NCT00257244).
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To determine whether risk-adjusted colorectal SSI rates are statistically reliable as hospital quality measures. ⋯ As currently constructed, colorectal SSI quality measures might not meet a high standard of statistical reliability for most hospitals, limiting their ability to confidently differentiate high and low performance. Despite an expectation of improving statistical power, combining superficial and deep/organ-space SSI into an "any SSI" measure worsens reliability.
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Observational Study
Effect of major and minor surgery on plasma levels of arginine, citrulline, nitric oxide metabolites, and ornithine in humans.
To determine the effect of surgical invasiveness on plasma levels of arginine, citrulline, ornithine, and nitric oxide (NO) in humans. ⋯ The level of surgical invasiveness has the most profound effect on plasma levels of ornithine. In addition, heavier surgical trauma is paired with lower postoperative levels of citrulline and NO metabolites than lighter surgery. It is suggested that surgical trauma stimulates the laparotomy group to consume significantly more ornithine, possibly for use in wound healing.
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To evaluate long-term outcomes after splenectomy for massive splenomegaly in a series of 222 consecutive patients. ⋯ Splenectomy for massive splenomegaly can be performed safely and offers durable palliation. Preoperative transfusion requirement is an indicator of hematological disease severity and predictor of decreased survival.
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Review Meta Analysis
Preoperative alcohol consumption and postoperative complications: a systematic review and meta-analysis.
To systematically review and summarize the evidence of the association between preoperative alcohol consumption and postoperative complications elaborated on complication type. ⋯ Preoperative alcohol consumption was associated with an increased risk of general postoperative morbidity, general infections, wound complications, pulmonary complications, prolonged stay at the hospital, and admission to intensive care unit.