Annals of surgery
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To determine the temporal relationship between reducing surgical complications and costs, using the study population of bariatric surgery. ⋯ When analyzing Medicare patients undergoing bariatric surgery, hospitals with the largest reductions in serious postoperative complications had the greatest decrease in per-patient payments. This study demonstrates the potential savings associated with quality improvement in high-risk surgical procedures.
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The aim of this study was to systematically review the risks and benefits of interventions designed to reduce intraoperative costs. ⋯ Almost all studies assessing interventions to reduce intraoperative costs have demonstrated cost savings with no apparent increase in adverse effects. Methodologic limitations, especially related to cost data, weaken the reliability of these estimates for most intervention categories. However, hospitals seeking to reduce costs may be able to do so safely by standardizing operative instruments or providing cost feedback to surgeons.
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To investigate safety and efficacy of temporary portal hemodynamics modulation with a novel percutaneously adjustable vascular ring (MID-AVR) onto a porcine model of 75% hepatectomy. ⋯ MID-AVR is safe for portal hemodynamics modulation. It might improve liver regeneration by protecting liver microarchitecture.
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To explore hospital-level variation in postoperative delirium using a multi-institutional data source. ⋯ Rates of postoperative delirium varied 8.5-fold across hospitals, and can feasibly be measured in surgical quality datasets. The model performed well with 10 to 12 variables and demonstrated applicability across surgical specialties. Such efforts are critical to better tailor quality improvement to older surgical patients.