Annals of surgery
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Multicenter Study
Updated Alternative Fistula Risk Score (ua-FRS) to Include Minimally Invasive Pancreatoduodenectomy: Pan-European Validation.
The aim of the study was to validate and optimize the alternative Fistula Risk Score (a-FRS) for patients undergoing minimally invasive pancreatoduodenectomy (MIPD) in a large pan-European cohort. ⋯ The updated a-FRS (www.pancreascalculator.com) now includes male sex as a risk factor and is validated for both MIPD and open pancreatoduodenectomy. The increased risk of POPF in laparoscopic MIPD was associated with single-row pancreatojejunostomy, which should therefore be discouraged.
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Randomized Controlled Trial
Prehospital Blood Product and Crystalloid Resuscitation in the Severely Injured Patient: A Secondary Analysis of the Prehospital Air Medical Plasma Trial.
The aim of this study was to determine whether prehospital blood products reduce 30-day mortality in patients at risk for hemorrhagic shock compared with crystalloid only resuscitation. ⋯ Patients receiving prehospital PRBC+plasma had the greatest mortality benefit. Crystalloid only had the worst survival. Patients with hemorrhagic shock should receive prehospital blood products when available, preferably PRBC+plasma. Prehospital whole blood may be ideal in this population.
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To determine the effect of a previously unassessed measure of quality-preventable hospitalization rate-on mortality after oncologic surgery for 4 procedures with established volume-outcome relationships. We hypothesize that hospitals with higher preventable hospitalization rates (indicating poor quality of primary care) have increased hospital mortality. Additionally, patients having surgery at hospitals with higher preventable hospitalization rates have increased mortality. ⋯ Preventable hospitalization rates could serve as warning signs of low quality of care and be a publically-reported quality measure.
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To compare the reoperation rate for recurrence of different lightweight to heavyweight meshes after an open anterior mesh (OAM) inguinal hernia repair. ⋯ Although lightweight meshes with partially absorbable component resulted in an increased risk of recurrence, there was no difference between regular LWM-PP and HWM. Considering that regular LWM-PP has less associated side effects there are no benefits of using HWM in OAM inguinal hernia repair.
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Diverse teams have proven their ability to reach superior performance and improve patients' outcomes. Nevertheless, differences in race, gender, age, nationality, skills, education, and experience act as powerful barriers to diversity and inclusion, which negatively impacts multiple healthcare organizations and limit the potential outcome of diverse teams. Knowledge Translation (KT) can help to bridge the gaps among all the various individuals involved, whether they be members of the surgical team or surgical patients.