Annals of surgery
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To identify if depression, resilience, and perceived control of health are related to 2.5-year mortality and instrumental activities of daily living (IADL) decline among older adults after surgery. ⋯ While depression confers greater risk of mortality and IADL decline, higher resilience and perceived control of health may be protective. Addressing psychosocial factors in the peri-operative period may improve outcomes among older adults.
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To establish whether Accreditation Council for Graduate Medical Education Milestones predict future performance of general surgery trainees. ⋯ The Milestones features that were most predictive of better patient outcomes related to intraoperative skills, ethical principles, and patient navigation and safety, measured 12-18 months prior to graduation. The development of a parsimonious set of evidence-based Milestones that better correlate with surgeon experience could enhance surgical education.
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To examine the association between surgeon gender and early postoperative complications, including 30-day death and readmission, in elective surgery. ⋯ These results support that surgeon gender is not associated with early postoperative outcomes, including mortality, readmission, or other complications in elective surgery. These findings encourage patients, healthcare providers, and stakeholders not to consider surgeon gender as a risk factor for postoperative complications.
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We evaluated the efficacy of risk-based, protocol-driven management versus (vs) usual management after elective major cancer surgery to reduce 30-day rates of postoperative death or serious complications (DSC) . ⋯ Risk-based, protocol-driven management did not reduce 30-day rate of DSC after elective major cancer surgery compared to usual management, nor improve postoperative health care utilization, HRQOL, or cancer outcomes. Trials are needed to identify cost-effective, tailored perioperative strategies to optimize outcomes after major cancer surgery.