Annals of surgery
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To create a novel comorbidity score tailored for surgical database research. ⋯ The CORE score may better predict in-hospital mortality after surgery due to comorbid diseases in outcome-based research.
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To determine whether state-level SEAD policies are associated with pediatric firearm homicides and suicides. ⋯ Professional Development and Student, Family and Community Engagement policies are associated with lower rates of pediatric firearm homicides, however, there was no significant association between pediatric firearm deaths and summary SEAD measures after adjustment. Certain SEAD policies may be helpful in decreasing pediatric firearm deaths.
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To identify characteristics associated with high- and low-quality multi-hospital systems for major cancer surgery. ⋯ The highest-quality multi-hospital systems had fewer, more geographically concentrated hospitals, with each performing more procedures per hospital. Among the highest-quality systems, diverse system phenotypes were represented, suggesting the potential to overcome structural limitations and achieve high quality.
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To investigate the impact of total pancreatectomy (TP) on oncological outcomes for patients at high-risk of local recurrence or secondary progression in the remnant gland after partial pancreatectomy (PP) for IPMN-associated cancer. ⋯ Since overall, patients with diffuse or multifocal IPMN with an invasive component do not benefit from TP in terms of OS, the indication for TP may be individualized to young patients who have sufficient life expectancy to benefit from the prevention of secondary progression or local recurrence.
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To determine the proportion and characteristics of injured rural residents treated at urban trauma centers (TCs), urban non-trauma centers (NTCs), rural TCs, and rural NTCs. ⋯ Rural non-trauma centers provided initial care for more than half of injured rural residents, including 2 in 5 of those with the most severe injuries, and managed more than 3 in 4 definitively. These hospitals may be an under-recognized component of the US trauma system.