Annals of surgery
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Comparative Study
Comparison between civilian burns and combat burns from Operation Iraqi Freedom and Operation Enduring Freedom.
To assess outcome differences between locally burned civilians and military personnel burned in a distant combat zone treated in the same facility. ⋯ Mortality does not differ between civilians evacuated locally and military personnel injured in distant austere environments treated at the same center.
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The purpose of this study was to determine the relationship between the American Society of Anesthesiologists' Physical Status (ASA PS) classifications and the other National Surgical Quality Improvement Program (NSQIP) preoperative risk factors. ⋯ The NSQIP risk factors other than ASA PS can and should be used to validate ASA PS classifications.
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There is a documented association between critically ill patients who are in refractory shock and adrenal insufficiency. The underlying pathophysiology may be related to ischemia, necrosis, reperfusion, or resuscitative dilution. We hypothesize this blunted adrenal response is due to ischemia and necrosis of the adrenal parenchyma. ⋯ Our model suggests that ischemia and necrosis of the adrenal glands may be responsible for the adrenal insufficiency seen in patients with hemorrhagic shock. Further research may enable clinicians to discern earlier which patients will benefit from adrenal corticoid replacement.
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Multicenter Study Comparative Study Clinical Trial
Laparoscopic versus open gastric bypass for morbid obesity: a multicenter, prospective, risk-adjusted analysis from the National Surgical Quality Improvement Program.
To compare laparoscopic versus open gastric bypass procedures with respect to 30-day morbidity and mortality rates, using multi-institutional, prospective, risk-adjusted data. ⋯ Multicenter, prospective, risk-adjusted data show that laparoscopic gastric bypass is safer than open gastric bypass, with respect to 30-day complication rate.
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Improving patient safety is an increasing priority for surgeons and hospitals since sentinel events can be catastrophic for patients, caregivers, and institutions. Patient safety initiatives aimed at creating a safe operating room (OR) culture are increasingly being adopted, but a reliable means of measuring their impact on front-line providers does not exist. ⋯ Safety climate in surgical departments can be validly measured and varies widely among hospitals, providing the opportunity to benchmark performance. Scores on the SAQ can serve to evaluate interventions to improve patient safety.