Arch Surg Chicago
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Variation in postoperative complications after abdominal aortic surgery contributes to differences in mortality between high- and low-volume hospitals. ⋯ The effect of hospital volume on mortality after abdominal aortic surgery is attributable to differences in postoperative complications and not preoperative differences in case-mix. Efforts to reduce the rates of postoperative complications may reduce mortality rates at low-volume hospitals.
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Negative appendectomy (NA)--the nonincidental removal of a normal appendix--occurs commonly but the associated clinical- and system-level costs are not well studied. ⋯ There are significant clinical and financial costs incurred by patients undergoing NA during the treatment of presumed appendicitis. These should be considered when evaluating system-level interventions to improve the management of appendicitis.
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Biography Historical Article
Frank Waxham and Charles Truax's Intubation of the larynx.
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Blood components undergo changes during storage that may affect the recipient, including the release of bioactive agents, with significant immune consequences. We hypothesized that transfusion of old blood increases infection risk in severely injured patients. ⋯ Transfusion of old blood is associated with increased infection after major injury. Other options, such as leukocyte-depleted blood or blood substitutes, may be more appropriate in the early resuscitation of trauma patients requiring transfusion.
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Focused abdominal sonography for trauma (FAST) is an unreliable method for assessing intra-abdominal injury in patients with seat belt marks. ⋯ This study confirms that FAST cannot reliably exclude intestinal injury in patients with seat belt marks.