The Journal of surgical research
-
Participation of women at national surgery conferences is an important aspect of achieving gender equity; however, participation has to be meaningful and representative of scientific and clinical achievement. We hypothesized that the presence of women on planning committees would increase the number of women speakers and the presence of women as moderators would increase the number of women panelists. Furthermore, we hypothesized that although women may be included as speakers, they are less likely to speak on clinical and technical surgical topics than men. ⋯ Despite increasing attention on improving diversity at surgical conferences, disparities continue to persist. As demonstrated in nonsurgical literature, planning committee gender diversity positively correlated with speaker diversity, and moderator diversity positively correlated with panel diversity. Women were more likely to speak on topics considered "soft sciences", such as professionalism and advocacy, and less likely to present on clinical topics, technical skill, or scientific research.
-
Multicenter Study Comparative Study
Management of Penetrating Traumatic Brain Injury: Operative versus Non-Operative Intervention.
Penetrating traumatic brain injury (pTBI) is the most lethal form of TBI, with mortality rates as high as 90%. This high mortality rate leads many providers to feel that the treatment of pTBI is futile. Contrary to this point of view, several studies have shown that victims of pTBI who present with a Glasgow Coma Scale (GCS) ≥6 have a reasonable chance of a meaningful outcome. This study sought to investigate outcomes of pTBI patients based on GCS score who underwent neurosurgical intervention (craniotomy or craniectomy) and compare them with patients who did not undergo surgical intervention. ⋯ Surgical intervention in pTBI patients with GCS 3-5 results in improved mortality but comes at a cost of increased resource utilization in the form of longer LOS and higher infection rate. On the other hand, in patients with GCS ≥6, surgery does not provide significant benefits in patient survival. Future prospective studies providing insight as to the impact of surgery on the resource utilization and quality of survival would be beneficial in determining the need for surgical intervention in this population.
-
Necrotizing soft-tissue infections (NSTIs) encompass a group of severe, life-threatening diseases with high morbidity and mortality. Evidence suggests advanced age is associated with worse outcomes. To date, no large data sets exist describing outcomes in older individuals, and risk factor identification is lacking. ⋯ In our Medicare data set, we identified several medical comorbidities that are associated with increased rates of in-hospital mortality. Patients with underlying cancers had the highest odds of increased mortality. The effect on outcomes of the potentially immunosuppressive cancer treatments in these patients is unknown. These data suggest that patients with underlying illnesses, especially cancer, kidney disease, or liver disease have higher mortalities and are more likely to be discharged to skilled nursing facilities or rehab. It is unclear why these illnesses were associated with these worse outcomes while others including diabetes and heart disease were not. These data suggest that these particular comorbid illnesses may have special prognostic implications, although further analysis is necessary to identify the causative factors.
-
Comparative Study
Platelet Transfusion After Traumatic Intracranial Hemorrhage in Patients on Antiplatelet Agents.
With an aging population, the number of patients on antiplatelet medications and traumatic brain injury (TBI) is increasing. Our study aimed to evaluate the role of platelet transfusion on outcomes after traumatic intracranial bleeding (IB) in these patients. ⋯ Level III prognostic.
-
Intravenous Iron in a Prehabilitation Program for Older Surgical Patients: Prospective Cohort Study.
Older patients often have iron deficiency anemia before surgery, which can be effectively treated with intravenous iron supplementation (IVIS). Anemia and blood transfusions are associated with an increased risk of delirium. The aim of this research was to assess the effectiveness and safety of using IVIS in a prehabilitation program. ⋯ Adding IVIS to prehabilitation programs is safe and diminishes differences in these concentrations between preoperatively anemic and nonanemic patients. IVIS may be worthwhile as an additional component of prehabilitation programs. Results merit further investigation.