Archives of surgery (Chicago, Ill. : 1960)
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Comparative Study
Predicting the risk of perioperative mortality in patients undergoing pancreaticoduodenectomy: a novel scoring system.
To develop and validate a risk score to predict the 30- and 90-day mortality after a pancreaticoduodenectomy or total pancreatectomy on the basis of preoperative risk factors in a high-volume program. ⋯ The risk scores accurately predicted 30- and 90-day mortality after pancreatectomy. They may help identify and counsel high-risk patients, support and calculate net benefits of therapeutic decisions, and control for selection bias in observational studies as propensity scores.
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Comparative Study
Differential association of race with treatment and outcomes in Medicare patients undergoing diverticulitis surgery.
Observed racial disparities in diverticulitis surgery have been attributed to differences in health insurance status and medical comorbidity. ⋯ Blacks underwent urgent/emergency surgery more often than did whites. Blacks demonstrated significantly increased mortality risk after controlling for age, sex, and comorbidities. These findings suggest that observed racial disparities encompass more than just insurance status and medical comorbidity. Mechanisms leading to worse outcomes for blacks must be elucidated.
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Comparative Study
Career phase of board-certified general surgeons: workload composition and outcomes.
To examine surgeon career phase and its association with surgical workload composition and outcomes of surgery. ⋯ Late-career GSs perform both better and worse compared with early-career GSs, relative to their workload composition and proportional surgical volume. Factors such as training and case complexity may contribute to these career-phase differences.
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To determine whether postoperative cardiac care by cardiothoracic surgeons in a semiclosed intensive care unit model could be distinguished from that given by intensivists who are not board certified in cardiothoracic surgery. ⋯ By virtue of their cardiac-specific operative and nonoperative training, cardiothoracic surgeons may be uniquely qualified to provide postoperative cardiac critical care. In a semiclosed unit where care of the patient is codirected, the improvements noted may have been facilitated by the commonalities between surgeons and intensivists associated with similar training and experiences.