Archives of surgery (Chicago, Ill. : 1960)
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To evaluate associations among hospital volume, costs, and length of stay (LOS) and to assess whether reduced hospital cost of care adversely affected quality of care. ⋯ Higher hospital volume is predictive of lower costs and LOS for patients undergoing gastric resection. By referring these patients to high-volume centers, we may improve quality of care and reduce costs. Furthermore, high-quality care can be maintained when costs are lowered due to high volume.
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To evaluate the effect of physician volume and specialty and hospital volume on population-level outcomes after endovascular repair of aortoiliac occlusive disease (AIOD). ⋯ Overall, volume at the physician and hospital levels appears to be a robust predictor of patient outcomes after endovascular interventions for AIOD. Surgeons performing endovascular procedures for AIOD have a decreased associated hospital cost compared with nonsurgeons.
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To determine the current incidence of postinjury abdominal compartment syndrome (ACS), the effect of intra-abdominal hypertension (IAH) on trauma outcomes, and the independent predictors of postinjury IAH. ⋯ Most of the severe shock/trauma patients developed sustained IAH. Based on univariate and multivariate analyses, there was no difference in outcomes between the trauma patients with IAH and those without. Multiple logistic regression analysis failed to show IAH as a predictor of MOF. The attenuation of the deadly ACS to a less deleterious IAH could be considered a success of the last decade in trauma and critical care.
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To evaluate outcomes of patients who undergo surgery with a do-not-resuscitate (DNR) order. ⋯ Surgical patients with DNR orders have significant comorbidities; many sustain postoperative complications, and nearly 1 in 4 die within 30 days of surgery. Do-not-resuscitate status appears to be an independent risk factor for poor surgical outcome.