Archives of surgery (Chicago, Ill. : 1960)
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Despite limited evidence of effect, β-blocker continuation has become a national quality improvement metric. ⋯ β-Blocker continuation on the day of and after surgery was associated with fewer cardiac events and lower 90-day mortality. A focus on β-blocker continuation is a worthwhile quality improvement target and should improve patient outcomes.
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Multicenter Study
Successful nonoperative management of the most severe blunt liver injuries: a multicenter study of the research consortium of new England centers for trauma.
Grade 4 and grade 5 blunt liver injuries can be safely treated by nonoperative management (NOM). ⋯ Nonoperative management was offered safely in two-thirds of grade 4 and grade 5 blunt liver injuries, with a 91.3% success rate. Only 6.5% of patients with NOM required a delayed operation because of liver-specific issues, and none experienced life-threatening complications because of the delay.
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Comparative Study
Routine same-day discharge after acute or interval appendectomy in children: a prospective study.
The outcomes of and parental satisfaction with same-day discharge in children undergoing laparoscopic appendectomy warrant making it the usual and customary pathway. ⋯ Routine same-day discharge after pediatric appendectomy seems safe, with good parental satisfaction.
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Multicenter Study
Long-term and perioperative corticosteroids in anastomotic leakage: a prospective study of 259 left-sided colorectal anastomoses.
To determine the risk factors for symptomatic anastomotic leakage (AL) after colorectal resection. ⋯ We found a significantly increased incidence of AL in patients treated with long-term corticosteroids and perioperative corticosteroids for pulmonary comorbidity. Therefore, we recommend that in this patient category, anastomoses should be protected by a diverting stoma or a Hartmann procedure should be considered to avoid AL.