Archives of surgery (Chicago, Ill. : 1960)
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Multicenter Study Comparative Study
Surgical site infections in colon surgery: the patient, the procedure, the hospital, and the surgeon.
To determine the role of the surgeon in the occurrence of surgical site infection (SSI) following colon surgery, with respect to his or her adherence to guidelines and his or her experience. ⋯ For reasons beyond adherence to guidelines or experience, the surgeon may constitute an independent risk factor for SSI after colon surgery.
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Multicenter Study Comparative Study
Incorrect surgical procedures within and outside of the operating room: a follow-up report.
To describe incorrect surgical procedures reported from mid-2006 to 2009 from Veterans Health Administration medical centers and build on previously reported events from 2001 to mid-2006. ⋯ The rate of reported adverse events and harm decreased, while reported close calls increased. Despite improvements, we aim to achieve further gains. Current plans and actions include sharing lessons learned from root cause analyses, policy changes based on root cause analysis review, and additional focused Medical Team Training as needed.
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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.