Archives of surgery (Chicago, Ill. : 1960)
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To examine the ability of the model for end-stage liver disease (MELD) score to predict the risk of mortality in trauma patients with cirrhosis. Although cirrhosis is associated with poor outcomes after injury, the relative effect of the severity of the cirrhosis on outcomes is unclear. The MELD score is a prospectively developed and validated scoring system, which is associated with increasing severity of hepatic dysfunction and risk of death in patients with chronic liver disease. ⋯ The MELD score is a simple objective tool for risk stratification in cirrhotic patients who have sustained injury.
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Gastroesophageal reflux disease (GERD) is common in patients with end-stage lung disease (ESLD). GERD may cause obliterative bronchiolitis after lung transplantation (LTx), represented by a decline in forced expiratory volume in 1 second (FEV(1)). ⋯ There should be a low threshold for performing objective esophageal testing including esophageal impedance because GERD may be occult and ARS may improve or prolong allograft and native lung function.
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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.