Archives of surgery (Chicago, Ill. : 1960)
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To investigate the clinical relevance of the TLR4 11367 polymorphism in patients with major trauma. ⋯ Combined with our previous in vitro functional study, the results suggest that the TLR4 11367 polymorphism might be a good predictor of who is more likely to develop complications such as sepsis or multiple organ dysfunction syndrome, depending on genotype.
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To determine whether quality measures based on injury-specific models provide a different perspective about relative hospital rankings compared with a single outcome measure based on all trauma patients. ⋯ A single composite measure based on all injured patients may not capture all the differences in hospital quality across different populations of injured patients.
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To identify rapidly modifiable risk factors that would improve surgical outcomes in elderly patients undergoing emergent colorectal procedures who are at high risk for morbidity and mortality. ⋯ Emergent colorectal procedures in the elderly are associated with significant morbidity and mortality. Minimizing the delay to definitive operative care may improve outcomes. These procedures frequently involve locally advanced colorectal cancer, emphasizing the need for improved colorectal cancer screening.
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Multicenter Study Comparative Study
Identification of specific quality improvement opportunities for the elderly undergoing gastrointestinal surgery.
Specific complications occur more frequently in elderly patients undergoing major gastrointestinal (GI) tract operations that may represent opportunities for quality improvement. ⋯ Morbidity and mortality are markedly higher in older patients. Quality measures for the elderly currently address only myocardial infarction, surgical site infection, and deep venous thrombosis. If care for the elderly is to be improved, quality improvement initiatives need to be expanded to include postoperative pulmonary and renal complications.
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Randomized Controlled Trial Comparative Study
Effect of stitch length on wound complications after closure of midline incisions: a randomized controlled trial.
In midline incisions closed with a single-layer running suture, the rate of wound complications is lower when a suture length to wound length ratio of at least 4 is accomplished with a short stitch length rather than with a long one. ⋯ In midline incisions closed with a running suture and having a suture length to wound length ratio of at least 4, current recommendations of placing stitches at least 10 mm from the wound edge should be changed to avoid patient suffering and costly wound complications.