0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
In This Issue of JAMA Surgery |

Highlights FREE

JAMA Surg. 2014;149(7):625. doi:10.1001/jamasurg.2013.3489.
Text Size: A A A
Published online

RESEARCH

Kim and colleagues designed a predictive model for adverse outcomes in older surgical patients. In a single-institution prospective cohort study, they performed a comprehensive geriatric assessment (CGA) of 275 elderly patients (aged ≥65 years) undergoing elective operation. A multidimensional frailty score (MFS) was established using the results of the CGA, and it was shown that the MFS is more useful than conventional methods for predicting the outcomes of geriatric patients.

Racial disparities in survival after trauma are well described for patients younger than 65 years. Similar information among older patients is lacking because existing trauma databases do not include important patient comorbidity information. Using a unique method for extracting trauma and comorbidity data on more than 1 million patients from the Nationwide Inpatient Sample (2003-2010), Hicks et al demonstrate that different racial disparities in survival after trauma exist between white and black patients depending on their age group. Although younger white patients have better outcomes after trauma than younger black patients, older black patients have better outcomes than older white patients.

There is growing interest in the use of health care resources by critical access hospitals (CAHs), key providers of medical care for many rural populations. Gadzinski et al used data from the Nationwide Inpatient Sample and American Hospital Association to perform a retrospective cohort study of patients undergoing common inpatient surgical procedures at CAHs or non-CAHs. They found that hospital transfers occur more often after surgical admissions at CAHs. However, the proportion of patients at CAHs using post–acute care is equal to or lower than that of patients treated in non-CAHs.

Brown and coauthors evaluate the effect of hospital length of stay and the occurrence of postoperative complications on total charges in patients undergoing elective pancreaticoduodenectomy. They performed a retrospective review of 89 cases identified in an institutional database of patients who underwent elective pancreaticoduodenectomy at an academic tertiary care center from December 1, 2007, through May 31, 2012, and concluded that efforts should be directed instead at reducing complications because this has a much more significant effect on financial outcomes.

Emerging data support bariatric surgery as a therapeutic strategy for management of type 2 diabetes. Halperin et al performed a 1-year pragmatic randomized trial to test the feasibility of methods to conduct a larger multisite trial to determine the long-term effect of Roux-en-Y gastric bypass surgery compared with an intensive diabetes medical and weight management program for type 2 diabetes. They found that patients in the surgical group were more likely to achieve glycemic, blood pressure, and lipid targets at 1 year.

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

812 Views
0 Citations
×

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs