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 Showing 1-20 of 93 Articles
Karan R. Chhabra, MD; Justin B. Dimick, MD, MPH

This Viewpoint considers 3 nuances of the policy debate regarding the regionalization of high-risk surgery by restricting care to high-volume centers of excellence.

Original Investigation 
Derek E. Go, MS; Daniel E. Abbott, MD; Koffi Wima, MS; Dennis J. Hanseman, PhD; Audrey E. Ertel, MD, MS; Alex L. Chang, MD; Shimul A. Shah, MD, MHCM; Richard S. Hoehn, MD
Includes: Supplemental Content

Importance  Safety-net hospitals care for vulnerable patients, providing complex surgery at increased costs. These hospitals are at risk due to changing health care reimbursement policies and demand for better value in surgical care.

Objective  To model different techniques for reducing the cost of complex surgery performed ...

Invited Commentary: Quality of Care and Cost at Safety-Net Hospitals; Taylor S. Riall, MD, PhD; Purvi Parikh, MD
Invited Commentary 
Taylor S. Riall, MD, PhD; Purvi Parikh, MD

In this issue of JAMA Surgery, Go et al1 use University HealthSystem Consortium data to demonstrate that high-burden hospitals (HBHs), while providing a safety net and caring for the most severely ill patients, had worse outcomes and higher costs after pancreaticoduodenectomy compared with low-burden hospitals (LBHs) ...

Surgical Innovation 
Paul D. DiMusto, MD; Herbert Chen, MD; K. Craig Kent, MD

This article discusses a hands-on training program that allows surgeons in practice to scrub alongside an expert, providing 1-on-1 exposure to new techniques and surgical skills.

Research Letter 
Joshua D. Brown, PharmD, MS; Jeffery C. Talbert, PhD

This study determines whether differences in the use of vena cava filters in hospitals in Kentucky can be explained by observable factors rather than potential reimbursement upcoding.

Original Investigation 
Michael L. Pezold, MD; Andrea L. Pusic, MD, MHS; Wess A. Cohen, MD; James P. Hollenberg, MD; Zeeshan Butt, PhD; David R. Flum, MD, MPH; Larissa K. Temple, MD

Importance  Identifying timely and important research questions using relevant patient-reported outcomes (PROs) in surgery remains paramount in the current medical climate. The inaugural Patient-Reported Outcomes in Surgery (PROS) Conference brought together stakeholders in PROs research in surgery with the aim of creating a research agenda to help ...

Invited Commentary: Defining a Valid Research Agenda; Lisa M. Kodadek, MD; Brandyn D. Lau, MPH, CPH; Elliott R. Haut, MD, PhD
Original Investigation 
Garth H. Utter, MD, MSc; Tejveer S. Dhillon, MD, MAS; Edgardo S. Salcedo, MD; Daniel J. Shouldice, BS; Cassandra L. Reynolds, MD; Misty D. Humphries, MD, MAS; Richard H. White, MD

Importance  Deep vein thrombosis (DVT) isolated to the calf veins (distal to the popliteal vein) is frequently detected with duplex ultrasonography and may result in proximal thrombosis or pulmonary embolism (PE).

Objective  To evaluate whether therapeutic anticoagulation is associated with a decreased risk for proximal DVT ...

Invited Commentary: Significance of Isolated Calf Vein Thrombosis; Xuan-Binh D. Pham, MD; Christian de Virgilio, MD
Original Investigation 
A. Rani Elwy, PhD; Kamal M. F. Itani, MD; Barbara G. Bokhour, PhD; Nora M. Mueller, MAA; Mark E. Glickman, PhD; Shibei Zhao, MPH; Amy K. Rosen, PhD; Dana Lynge, MD; Melissa Perkal, MD; Erica A. Brotschi, MD; Vivian M. Sanchez, MD; Thomas H. Gallagher, MD
Includes: Supplemental Content

Importance  Surgeons are frequently faced with clinical adverse events owing to the nature of their specialty, yet not all surgeons disclose these events to patients. To sustain open disclosure programs, it is essential to understand how surgeons are disclosing adverse events, factors that are associated with reporting ...

Invited Commentary 
Lisa M. Kodadek, MD; Brandyn D. Lau, MPH, CPH; Elliott R. Haut, MD, PhD
Invited Commentary 
Xuan-Binh D. Pham, MD; Christian de Virgilio, MD

Clotting or bleeding? Which is worse? Surgeons grapple with this age-old conundrum every day. When we err on the side of withholding anticoagulants, we face the former, whereas aggressive blood thinning inevitably risks the latter. With the growing body of evidence that calf deep vein thrombosis (DVT) can ...

JAMA Surgery Clinical Challenge 
Nitin Vashistha, MS; Rakesh Tandon, MD, PhD; Dinesh Singhal, MS

A young adult presented with a progressively growing abdominal lump that left him feeling a dull ache and heavy. Ten weeks previously he was hospitalized and conservatively managed for acute pancreatitis. What is your diagnosis?

Research Letter 
Joseph Featherall, BS; Jacob A. Miller, BS; E. Emily Bennett, MD; Daniel Lubelski, MD; Hannah Wang, BS; Tagreed Khalaf, MD; Ajit A. Krishnaney, MD

This study compares surgical site infections and costs of care for patients undergoing spinal surgery before and after implementation of an infection prevention bundle in the neurosurgical unit of the Cleveland Clinic.

Wiley W. Souba, MD, ScD, MBA

This Viewpoint discusses resilience as a response to work stressors and burnout, and argues that shifting the “frame” through which challenges are perceived can lead to more resilient leadership.

Original Investigation 
Julia R. Berian, MD; Sanjay Mohanty, MD, MS; Clifford Y. Ko, MD, MS, MSHS; Ronnie A. Rosenthal, MS, MD; Thomas N. Robinson, MD, MS

Importance  Older adults are at increased risk for adverse events after surgical procedures. Loss of independence (LOI), defined as a decline in function or mobility, increased care needs at home, or discharge to a nonhome destination, is an important patient-centered outcome measure.

Objective  To evaluate LOI ...

Invited Commentary: Focus on Surgical Outcomes That Matter to Older Patients; Anne M. Suskind, MD, MS; Emily Finlayson, MD, MS
Original Investigation 
Itamar Ashkenazi, MD; William P. Schecter, MD; Kobi Peleg, PhD; Adi Givon, BA; Oded Olsha, MB, BS; Fernando Turegano-Fuentes, MD; Ricardo Alfici, MD; and the Israeli Trauma Group

Importance  Head injury following explosions is common. Rapid identification of patients with severe traumatic brain injury (TBI) in need of neurosurgical intervention is complicated in a situation where multiple casualties are admitted following an explosion.

Objective  To evaluate whether Glasgow Coma Scale (GCS) score or the ...

Invited Commentary 
Anne M. Suskind, MD, MS; Emily Finlayson, MD, MS

Loss of independence is a devastating life change for older adults. Compared with younger individuals, older adults value functional independence over morbidity when rating factors that are important to their general well-being.1 Although most of the surgical literature focuses on morbidity and mortality as measures of surgical ...

Marisa Pulcrano, BA; Stephen R. T. Evans, MD; Michael Sosin, MD
Includes: Supplemental Content

Importance  Establishing strategies to minimize the burden of burnout and poor quality of life (QOL) on surgeons relies on a thorough understanding of QOL and burnout among the various surgical specialties.

Objectives  To systematically review the literature across multiple surgical specialties and provide a comprehensive understanding ...

Research Letter 
Misty Humphries, MD; Mandy K. Blume, BS; Maria Ceja Rodriguez, BS; Joseph J. DuBose, MD; Joseph M. Galante, MD

This cohort study examines associations between anticoagulation during arterial repair or bypass and repair thrombosis or limb amputation among patients with traumatic vascular injury of the extremities.

Original Investigation 
Marcel J. van der Poel, BSc; Marc G. Besselink, MD, MSc, PhD; Federica Cipriani, MD; Thomas Armstrong, MD, PhD; Arjun S. Takhar, MD, PhD; Susan van Dieren, PhD; John N. Primrose, MD, PhD, FRCS; Neil W. Pearce, MD, FRCS; Mohammad Abu Hilal, MD, PhD, FRCS

Importance  Widespread implementation of laparoscopic hemihepatectomy is currently limited by its technical difficulty, paucity of training opportunities, and perceived long and harmful learning curve. Studies confirming the possibility of a short and safe learning curve for laparoscopic hemihepatectomy could potentially benefit the further implementation of the technique....

Invited Commentary: Learning Curve in Laparoscopic Major Hepatectomy; Susannah M. Cheek, MD; David A. Geller, MD
Original Investigation 
Ara Ko, MD, MPH; Megan Y. Harada, BA; Galinos Barmparas, MD; Kevin Chung, PharmD; Russell Mason, PharmD; Dorothy A. Yim, BS; Navpreet Dhillon, MD; Daniel R. Margulies, MD; Bruce L. Gewertz, MD; Eric J. Ley, MD
Includes: Supplemental Content

Importance  Trauma patients are at high risk for developing venous thromboembolism (VTE). The VTE rate when enoxaparin sodium is dosed by anti–factor Xa (anti-Xa) trough level is not well described.

Objective  To determine whether targeting a prophylactic anti-Xa trough level by adjusting the enoxaparin dose would ...

Invited Commentary: Anti–Factor Xa Assay—A Changing Standard for Venous Thromboprophylaxis?; Kristin Cook, MD; Massimo Napolitano, MD; Frank T. Padberg Jr, MD

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