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 Showing 1-20 of 68 Articles
Original Investigation 
Gaya Spolverato, MD; Yuhree Kim, MD, MPH; Aslam Ejaz, MD, MPH; Steven M. Frank, MD; Timothy M. Pawlik, MD, MPH, PhD
Includes: Supplemental Content

Importance  Delta hemoglobin (ΔHb), defined as the difference between the preoperative hemoglobin (Hb) level and the nadir Hb level during a patient’s hospitalization, may be associated with adverse outcomes even if the absolute level of Hb remains greater than the transfusion threshold of 7 g/dL.

Objective  ...

Invited Commentary: Determining When Patients Need Transfusions; Samuel A. Tisherman, MD
Invited Commentary 
Samuel A. Tisherman, MD

Blood transfusions save lives but carry risks, including immunosuppression, infections, and transfusion reactions. For stable patients, a restrictive transfusion strategy (transfusions for a hemoglobin [Hb] level of <7 g/dL [to convert to grams per liter, multiply by 10.0]) is safe, possibly beneficial, and saves money.13...

Review  FREE
Luke M. Funk, MD, MPH; Sally Jolles, MA; Laura E. Fischer, MD, MS; Corrine I. Voils, PhD
Includes: Supplemental Content

Importance  Although bariatric surgery is the most cost-effective treatment for severe obesity, less than 1% of severely obese patients undergo it. Reasons for this low use are unclear.

Objectives  To identify patient and referring practitioner characteristics associated with the likelihood of undergoing bariatric surgery.

Evidence Review...

Research Letter 
Dennis Y. Kim, MD; Nariman Nassiri, MD, MPH; Christian de Virgilio, MD; Michael P. Ferebee; Amy H. Kaji, MD, PhD; Camille E. Hamilton, BA; Darin J. Saltzman, MD, PhD

This study identifies clinical variables associated with the presence of complicated appendicitis.

Research Letter 
Elliott R. Haut, MD, PhD; Brandyn D. Lau, MPH, CPH; Peggy S. Kraus, PharmD; Deborah B. Hobson, BSN; Bhunesh Maheshwari, MBBS; Peter J. Pronovost, MD, PhD; Michael B. Streiff, MD

This study attempts to characterize the true preventability of venous thromboembolism (VTE) by identifying the proportion of patients with VTE who had received “defect-free care.”

Original Investigation  FREE
Aaron J. Dawes, MD; Greg D. Sacks, MD, MPH; H. Gill Cryer, MD, PhD; J. Peter Gruen, MD; Christy Preston, RN; Deidre Gorospe, RN; Marilyn Cohen, RN; David L. McArthur, PhD, MPH; Marcia M. Russell, MD; Melinda Maggard-Gibbons, MD, MSHS; Clifford Y. Ko, MD, MS, MSHS; for the Los Angeles County Trauma Consortium
Includes: Supplemental Content

Importance  Compliance with evidence-based guidelines in traumatic brain injury (TBI) has been proposed as a marker of hospital quality. However, the association between hospital-level compliance rates and risk-adjusted clinical outcomes for patients with TBI remains poorly understood.

Objective  To examine whether hospital-level compliance with the Brain ...

Invited Commentary: Determining Outcomes After Traumatic Brain Injury; Martin A. Schreiber, MD
Original Investigation 
Jesse D. Pasternak, MD; Carolyn D. Seib, MD, MSc; Natalie Seiser, MD, PhD; J. Blake Tyrell, MD; Chienying Liu, MD; Robin M. Cisco, MD; Jessica E. Gosnell, MD; Wen T. Shen, MD, MA; Insoo Suh, MD; Quan-Yang Duh, MD

Importance  Adrenal incidentalomas are found in 1% to 5% of abdominal cross-sectional imaging studies. Although the workup and management of unilateral lesions are well established, limited information exists for bilateral incidentalomas.

Objective  To compare the natural history of patients having bilateral incidentalomas with those having unilateral ...

Invited Commentary: Nonoperative Management of Bilateral Adrenal Incidentalomas; Linwah Yip, MD; Sally E. Carty, MD
Original Investigation 
Jeffrey D. Crawford, MD; Kevin M. Allan, BS; Karishma U. Patel; Kyle D. Hart, PhD; Martin A. Schreiber, MD; Amir F. Azarbal, MD; Timothy K. Liem, MD; Erica L. Mitchell, MD; Gregory L. Moneta, MD; Gregory J. Landry, MD

Importance  The Denver criteria grade blunt cerebrovascular injuries (BCVIs) but fail to capture many patients with indeterminate findings on initial imaging.

Objective  To evaluate outcomes and clinical significance of indeterminate BCVIs (iBCVIs).

Design, Setting, and Participants  A retrospective review of all patients treated for BCVIs ...

Invited Commentary 
Martin A. Schreiber, MD

Dawes and colleagues1 have evaluated the relationship between compliance with the Brain Trauma Foundation guidelines and outcomes in patients with traumatic brain injury (TBI) in a consortium of 14 hospitals in Los Angeles County. They found wide variance in compliance within the consortium and no association between ...

Invited Commentary 
Jason T. Lee, MD

The increasing reliance on and relative availability of high-quality cross-sectional imaging of vascular structures has altered the workup of patients with blunt trauma. Traditional 2-dimensional angiography and the extensive resources necessary to perform these procedures in critically injured patients have largely been replaced by rapid computed tomography angiography ...

Invited Commentary 
Linwah Yip, MD; Sally E. Carty, MD

Incidentally identified adrenal nodules are seen bilaterally in as many as 17% of patients as reported in Pasternak et al.1 The management of patients with bilateral incidentalomas presents a clinical challenge and is optimized with a multidisciplinary and experienced approach that is highlighted beautifully in this high-volume ...

Comment & Response 
Jonathan Alistair Cook, PhD; Gary S. Collins, PhD

To the Editor We read with great interest the study by Tevis et al1 describing the development of a nomogram to predict the 30-day risk of readmission for patients following hospital discharge after general surgery. However, deficiencies in the methods and in the reporting limit the usefulness ...

Comment & Response 
Sarah E. Tevis, MD; Gregory D. Kennedy, MD, PhD

In Reply The letter by Cook and Collins focuses on the details of the nomogram equation and promotes the use of the Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD) Statement developed by their group.1 We acknowledge that individuals with a background ...

Haile T. Debas, MD

This Viewpoint discusses the recent developments in global surgery and the future of global surgery in the United States.

Original Investigation 
D. Peter O’Leary, PhD; Noel Lynch, MCh; Cillian Clancy, MB; Desmond C. Winter, MD; Eddie Myers, MD

Importance  This Delphi study provides consensus related to many aspects of acute diverticulitis and identifies other areas in need of research.

Objective  To generate an international, expert-based, consensus statement to address controversies in the management of acute diverticulitis.

Design, Setting, and Participants  This study was ...

Original Investigation  FREE
Jerry J. Kim, MD; Dennis Y. Kim, MD; Amy H. Kaji, MD, PhD; Edward D. Gifford, MD; Christopher Reid, MD; Richard A. Sidwell, MD; Mark E. Reeves, MD, PhD; Thomas H. Hartranft, MD; Kenji Inaba, MD; Benjamin T. Jarman, MD; Chandrakanth Are, MD; Joseph M. Galante, MD; Farin Amersi, MD; Brian R. Smith, MD; Marc L. Melcher, MD, PhD; M. Timothy Nelson, MD; Timothy Donahue, MD; Garth Jacobsen, MD; Tracey D. Arnell, MD; Christian de Virgilio, MD
Includes: Supplemental Content

Importance  Few large-scale studies have quantified and characterized the study habits of surgery residents. However, studies have shown an association between American Board of Surgery In-Training Examination (ABSITE) scores and subsequent success on the American Board of Surgery Qualifying and Certifying examinations.

Objectives  To identify the ...

The study by Kim et al1 in this issue of JAMA Surgery provides excellent guidance for both residents and residency program directors. The authors report the results of an anonymous survey of 266 residents from 15 diverse residency programs that explored their study habits and attitudes about ...

JAMA Surgery Clinical Challenge 
Roberto J. Vidri, MD; Michael P. Vezeridis, MD

A woman in her mid-50s presented to the clinic with a 6-month history of progressive swelling and pain on the right side of her neck. What is your diagnosis?

Original Investigation 
Trit Garg, BA; Laurence C. Baker, PhD; Matthew W. Mell, MD, MS

Importance  The Society for Vascular Surgery recommends annual surveillance with computed tomography (CT) or ultrasonography after endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysms. However, such lifelong surveillance may be unnecessary for most patients, thereby contributing to overuse of imaging services.

Objective  To investigate whether ...

Invited Commentary: Follow-up Surveillance After Endovascular Aneurysm Repair; Andrew W. Hoel, MD; Andres Schanzer, MD
Original Investigation  FREE
Aimee E. Gough, MD; Steven Chang, MD; Subhash Reddy, MBBS; Lisa Ferrigno, MD; Marc Zerey, MD; Jonathan Grotts, MA; Samantha Yim, BSN; David S. Thoman, MD
Includes: Supplemental Content

Importance  Laparoscopic ventral hernia repair (LVHR) using mesh is a well-established intervention for ventral hernia, but pain control can be challenging.

Objective  To determine whether instillation of a long-acting local anesthetic between the mesh and the peritoneum after LVHR reduces pain or narcotic requirements.

Design, Setting, ...

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