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 Showing 1-20 of 101 Articles
Krishnan Raghavendran, MD; Mahesh C. Misra, MBBS, MS; Michael W. Mulholland, MD, PhD

This Viewpoint discusses improving delivery of care to surgical/trauma patients in the developing world through collaborations with academic institutions, such as the University of Michigan–All India Institutes of Medical Sciences collaborative.

Original Investigation  FREE
Shayna Sarosiek, MD; Denis Rybin, PhD; Janice Weinberg, ScD; Peter A. Burke, MD; George Kasotakis, MD, MPH; J. Mark Sloan, MD

Importance  Trauma patients admitted to the hospital are at increased risk of bleeding and thrombosis. The use of inferior vena cava (IVC) filters in this population has been increasing, despite a lack of high-quality evidence to demonstrate their efficacy.

Objective  To determine if IVC filter insertion ...

Invited Commentary: Inferior Vena Cava Filters in Trauma Patients; Paul Waltz, MD; Brian S. Zuckerbraun, MD
Original Investigation 
Chad Ellimoottil, MD, MS; Andrew M. Ryan, PhD; Hechuan Hou, MS; James M. Dupree, MD, MPH; Brian Hallstrom, MD; David C. Miller, MD, MPH
Includes: Supplemental Content

Importance  Under the Comprehensive Care for Joint Replacement (CJR) model, hospitals are held accountable for nearly all Medicare payments that occur during the initial hospitalization until 90 days after hospital discharge (ie, the episode of care). It is not known whether unrelated expenditures resulting from this “broad” ...

Original Investigation 
Charles A. Karcutskie, MD, MA; Jonathan P. Meizoso, MD; Juliet J. Ray, MD; Davis Horkan, MD; Xiomara D. Ruiz, MD; Carl I. Schulman, MD, PhD, MSPH; Nicholas Namias, MD, MBA; Kenneth G. Proctor, PhD

Importance  To date, no study has assessed whether the risk of venous thromboembolism (VTE) varies with blunt or penetrating trauma.

Objective  To test whether the mechanism of injury alters risk of VTE after trauma.

Design, Setting, and Participants  A retrospective database review was conducted of ...

Invited Commentary: Prevention of Venous Thromboembolism in the Trauma Population; Christopher R. Ramos, MD; Luke P. Brewster, MD, PhD
Invited Commentary 
Paul Waltz, MD; Brian S. Zuckerbraun, MD

Venous thromboembolism (VTE) and subsequent pulmonary embolism represent a major source of morbidity and mortality.1 Trauma patients are a population with a variety of risk factors for the development of VTE, coupled with potential complicating injuries that may prevent the use of pharmacologic prophylaxis. Therefore, insertion of ...

Invited Commentary 
Christopher R. Ramos, MD; Luke P. Brewster, MD, PhD

In this issue of JAMA Surgery, a retrospective review by Karcutskie et al1 funded by the US Navy and Army examines 813 patients with blunt trauma and 324 patients with penetrating trauma to identify different contributors to the risk of venous thromboembolism (VTE) according to type ...

This study identifies variation in open Roux-en-Y gastric bypass surgeries by health insurance status.

Research Letter 
Lane L. Frasier, MD; Sudha R. Pavuluri Quamme, MD, MS; Aimee Becker, MD; Sara Booth, RN, BSN; Adam Gutt, RN, BSN; Douglas Wiegmann, PhD; Caprice C. Greenberg, MD, MPH

This exploratory qualitative study engaged stakeholders as part of an attempt to design and implement best practice guidelines or team training interventions to enhance communication and teamwork in the operating room.

Research Letter 
Hillary J. Mull, PhD, MPP; Amy K. Rosen, PhD; Steven D. Pizer, PhD; Kamal M. F. Itani, MD

This case-control study examines postoperative outcomes following in Veterans Administration ambulatory surgery centers vs hospital outpatient departments in patients who underwent inguinal hernia surgery.

Original Investigation 
Bryan Sakamoto, MD, PhD; Gene Harker, MD, PhD; Andrew C. Eppstein, MD; Kenneth Gwirtz, MD
Includes: Supplemental Content

Importance  Quality of recovery (directly associated with patient satisfaction) is an important clinical outcome measurement and a surrogate of anesthetic/surgical care quality.

Objectives  To compare the efficacy of a transversus abdominis plane (TAP) block with dexamethasone sodium phosphate and preperitoneal instillation of local anesthetic (PILA) with ...

Original Investigation 
Mark D. Tyson, MD; Amy J. Graves, MS, MPH; Brock O’Neil, MD; Daniel A. Barocas, MD, MPH; Sam S. Chang, MD, MBA; David F. Penson, MD, MPH; Matthew J. Resnick, MD, MPH
Includes: Supplemental Content

Importance  The reporting of individual urologist rates of observation for localized prostate cancer may be a valuable performance measure with important downstream implications for patient and payer stakeholder groups. However, few studies have examined the urologist-level variation in the use of observation across all risk strata of ...

Original Investigation 
Nader N. Massarweh, MD, MPH; Panagiotis Kougias, MD, MSc; Mark A. Wilson, MD, PhD

Importance  The quality of surgical care in the Veterans Health Administration improved markedly in the 1990s after implementation of the Veterans Affairs (VA) National Surgical Quality Improvement Program (now called the VA Surgical Quality Improvement Program). Although there have been many recent evaluations of surgical care in ...

Invited Commentary: Codman, Hawthorne, and End Results of a Watched System; Jason M. Johanning, MD, MS; Shipra Arya, MD, SM
Invited Commentary 
Jason M. Johanning, MD, MS; Shipra Arya, MD, SM

Ever since Ernest A. Codman first advocated measuring outcomes of patients through End Results Cards,1 the goal of surgical quality has been to study the results of operative intervention and improve those results through systematic analysis. The article by Massarweh et al2 clearly documents that the ...

Sakamoto and colleagues1 present a randomized, prospective, single-blinded study examining early recovery after bilateral laparoscopic inguinal hernia repair. One treatment group had a transversus abdominis block (TAP) performed by the anesthesiologist, while another group had preperitoneal installation of local anesthetic (PILA) and dexamethasone by the surgeon. A ...

JAMA Surgery Clinical Challenge 
Christopher Mehta, MD; Kirtee Raparia, MD; Ankit Bharat, MD

A man in his 40s training for weight-lifting presented with new-onset progressive dizziness, lightheadedness, and shortness of breath. What is your diagnosis?

Research Letter 
Michael Jones, MD; Stephen Johans, MD; Andrea Ziegler, MD; Kevin C. Welch, MD; Monica O. Patadia, MD; Chirag R. Patel, MD; Anand V. Germanwala, MD

This study examines if outcomes of veterans undergoing endoscopic endonasal skull base surgery in the VA system rival those in other published studies.

Matthew J. Levy, DO, MSc; Lenworth M. Jacobs, MD, MPH

This Viewpoint discusses the importance of recommendations for all responders, including bystanders, to have the education and necessary equipment to stop severe bleeding, similar to use of cardiopulmonary resuscitation and automated external defibrillators.

Original Investigation 
Kelly R. Haisley, MD; Amy E. Laird, PhD; Nima Nabavizadeh, MD; Ken M. Gatter, MD, JD; John M. Holland, MD; Gina M. Vaccaro, MD; Charles R. Thomas Jr, MD; Paul H. Schipper, MD; John G. Hunter, MD; James P. Dolan, MD, MCR

Importance  Pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (CRT) may be a clinical prognostic marker of superior outcomes. In patients with esophageal cancer, pCR is associated with increased survival. While mechanisms for increasing the likelihood of pCR remain unknown, in other solid tumors, higher rates of pCR ...

Original Investigation 
Frank A. Lederle, MD; Kevin T. Stroupe, PhD; Tassos C. Kyriakides, PhD; Ling Ge, MS; Julie A. Freischlag, MD; for the Open vs Endovascular Repair (OVER) Veterans Affairs Cooperative Study Group
Includes: Supplemental Content

Importance  Because of the similarity in clinical outcomes after elective open and endovascular repair of abdominal aortic aneurysm (AAA), cost may be an important factor in choosing a procedure.

Objective  To compare total and AAA-related use of health care services, costs, and cost-effectiveness between groups randomized ...

Invited Commentary: Cost Equipoise; Gilbert R. Upchurch Jr, MD
Original Investigation 
Hilde Risstad, MD; Marius Svanevik, MD; Jon A. Kristinsson, MD, PhD; Jøran Hjelmesæth, MD, PhD; Erlend T. Aasheim, MD, PhD; Dag Hofsø, MD, PhD; Torgeir T. Søvik, MD, PhD; Tor-Ivar Karlsen, PhD; Morten W. Fagerland, MSc, PhD; Rune Sandbu, MD, PhD; Tom Mala, MD, PhD
Includes: Supplemental Content

Importance  Up to one-third of patients undergoing bariatric surgery have a body mass index (BMI) of more than 50. Following standard gastric bypass, many of these patients still have a BMI greater than 40 after peak weight loss.

Objective  To assess the efficacy and safety of ...

Invited Commentary: Bariatric Surgery in Patients With BMI Greater Than 50; Oliver A. Varban, MD; Justin B. Dimick, MD, MPH

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