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 Showing 21-40 of 136 Articles
Comment & Response 
Charles E. Edmiston Jr, PhD; David Leaper, MD

To the Editor We want to report incomplete potential conflict of interest disclosures for the Original Investigation entitled, “Evidence for a Standardized Preadmission Showering Regimen to Achieve Maximal Antiseptic Skin Surface Concentrations of Chlorhexidine Gluconate, 4%, in Surgical Patients,”1 which was published online in JAMA Surgery on ...

In the Original Investigation entitled “Evidence for a Standardized Preadmission Showering Regimen to Achieve Maximal Antiseptic Skin Surface Concentrations of Chlorhexidine Gluconate, 4%, in Surgical Patients” published online August 26, 2105, and in the November 2015 issue of JAMA Surgery,1 2 authors should have reported additional ...

Krislynn M. Mueck, MD, MPH; Luke R. Putnam, MD, MS; Lillian S. Kao, MD, MS

This Viewpoint discusses Standards for Quality Improvement Reporting Excellence (SQUIRE) 2.0 and how they can be used for to plan and design a quality improvement intervention.

Original Investigation 
Jeffrey H. Silber, MD, PhD; Paul R. Rosenbaum, PhD; Matthew D. McHugh, PhD, JD, RN, MPH; Justin M. Ludwig, MA; Herbert L. Smith, PhD; Bijan A. Niknam, BS; Orit Even-Shoshan, MS; Lee A. Fleisher, MD; Rachel R. Kelz, MD, MSCE; Linda H. Aiken, PhD, RN
Includes: Supplemental Content

Importance  The literature suggests that hospitals with better nursing work environments provide better quality of care. Less is known about value (cost vs quality).

Objectives  To test whether hospitals with better nursing work environments displayed better value than those with worse nursing environments and to determine ...

Invited Commentary: Revisiting Nursing’s Effect on Surgical Quality and Cost; Amir A. Ghaferi, MD, MS; Christopher R. Friese, PhD, RN, AOCN
Original Investigation 
Daniel I. McIsaac, MD, MPH, FRCPC; Gregory L. Bryson, MD, FRCPC, MSc; Carl van Walraven, MD, FRCPC, MSc
Includes: Supplemental Content

Importance  Single-center studies identify frailty as a risk factor for 30-day postoperative mortality. The long-term and population-level effect of frailty on postoperative mortality is, to our knowledge, poorly described, as are the interactions of frailty with important predictors of mortality.

Objective  To measure the population-level effect ...

Invited Commentary: Frailty and Mortality After Surgery in Elderly Individuals; Jason M. Johanning, MD, MS; Daniel Hall, MD, MDiv, MS; Shipra Arya, MD, MS
Invited Commentary 
Amir A. Ghaferi, MD, MS; Christopher R. Friese, PhD, RN, AOCN

Improvements in surgical safety remain an important focus of hospitals and clinicians. With nearly 100 000 patients dying per year in the United States after undergoing elective surgery and mortality rates varying from 2-fold to 10-fold across hospitals,13 excess surgical mortality qualifies as a significant public ...

Invited Commentary 
Jason M. Johanning, MD, MS; Daniel Hall, MD, MDiv, MS; Shipra Arya, MD, MS

Frailty is increasingly recognized as a key determinant of poor surgical outcomes. The impact of frailty assessment at the patient and system level has significant implications.

JAMA Surgery Clinical Challenge 
Dustin Y. Yoon, MD; Albert A. Nemcek, MD; Melina R. Kibbe, MD

An active man in his early 80s presented to the hospital with a 6-month history of cramping epigastric abdominal pain that occurred 30 minutes after eating solid food and was associated with nausea and vomiting. His medical history was significant for atrial fibrillation and a history of an ...

Comment & Response 
Julie L. Holihan, MD; Lillian S. Kao, MD, MS; Mike K. Liang, MD

In Reply We appreciate the comments and insight Dr Aanning shared regarding our study.1 Dr Aanning recommended repeating the baseline computed tomographic (CT) scan with the patient performing the Valsalva maneuver. Previous studies have suggested that the Valsalva maneuver can increase confidence in the diagnosis by making ...

Comment & Response 
Harald L. Aanning, MD

To the Editor Dr Holihan and colleagues1 have suggested that high interobserver variability limited the reliability of computed tomographic scans in diagnosing ventral hernia recurrence. We have repeated the baseline computed tomographic scan with a limited scan and with the patient performing the Valsalva maneuver. Any ventral ...

Original Investigation 
Brett L. Ecker, MD; Kristina D. Simmons, PhD; Salman Zaheer, MD; Sarah-Lucy C. Poe, MS; Edmund K. Bartlett, MD; Jeffrey A. Drebin, MD, PhD; Douglas L. Fraker, MD; Rachel R. Kelz, MD; Robert E. Roses, MD; Giorgos C. Karakousis, MD

Importance  Blood transfusion can be a lifesaving treatment for the surgical patient, yet transfusion-related immunomodulation may underlie the association of allogeneic transfusion with increased perioperative morbidity and possibly poorer long-term oncologic outcomes.

Objective  To evaluate trends in transfusion rates for major abdominal oncologic resections to assess ...

Invited Commentary: Evaluating Appropriate Blood Transfusion in Cancer Surgery; David D. Odell, MD, MMSc; Karl Y. Bilimoria, MD, MS
Original Investigation 
Eric M. Campion, MD; Catherine Juillard, MD, MPH; M. Margaret Knudson, MD; Rochelle Dicker, MD; Mitchell J. Cohen, MD; Robert Mackersie, MD; Andre R. Campbell, MD; Rachael A. Callcut, MD, MSPH

Importance  To date, a substantial portion of multiple casualty incident literature has focused exclusively on prehospital and emergency department resources needed for optimal disaster response. Thus, inpatient resources required to care for individuals injured in multiple casualty events are not well described.

Objective  To highlight the ...

Invited Commentary 
David D. Odell, MD, MMSc; Karl Y. Bilimoria, MD, MS

The desire to limit blood use in oncologic surgery originated with the finding of increased immunosuppression in patients who received transfusions while undergoing a renal transplant.1 Subsequently, an association was demonstrated between transfusion and increased rates of cancer recurrence and worse overall oncologic prognosis,2 with the ...

Surgical Innovation 
Sunil Singhal, MD

This article examines fluorescent labeling of tumor cells during surgery and its impact on intraoperative detection of cancer cells.

Comment & Response 
Russ S. Kotwal, MD, MPH; Howard R. Champion, FRCS; Kirby R. Gross, MD

In Reply We thank Lt Col Reade for his thoughtful and most pertinent comments, which highlight some very important points. We agree that the Injury Severity Score (ISS) is an imperfect tool for controlling for case mix in combat injury because it may underestimate complex battlefield wounds,1...

Comment & Response 
Michael C. Reade, MBBS, MPH, DPhil, FCICM

To the Editor The study by Kotwal et al1 demonstrating a lower case fatality rate and (adjusted for Injury Severity Score) a lower killed in action rate after the 2009 mandate to transport wounded US military casualties from the battlefield in Afghanistan is a resounding endorsement of ...

Michael Nurok, MBChB, PhD; Nicholas Sadovnikoff, MD; Bruce Gewertz, MD

This Viewpoint argues for the importance of interdisciplinary care in surgery and medicine, and proposes ways to incentivize physicians to move beyond assertion of individual control of patient care.

Original Investigation 
Tracy Smith, MS; Xinli Li, PhD; William Nylander, MD, MBA; William Gunnar, MD, JD
Includes: Supplemental Content

Importance  For more than 2 decades, the Veterans Health Administration (VHA) has relied on risk-adjusted, postoperative, 30-day mortality data as a measure of surgical quality of care. Recently, the use of 30-day mortality data has been criticized based on a theory that health care professionals manage patient ...

Invited Commentary: Thirty-Day Postoperative Mortality; Kamal M. F. Itani, MD
Original Investigation 
Sigrid Bjerge Gribsholt, MD; Ane Mathilde Pedersen, MD; Elisabeth Svensson, PhD; Reimar Wernich Thomsen, PhD; Bjørn Richelsen, DMSc
Includes: Supplemental Content

Importance  Population-based studies on the prevalence of symptoms after Roux-en-Y gastric bypass (RYGB) surgery are sparse. Knowledge about possible predictors of these symptoms is important for prevention.

Objectives  To examine patients’ overall well-being and the prevalence and predictors of medical, nutritional, and surgical symptoms after RYGB ...

Invited Commentary 
Kamal M. F. Itani, MD

In March 2015, The New York Times reported on a patient in her 90s who underwent valve replacement surgery complicated by progressive deterioration.1 The surgeons were optimistic that she would recover, recommended aggressive care, and deferred palliative care options until postoperative day 30, by which time the ...

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