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 Showing 81-100 of 101 Articles
Todd A. Jaffe, BBA; Steven J. Hasday, BS; Justin B. Dimick, MD, MPH

This Viewpoint explores the limits of the methods used in the Surgeon Scorecard, uses laparoscopic cholecystectomy data to illustrate the inherent statistical challenges the Scorecard faces, and suggests improvements for future surgical performance assessments.

Original Investigation 
Lynne Moore, PhD; François Lauzier, MD, MSc, FRCPC; Henry T. Stelfox, MD, PhD, FRCPC; John Kortbeek, MD, FRCSC; Richard Simons, MA, FRCSC; Simon Berthelot, MD, MSc, FRPCP; Julien Clément, MD, FRCSC; Gilles Bourgeois, MD; Alexis F. Turgeon, MD, MSc, FRCPC
Includes: Supplemental Content

Importance  The rate of complications among injury admissions has been estimated to be more than 3 times that observed for general admissions, and complications have been targeted as an important quality-of-care metric. Despite the negative effect of complications on resource use and patient mortality and morbidity, there ...

Original Investigation 
Matthias Bock, MD, Priv Doz; Antonio Fanolla, MS; Isabelle Segur-Cabanac, MD; Franco Auricchio, MD; Carla Melani, MS; Flavio Girardi, MD; Horand Meier, MD; Armin Pycha, MD
Includes: Supplemental Content

Importance  The appropriately coached implementation of surgical safety checklists (SSCs) reduces the incidence of perioperative complications and 30-day mortality of patients undergoing surgery. The association of the introduction of SSCs with 90-day mortality remains unclear.

Objective  To assess the association between the implementation of SSCs and ...

Invited Commentary: The Surgical Checklist; William Berry, MD, MPH; Alex Haynes, MD, MPH; Janaka Lagoo, MD
Invited Commentary 
William Berry, MD, MPH; Alex Haynes, MD, MPH; Janaka Lagoo, MD

Surgical safety checklists (SSCs) are associated with reductions in postoperative morbidity and mortality and have now achieved widespread implementation, although the quality of implementation remains unclear in many settings.1,2 In this issue of JAMA Surgery, Bock and colleagues3 evaluate the effect of introducing ...

Comment & Response 
Simon Erridge; Swathikan Chidambaram

To the Editor We would first like to thank Hatoum et al1 for their contribution to the discussion on identifying improved predictors of the response of comorbidities to bariatric surgery. In their study,1 they determined remission of comorbidities via records of diagnosis and prescription drug fills. ...

Original Investigation 
Marco Milone, MD; Loredana Maria Sosa Fernandez, MD; Mario Musella, MD; Francesco Milone, MD
Includes: Supplemental Content

Importance  Video-assisted ablation of pilonidal sinus (VAAPS) is a new minimally invasive treatment based on the complete removal of the sinus cavity with a minimal surgical wound.

Objective  To validate the safety and efficacy of VAAPS.

Design, Setting, and Participants  From January 1, 2012, through ...

Research Letter 
Breanne V. Britton, BA; Neeraja Nagarajan, MD, MPH; Cheryl K. Zogg, MSPH, MHS; Shalini Selvarajah, MD, MPH; Maya J. Torain, BS; Ali Salim, MD; Adil H. Haider, MD, MPH

This pilot study assesses US surgeons’ awareness of racial/ethnic disparities in surgical outcomes and processes of surgical care.

Comment & Response 
David N. Blitzer, BA; Rajan Gupta, MD; Gregory L. Peck, DO

To the Editor We read the insightful Viewpoint by Debas1 describing the “emergence and future of global surgery.” Indeed, we agree with the need for competency standards, societal involvement, and resource support as means to sustainability, but we suggest the following additional points: (1) encouraging surgeons early ...

Comment & Response 
Kathleen M. Casey, MD; Alexander A. Hannenberg, MD

To the Editor We applaud the recent Viewpoint by Debas1 calling for the formation of a “Consortium for Global Surgery” composed of academic institutions and surgical associations and organizations. Coordination and collaboration will be essential in effectively mobilizing assets from the United States and beyond to address ...

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.

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 ...

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 ...

Comment & Response 
David J. R. Morgan, MBBS, FACEM, FCICM; Kwok M. Ho, MBBS, FCICM, FANZCA, PhD

To the Editor We read with interest the recently published article by Bhatti et al,1 not the least because of the wide media coverage that this article has received around the world since its release.26 By the very nature of it being a retrospective, ...

Comment & Response 
Junaid A. Bhatti, MBBS, MSc, PhD; Avery B. Nathens, MD, PhD, FRCSC; Donald A. Redelmeier, MD, MSHSR, FRCPC

In Reply Morgan and Ho are concerned that media reporting of only relative increases in the risk of self-harm might mislead health policy makers and the public. We agree, and therefore provide actual counts, so that readers can judge absolute risks and the number needed to harm.1...

Comment & Response 
Xiulu Ruan, MD; Katherine Bydalek, MSN, FNP-BC, PhD; Srinivas Chiravuri, MD

To the Editor We read with interest the article by Bhatti and colleagues1 published in JAMA Surgery. The authors conducted a longitudinal cohort analysis to compare self-harm behavior 3 years before and 3 years after bariatric surgery. They found that the number of self-harm emergencies significantly ...

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