American journal of surgery
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Comparative Study
Comparison of prescribing patterns before and after implementation of evidence-based opioid prescribing guidelines for the postoperative urologic surgery patient.
We developed evidence-based guidelines for postoperative opioid prescribing after urologic surgery and assessed changes in prescribing after implementation. ⋯ Fewer opioids were prescribed after implementing a prescribing guideline. Additional study is required to assess patient opioid utilization.
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The preoperative and intraoperative factors that could predict a higher risk of anastomotic/staple line leak for gastric cancer patients has not been accurately defined. ⋯ In a large single-institutional study, POCs were associated with decreased survival in patients undergoing surgery for gastric adenocarcinoma. Optimizing these patients post-operatively with limited anastomotic stress and enteral feeding tube may allow for a less complicated course.
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Hospital ranking systems are often used by individuals to inform choice around which healthcare system may be best equipped to manage their care. ⋯ Rank position among hospitals within the USNWR "honor roll" was not associated with differences in patient outcomes following surgical intervention. Patients and hospitals need to exercise caution when placing weight on rank-position among hospitals as a means to discriminate clinical outcomes and quality of actual patient care.
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Editorial Historical Article
Surgeons, plague, and leadership: A historical mantle to carry forward.
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Multicenter Study
Modified frailty index predicts high-risk patients for readmission after colorectal surgery for cancer.
Modified frailty index (mFI) has been proposed as a reliable tool in predicting postoperative outcomes after surgery. This study aims to evaluate whether mFI could be utilized to predict readmissions after colorectal resection for patients with cancer by using nationwide cohort. ⋯ An 11-point modified frailty index as measured in NSQIP correlates with readmissions after colorectal resection in patients with colon and rectal cancer.