Journal of the American College of Surgeons
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Comparative Study
Reduced incidence of gestational diabetes with bariatric surgery.
Obesity is a risk factor for gestational diabetes mellitus (GDM), and bariatric surgery is an effective treatment for obesity. Our objective was to determine the association of bariatric surgery with the incidence of GDM and related complications. ⋯ Bariatric surgery is associated with a decreased incidence of GDM and cesarean section in subsequent pregnancies. This potential effect of bariatric surgery should be considered in the management of obese women of childbearing age. Prospective studies are needed to confirm these findings.
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Comparative Study
Sarcopenia and mortality after liver transplantation.
Surgeons frequently struggle to determine patient suitability for liver transplantation. Objective and comprehensive measures of overall burden of disease, such as sarcopenia, could inform clinicians and help avoid futile transplantations. ⋯ Central sarcopenia strongly correlates with mortality after liver transplantation. Such objective measures of patient frailty, such as sarcopenia, can inform clinical decision making and, potentially, allocation policy. Additional work is needed develop valid and clinically relevant measures of sarcopenia and frailty in liver transplantation.
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Comparative Study
A population-based analysis of neighborhood socioeconomic status and injury admission rates and in-hospital mortality.
Research indicates that neighborhood socioeconomic status (N-SES) is inversely related to injury and injury-related mortality. We hypothesized that injury-related hospitalization rates would vary by N-SES and that N-SES would be related to in-hospital mortality. ⋯ N-SES was inversely related to crude injury rates for all mechanisms. However, in-hospital mortality was not associated with N-SES level.
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Comparative Study
Laparoscopic approach significantly reduces surgical site infections after colorectal surgery: data from national surgical quality improvement program.
The goal of this study was to compare surgical site infection (SSI) rates between laparoscopic (LAP) and open colorectal surgery using the National Surgical Quality Improvement Program (NSQIP) database. ⋯ The LAP approach is independently associated with a reduced SSI when compared with open surgery and should, when feasible, be considered for colon and rectal conditions.
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This study examines the development and implementation of a pilot human factors curriculum during a 2-year period. It is one component of a comprehensive 5-year human factors curriculum spanning core competencies of interpersonal and communication skills, systems-based practice, and professionalism and using low-and high-fidelity simulation techniques. ⋯ This unique and comprehensive human factors curriculum is shown to be effective in building communication competency for junior-level residents in the human and emotional aspects of surgical training and practice. Continued refinement and ongoing data acquisition and analyses are underway.