Journal of the American College of Surgeons
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NSQIP and the Accordion Severity Grading System have recently been used to develop quantitative methods for measuring the burden of postoperative complications. However, other audit methods such as chart reviews and prospective institutional databases are commonly used to gather postoperative complications. The purpose of this study was to evaluate discordance between different audit methods in pancreatoduodenectomy--a common major surgical procedure. The chief aim was to determine how these different methods could affect quantitative evaluations of postoperative complications. ⋯ There are important differences in perceived surgical outcomes based on the method of complication retrieval. The non-NSQIP methods used in this study could not be substituted for NSQIP in a quantitative analysis unless that analysis was limited to severe complications.
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Despite evidence that electronic medical record (EMR) information technology innovations can enhance the quality of trauma center care, few investigations have systematically assessed United States (US) trauma center EMR capacity, particularly for screening of mental health comorbidities. ⋯ Most US level I and II trauma centers have installed EMR systems; however, marked heterogeneity exists with regard to EMR type, available features, and turnover. A minority of centers have leveraged their EMR for screening of mental health comorbidities among trauma inpatients. Greater attention to effective EMR use is warranted from trauma accreditation organizations.
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Randomized Controlled Trial
Ice packs reduce postoperative midline incision pain and narcotic use: a randomized controlled trial.
Postoperative pain is an unavoidable consequence of open abdominal surgery. Although cryotherapy, the application of ice to a surgical wound site, has been shown to be effective in reducing postoperative pain in orthopaedic, gynecologic, and hernia operations, it has not been assessed in patients who undergo major open abdominal operations. We hypothesized that patients who receive cryotherapy would report lower pain scores as a primary outcomes measure. ⋯ Ice packs are a simple, cost-effective adjuvant for decreasing postoperative pain and narcotic use in patients undergoing major abdominal operations.