Journal of the American College of Surgeons
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Transsphenoidal surgery is a common neurosurgical procedure for accessing the pituitary and anterior skull base, yet few multicenter analyses have evaluated outcomes after this procedure. ⋯ Overall rates of adverse events in patients undergoing transsphenoidal surgery are relatively low, and most occur before discharge from the hospital. Post-discharge complications associated with transsphenoidal surgery include deep vein thrombosis, pulmonary embolism, and urinary tract infection. Delayed postoperative cerebrospinal fluid leak is the major cause of reoperation, and hyponatremia is the major cause of readmission.
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Efforts to improve pediatric trauma outcomes need detailed data, optimally collected at lowest cost, to assess processes of care. We developed a novel database by merging 2 national data systems for 5 pediatric trauma centers to provide benchmarking metrics for mortality and non-mortality outcomes and to assess care provided throughout the care continuum. ⋯ Merging 2 data systems allowed for improved risk-adjusted modeling for mortality and functional status. The merged database allowed for patient evaluation throughout the care continuum on a multi-institutional level. Merging existing data is feasible, innovative, and has potential to impact care with minimal new resources.
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Mastectomy with immediate breast reconstruction (M+IBR) is performed increasingly for breast cancer treatment, but whether this trend extends to the growing number of women diagnosed at age 65 or older is unknown. We studied the effects of age and comorbidities on the use and outcomes of M+IBR. ⋯ Rates of M+IBR rates are increasing, with 10% of M+IBR patients now age 65 or older. Higher 30-day unplanned readmission rates in elderly M+IBR patients with or without comorbidities suggest the need to establish criteria for safe M+IBR in these patients.