Journal of the American College of Surgeons
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Anti-reflux procedures (ARPs) are effective treatments for gastroesophageal reflux disease (GERD). However, variation in objective and patient reported outcomes persists. Limited evidence and anecdotal experience suggest that patient sex may play a role. The objective of this study was to compare outcomes after ARPs between male and female patients. ⋯ While patients of either sex experience symptom improvement and low rates of recurrence after ARPs, females are more likely to endorse gas/bloat compared to males. Final distensibility ≥3mm 2/mmHg carries a high risk of recurrence. These results may augment how physicians prognosticate during consultations and tailor their treatments in patients with GERD.
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The direct association between procedure risk and outcomes in elderly emergency general surgery (EGS) patients has not been analyzed. Studies only highlight the importance of frailty. A comprehensive analysis of relevant risk factors and their association with outcomes in elderly EGS patients is lacking. We hypothesized that procedure risk has a stronger association with relevant outcomes in elderly EGS patients compared to frailty. ⋯ Assessing frailty in the elderly EGS patient population without adjusting for the type of procedure or procedure risk ultimately presents an incomplete representation of how frailty impacts patient-related outcomes.
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In recent years, there has been growing interest in laparoscopic liver resection (LLR) and the audit of the results of surgical procedures. The aim of this study was to define reference values for LLR in segments 7 and 8. ⋯ This study shows the need to establish standards for the postoperative outcomes in LLR based on the complexity of the resection and the location of the lesions.
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Mild traumatic brain injury (mTBI) encompasses a spectrum of disability including early cognitive impairment (ECI). The Brain Injury Guidelines (BIG) suggest mTBI patients can be safely discharged from the Emergency Department. Although half of mTBI patients with intracranial hemorrhage (ICH) have evidence of ECI, it is unclear what percentage of these patients' ECI persists after discharge. We hypothesize a significant proportion of trauma patients with mTBI and ECI at presentation have persistent ECI at 30-day follow-up. ⋯ Over one-third of mTBI patients with ICH had ECI. At 30-day post-discharge follow-up over one-fourth of these patients had persistent ECI and 33% had concussion symptoms. This highlights the importance of identifying ECI prior to discharge as a significant portion may have ongoing difficulties reintegrating into work and society.