Annals of surgery
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Nearly 75% of newly diagnosed cancer patients in the United States will receive care from a hospital that is accredited by the Commission on Cancer (CoC). To support hospitals in their quality assurance efforts, the CoC maintains a portfolio of quality measures to give hospitals compliance data with select best practices for cancer care. As the CoC quality measures have evolved over recent years, many clinicians may lack awareness of the intent and content of the measure portfolio, as well as the mechanism by which new measures originate. ⋯ In the following overview, we outline the current measure process, highlight important changes to the portfolio, and share opportunities to further increase the impact.
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Nearly two hospital mergers occur per week and the majority of hospitals are now part of a larger health system. As health systems continue to grow in size and geographic coverage, these changes could have unintended consequences for many different healthcare stakeholders. This surgical perspective outlines emerging challenges associated with the growth of health systems and potential strategies to monitor and mitigate the potential adverse impact of these ongoing changes.
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The aim of this study was to develop a novel machine learning model to predict clinically relevant postoperative pancreatic fistula (CR-POPF) following pancreaticoduodenectomy (PD). ⋯ Our novel machine learning model consistently outperformed the previously validated mFRS within internal and external validation cohorts, thereby demonstrating its generalizability and utility for enhancing prediction of CR-POPF.
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The aim of this study was to describe the surgeon's ability to accurately predict the margin following resection of colorectal liver metastases (CRLMs). ⋯ Surgeons are inaccurate at predicting positive and close surgical margins following resection of CRLM. A predicted close margin should not necessarily preclude resection.
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Randomized Controlled Trial Multicenter Study
Early Cold Stored Platelet Transfusion Following Severe Injury: A Randomized Clinical Trial.
To determine the feasibility, efficacy, and safety of early cold stored platelet transfusion compared with standard care resuscitation in patients with hemorrhagic shock. ⋯ In severely injured patients, early cold stored platelet transfusion is feasible, safe and did not result in a significant lower rate of 24-hour mortality. Early cold stored platelet transfusion did not result in a higher incidence of arterial and/or venous thrombotic complications or adverse events. The storage age of the cold stored platelet product was not associated with significant outcome differences.