Annals of surgery
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To determine the in-hospital mortality rates for patients undergoing colorectal resection for malignant or benign conditions, and to identify risk factors for in-hospital death, particularly the relationships with surgeon and hospital volume. ⋯ This large, population-based study suggests that surgeons who perform high volumes of colorectal resections achieve lower in-hospital mortality rates than surgeons with low volumes, whereas the hospital volume does not influence mortality.
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To develop and validate a new ICD-9 injury model that uses regression modeling, as opposed to a simple ratio measurement, to estimate empiric injury severities for each of the injuries in the ICD-9-CM lexicon. ⋯ Because TMPM-ICD9 uniformly out-performs ICISS and the SWI model, it should be used in preference to ICISS for risk-adjusting trauma outcomes when injuries are recorded using ICD9-CM codes.
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The trauma injury severity score (TRISS) has been used for over 20 years for retrospective risk assessment in trauma populations. The TRISS has serious limitations, which may compromise the validity of trauma care evaluations. ⋯ Our results suggest that adopting the TRAM could improve the validity of trauma care evaluations and trauma outcome research.
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Plasma vascular endothelial growth factor (VEGF) levels are elevated for weeks after minimally invasive colorectal resection (MICR). Decreased plasma angiopoietin-(Ang) 1 and increased Ang-2 levels have been noted on postoperative days (POD) 1 and 3. These proangiogenic changes may stimulate tumor growth postoperatively (postop). This study's purpose was to track plasma VEGF, Ang-1, and Ang-2 levels for 4 to 8 weeks after MICR for cancer and to assess the impact of preoperative (preop) and postop plasma on in vitro endothelial cell (EC) behavior. ⋯ MICR is associated with proangiogenic plasma changes for 2 to 4 weeks and plasma from POD 7 to 13 and 14 to 20 stimulated EC growth, invasion, and migration. Postop plasma may stimulate the growth of residual tumor.
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To test the construct validity of the Observational Teamwork Assessment for Surgery (OTAS) tool. ⋯ OTAS exhibits adequate construct validity as assessed by consistency in the scoring by expert versus novices-ie, expert raters produce significantly more consistent scoring than novice raters. Further validation should assess the learning curve for novices in OTAS. Relationships between OTAS, measures of technical skill, and behavioral responses to surgical crises should also be quantified.