Annals of surgery
-
Multicenter Study Comparative Study
Antibiotic choice is independently associated with risk of surgical site infection after colectomy: a population-based cohort study.
To determine which perioperative care practices are associated with decreased risk of surgical site infection (SSI) after colectomy surgery. ⋯ In Michigan, several perioperative care practices are independently associated with decreased risk of SSI after colectomy, including SCIP-2-compliant prophylactic antibiotics, postoperative normothermia, glucose control, and oral antibiotics. Furthermore, specific prophylactic antibiotic choices are associated with lower risk of SSI. These results account for patient factors and unmeasured hospital effects, suggesting that dissemination of these perioperative care practices may decrease SSI rates.
-
Multicenter Study Comparative Study
Validity and feasibility of the american college of surgeons colectomy composite outcome quality measure.
To develop a reliable, robust, parsimonious, risk-adjusted 30-day composite colectomy outcome measure. ⋯ It is feasible to design a measure with a composite outcome of death or serious morbidity after colon surgery that has a low burden for data collection, has substantial clinical importance, and has acceptable reliability.
-
Multicenter Study
A statewide, community-based assessment of alvimopan's effect on surgical outcomes.
Alvimopan was approved by the Food and Drug Administration in May 2008 and has been shown to accelerate gastrointestinal recovery after colectomy. Our independent study evaluated alvimopan as it is used in actual hospital practice in the state of Michigan. We hypothesized that alvimopan significantly decreases incidence of prolonged ileus and reduces length of stay (LOS) in patients who have undergone colectomy. ⋯ This study suggests that the actual utilization of alvimopan leads to a reduction in prolonged ileus and LOS in patients who underwent colectomy. By accelerating postoperative recovery, alvimopan has the potential to benefit patients and health care systems by improving outcomes, ensuring patient comfort, and reducing cost.
-
Multicenter Study Comparative Study
Surgical adverse outcomes in patients with schizophrenia: a population-based study.
To validate the global features of postoperative adverse outcomes for surgical patients with schizophrenia. ⋯ Surgical patients with schizophrenia showed significantly higher postoperative adverse outcome rates with risk of 30-day mortality nearly threefold when compared with patients without mental disorders. Our findings suggest the urgency revising the protocol of postoperative care for this specific population.
-
Multicenter Study Clinical Trial
Past history of skin infection and risk of surgical site infection after elective surgery.
To identify baseline patient characteristics associated with increased susceptibility to surgical site infection (SSI) after elective surgery. ⋯ A history of skin infection identified a state of enhanced susceptibility to SSI at baseline that is independent of traditional SSI risk factors and adherence to current infection control practices.