Annals of surgery
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Multicenter Study
Specificity of procedure volume and in-hospital mortality association.
Several studies have examined the association between procedure-specific volume and in-hospital mortality and concluded that high-volume hospitals have lower mortality rates when compared with low-volume hospitals. There is a paucity of studies examining the association between unrelated procedure volume and in-hospital mortality. The objective of our study is to examine the procedure-specific volume-outcome association as well as unrelated procedure volume-outcome association for 5 procedures: coronary artery bypass graft (CABG), percutaneous coronary interventions (PCI), elective abdominal aortic aneurysm repair (AAA), pancreatectomy (PAN), and esophagectomy (ESO). ⋯ Hospital volume-in-hospital mortality association appears largely to be specific to the procedure being studied.
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Randomized Controlled Trial Multicenter Study Comparative Study
Prospective randomized study comparing sentinel lymph node evaluation with standard pathologic evaluation for the staging of colon carcinoma: results from the United States Military Cancer Institute Clinical Trials Group Study GI-01.
The principal role of sentinel lymph node (SLN) sampling and ultrastaging in colon cancer is enhanced staging accuracy. The utility of this technique for patients with colon cancer remains controversial. ⋯ SLN mapping, step sectioning, and immunohistochemistry (IHC) identifies small volume nodal disease and improves staging in patients with resectable colon cancer. A prospective trial is ongoing to determine the clinical significance of colon cancer micrometastasis in sentinel lymph nodes.
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Multicenter Study Clinical Trial
Early assessment of pancreatic infections and overall prognosis in severe acute pancreatitis by procalcitonin (PCT): a prospective international multicenter study.
Pancreatic infections and sepsis are major complications in severe acute pancreatitis (AP) with significant impact on management and outcome. We investigated the value of Procalcitonin (PCT) for identifying patients at risk to develop pancreatic infections in severe AP. ⋯ Monitoring of PCT allows early and reliable assessment of clinically relevant pancreatic infections and overall prognosis in AP. This single test parameter significantly contributes to an improved stratification of patients at risk to develop major complications.
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Multicenter Study
The association between fluid administration and outcome following major burn: a multicenter study.
To determine patient and injury variables that influence fluid requirements following burn injury and examine the association between fluid volume received and outcome. ⋯ TBSA, age, weight, and intubation status on admission were significant predictors of fluid received. Patients who received larger volumes of resuscitation fluid were at higher risk for injury complications and death.
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Multicenter Study
Serum macrophage migration inhibitory factor is an early marker of pancreatic necrosis in acute pancreatitis.
To determine if 24-hour blood concentrations of macrophage migration inhibitory factor (MIF), soluble CD14, and CD163 receptors could predict complications associated with acute pancreatitis (AP). ⋯ The prognostic utility of 24-hour plasma MIF concentration in predicting PN has major clinical and healthcare resource implications. Its mechanistic pathway may afford novel therapeutic interventions in clinical disease by using blocking agents to ameliorate the systemic manifestations of AP.