Surgery
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Patients presenting with acute mesenteric ischemia (AMI) sufficiently advanced to require bowel resection have a high morbidity and mortality. The objective of this study was to analyze these patients to determine if certain pre- or intraoperative variables are predictive of death or complications which could then be used to develop a predictive model to aid in surgical decision-making. ⋯ Mortality and morbidity rates after bowel resection for AMI are high. A risk calculator for prediction of postoperative mortality and morbidity has been developed and awaits validation in subsequent studies.
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There is increasing evidence to suggest that racial disparities exist in outcomes for trauma. Minorities and the uninsured have been found to have higher mortality rates for blunt and penetrating trauma. However, mechanisms for these disparities are incompletely understood. Limiting the inquiry to a homogenous group, those with lower extremity vascular injuries (LEVIs), may clarify these disparities. ⋯ For patients with LEVI, mortality disparities based on race or insurance status were only observed for penetrating trauma. It is possible that injury heterogeneity or patient cohort differences may partly explain mortality disparities that have been observed between racial and socioeconomic groups.
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Warfarin and antiplatelet agents (WAA) are prevalent among trauma patients, but the impact of these agents on patient outcomes has not been clearly defined. In this study, we examined the impact of preinjury WAA on outcomes in trauma patients. ⋯ Preinjury warfarin treatment was found to be an independent risk factor for mortality. WAA agents increased risk of ICH. Among those patients with ICH, only warfarin was associated with increased mortality. Antiplatelet agents did not affect mortality or LOS.
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To compare single-incision laparoscopic (SIL) with multiport laparoscopic (LAP) colectomy in patients with colon cancer to assess oncologic resection and 1-year outcomes. ⋯ These data suggest that SIL colectomy for cancer provides equivalent oncologic resection and 1-year outcomes compared with a standard LAP technique. Further studies are required to determine long-term oncologic outcomes, including recurrence and survival rates.