Predicting Postoperative Complications after Acute Care Surgery: How Accurate Is the ACS NSQIP Surgical Risk Calculator?

The ACS NSQIP Surgical Risk Calculator (SRC) is an evidence-based clinical tool commonly used for evaluating postoperative risk. The goal of this study was to validate SRC-predicted complications by comparing them with observed outcomes in the acute care surgical setting. In this study, pre- and postoperative data from 1693 acute care surgeries (hernia repair, enterolysis, intestinal incision/excision and enterectomy, gastrectomy, debridement, colectomy, appendectomy, cholecystectomy, gastrorrhaphy, and incision and drainage of soft tissue, breast abscesses, and removal of foreign bodies) performed at a Level I trauma center over a five-year time period were abstracted.

Impact of blunt pulmonary contusion in polytrauma patients with rib fractures.

Background: We investigated the impact of blunt pulmonary contusion (BPC) in patients with rib fractures.

Methods: Adult patients with rib fractures caused by blunt mechanisms were enrolled over 3 years at a Level 1 trauma center. BPC was defined according to percentage of lung affected as: moderate (1-19% contusion) or severe (≥20% contusion).

Patient Characteristics Associated with Comfort Care among Trauma Patients at a Level I Trauma Center.

Trauma patients admitted to the intensive care unit are a unique population with high mortality. This study aims to identify characteristics predicting the likelihood of progressing to palliative management often referred to as comfort care measures, thus enabling the trauma team to broach end-of-life decisions earlier in these patients' care. This is a retrospective analysis of the prospectively collected New York State Trauma Registry database for a single Level I trauma center for patients admitted from 2008 to 2015.

Perceptions in rib injuries: A multidisciplinary single center survey of clinician differences in risk stratification and management of patients with rib fractures.

Background: Although associated with significant morbidity, there is no universally accepted management of rib fractures. We hypothesized that variations in risk stratification may influence this.

Methods: A questionnaire was developed to assess providers' perceived risk factors and injury stratification of rib fracture patients at a Level 1 trauma center.

Outcomes of preinjury anticoagulation in patients with traumatic rib fractures.

Background: Anticoagulant and antiplatelet agents (ACAP) have been shown to negatively affect trauma patients.

Methods: Outcomes in adults with rib fractures were reviewed. Pearson chi-square test was used for analysis.

Sharps and Needlestick Injuries Among Medical Students, Surgical Residents, Faculty, and Operating Room Staff at a Single Academic Institution.

Background: The hospital is a place of high risk for sharps and needlestick injuries (SNI) and such injuries are historically underreported.

Methods: This institutional review board approved study compares the incidence of SNI among all surgical personnel at a single academic institution via an anonymous electronic survey distributed to medical students, surgical residents, general surgery attendings, surgical technicians, and operating room nurses.

Results: The overall survey response rate was 37% (195/528).

Open reduction and internal fixation of rib fractures in polytrauma patients with flail chest.

Background: Open reduction and internal fixation (ORIF) of fractured ribs for flail chest is safe and effective but who is most likely to benefit is unknown. Our purpose is to compare ORIF with nonoperative management (NOM) in polytrauma patients.

Methods: Albany Medical Center Hospital Trauma Registry was queried for adult patients with flail chest admitted over 7 years.

Management of splenic trauma: a single institution's 8-year experience.

Background: Management of splenic trauma has evolved, with current practice favoring selective angiographic embolization and non-operative treatment over immediate splenectomy. Defining the optimal selection criteria for the appropriate management strategy remains an important question.

Methods: This retrospective registry review was conducted at a Level I trauma center.

Impact of preinjury warfarin and antiplatelet agents on outcomes of trauma patients.

Background: 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.

Methods: A 40-month (September 2004 to December 2007) retrospective review of data in the trauma registry at a New York State level 1 trauma center was performed.

Effect of comorbidities and medications on left ventricular mass regression after bariatric surgery.

Hypertension, diabetes, and obesity frequently coexist and significantly contribute to cardiovascular morbidity and mortality. Weight loss in obese individuals has been associated with improved blood pressure control and regression in left ventricular (LV) hypertrophy. The authors investigated the impact of comorbidity and medication on clinical and echocardiographic parameters after weight loss in obese patients.

The impact of weight loss on cardiac structure and function in obese patients.

Background: Obesity frequently results in structural and physiologic changes in the cardiovascular system. Whether weight reduction leads to reversal of these changes is not well-established. This investigation sought to identify the effect of a weight reduction program on right and left ventricular structure and function.

Gastro-broncho-pleural fistula after laparoscopic gastric band placement.

Laparoscopic gastric band placement is a common procedure for morbid obesity. Common complications include gastric perforation, band erosion, and band slippage. We present the first report in the literature of gastro-bronchial-pleural fistula after laparoscopic gastric band placement.

Comparing outcomes of laparoscopic versus open bariatric surgery.

Objective: The objective of this study was to use nationally representative data to compare outcomes of open gastric bypass (OGB) versus laparoscopic gastric bypass (LGB) surgery.

Background: The number of bariatric procedures continues to grow. Increasingly, these surgeries are being performed laparoscopically.

Regional variations in gastric bypass surgery: results from the 2005 nationwide inpatient sample.

Background: The purpose of this study is to use nationally representative data to examine regional variations in the use and outcomes of gastric bypass surgery.

Methods: Using data from the Nationwide Inpatient Sample (NIS), we identified adults undergoing gastric bypass surgery (n = 92,910) in 2005. Following descriptive analyses, multiple logistic regression models were constructed to examine regional variations in the likelihood of laparoscopic vs.

Cystogram may be unreliable in cases of gunshot wounds to the bladder: a case report.

Introduction: Gunshot wounds to the bladder are not uncommon; however it is unusual that a bullet come to rest within the urinary bladder. Properly performed plain film cystography is trusted as a highly sensitive tool for identifying significant bladder injuries due to both blunt and penetrating trauma. Several reports suggest that cystography may be less sensitive in cases of gunshot wounds to the bladder.

Relationship between surgeon and hospital volume and readmission after bariatric operation.

Background: Few studies have focused on the relationship between provider volume and short-term readmissions among bariatric operation patients.

Study Design: Using New York State's inpatient discharge database, we identified adults undergoing a bariatric procedure between January 1, 2003, and November 30, 2003 (n = 7,868). After preliminary descriptive analyses, a multiple logistic regression model was constructed to examine the relationship between surgeon and hospital volume and readmission after 30 days of discharge for bariatric operation, while controlling for demographics, comorbidity, and length of index hospitalization.

Predictors of in-hospital postoperative complications among adults undergoing bariatric procedures in New York state, 2003.

Background: Our aim was to determine the relationship between patient level characteristics and in-hospital postoperative complications among obese adults who underwent a bariatric procedure in New York state in 2003. Understanding patient level factors that predict or are associated with adverse outcomes among bariatric surgery patients can help to identify patients who need to be monitored particularly carefully.

Methods: Using New York's inpatient discharge database, we identified adults who underwent a bariatric operation between January 1, 2003 and December 31, 2003 (n=7,868).

Elderly trauma inpatients in New York state: 1994-1998.

Background: The aging of the population in the United States has led to an increase in geriatric trauma. This study aimed to examine the characteristics and outcomes of geriatric trauma patients in New York State.

Methods: Four groups of elderly trauma patients (ages 40-64, 65-74, 75-84, and 85+ years) were contrasted with younger adults ages 13 to 39 years with respect to mechanism of injury, discharge disposition, hospital length of stay, comorbidities, and type of hospital in which they were treated.