A Palliative Care Curriculum May Promote Resident Self-Reflection and Address Moral Injury.

Introduction: There is a lack of formal palliative care education for surgical trainees, and the demanding nature of surgical training and exposure to challenging clinical scenarios can contribute to moral injury. We developed a palliative care curriculum to promote self-reflection, aiming to address moral injury in residents.

Methods: Five 1-h palliative care sessions were delivered over the academic year to all post-graduate year (PGY) levels covering the following topics: personal awareness, delivering bad news, surgical palliation for cancer pathology, surgical palliation for noncancer pathology, and urgent palliative care.

Pressure ulcers in paediatric patients on extracorporeal membrane oxygenation.

It has been shown that pressure ulcer formation in critically ill paediatric patients increases morbidity and mortality. We sought to identify factors associated with pressure ulcer formation in paediatric patients on extracorporeal membrane oxygenation (ECMO). From December 2014 to 2015, we identified patients at our institution who developed a pressure ulcer to create two cohorts: ulcer and no ulcer.

High volume crystalloid resuscitation adversely affects pediatric trauma patients.

Background: Aggressive fluid resuscitative strategies have been the cornerstone of early trauma management for decades. However, recent prospective adult studies have challenged this practice, underlining the detrimental effect of positive fluid balance on cardiopulmonary function. Fluid overload has been associated with impaired oxygenation and morbidity in critically ill adults, but data is lacking in pediatric trauma patients.

Mortality in patients with end-stage renal disease and the risk of returning to the operating room after common General Surgery procedures.

Background: The prevalence of end-stage renal disease (ESRD) has increased, and there is limited data on the risks faced by this patient population undergoing surgery.

Methods: Using American College of Surgeons National Surgical Quality Improvement Program, we identified common surgical procedures undergone by patients with ESRD. These patients were compared with a matched-control group.

How sick are dialysis patients undergoing cholecystectomy? Analysis of 92,672 patients from the American College of Surgeons National Surgical Quality Improvement Program database.

Background: Although cholecystectomy is one of the most common surgical procedures performed in the United States, there is an absence of data on the risks of cholecystectomy in dialysis patients. Our objective was to analyze the outcomes of cholecystectomy in dialysis patients.

Methods: Using the American College of Surgeons National Surgical Quality Improvement Program database, we selected all patients who underwent cholecystectomy from 2005 to 2010.

End-stage renal disease increases the risk of mortality after appendectomy.

Introduction: With each passing year, the number of patients with end-stage renal disease (ESRD) is increasing steadily, but there are limited data on the postoperative outcomes of these patients after appendectomy.

Methods: Using the Nationwide Inpatient Sample, we identified all patients who underwent appendectomy in the United States between 1998 and 2010. We used International Classification of Diseases, 9th Revision, Clinical Modification codes to identify patients with ESRD and to track postoperative complications during hospital admission.

Predicting the risk of death following coronary artery bypass graft made simple: a retrospective study using the American College of Surgeons National Surgical Quality Improvement Program database.

Introduction: Risk models to predict 30-day mortality following isolated coronary artery bypass graft is an active area of research. Simple risk predictors are particularly important for cardiothoracic surgeons who are coming under increased scrutiny since these physicians typically care for higher risk patients and thus expect worse outcomes. The objective of this study was to develop a 30-day postoperative mortality risk model for patients undergoing CABG using the American College of Surgeons National Surgical Quality Improvement Program database.