Objectives: To evaluate the association between the timing of hip fracture surgery with postoperative length of stay and outcomes.
Design: Retrospective review using the American College of Surgeons National Surgical Quality Improvement Program database.
Setting: National inquiry database incorporating 140 academic and private medical centers.
Patients: Seventeen thousand four hundred fifty-nine patients who underwent surgery for a hip fracture between 2006 and 2013 were identified from the National Surgical Quality Improvement Program database.
Intervention: Surgical management of hip fractures was performed at the discretion of participating surgeons.
Outcome Measure: Thirty-day outcomes including postoperative length of stay, readmission rates, reoperation rates, complications, and mortality rates.
Results: Of the 17,459 patients, 4107 (23.5%) were operated on within 24 hours, 8740 (50.1%) within 24-48 hours, and 4612 (26.4%) more than 48 hours after hospital admission. Increased time to surgery was associated with longer postoperative hospital length of stay. Prolonged time to surgery did not adversely affect postoperative outcomes.
Conclusions: Although a delay in the management of hip fractures is associated with an increase in postoperative hospital length of stay, 30-day postoperative outcomes are not adversely affected in patients undergoing hip fracture fixation.
Level Of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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http://dx.doi.org/10.1097/BOT.0000000000001306 | DOI Listing |
Background: Liver malignancies present substantial challenges to surgeons due to the extensive hepatic resections required, frequently resulting in posthepatectomy liver failure. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) was designed to increase the resectable liver volume, yet it is associated with significant mortality and morbidity rates. Recently, minimally invasive techniques have been incorporated into ALPPS, with the potential to improve the procedure's safety profile whilst maintaining efficacy.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Department of Pediatric Intensive Care Medicine, Life Support Center, Hacettepe University, Ankara, Turkey.
Importance: This study addresses the characteristics, kidney replacement therapy (KRT) modalities, and outcomes in children diagnosed with crush syndrome following an earthquake in Turkey.
Objective: To analyze the associations of different KRT modalities with long-term dialysis dependency and length of stay (LOS) in the pediatric intensive care unit (PICU).
Design, Setting, And Participants: This multicenter, prospective, and retrospective cohort study was conducted across 20 PICUs in Turkey.
JAMA
January 2025
Worcestershire Royal Hospital, Worcester, United Kingdom.
Importance: Patients undergoing unplanned abdominal surgical procedures are at increased risk of surgical site infection (SSI). It is not known if incisional negative pressure wound therapy (iNPWT) can reduce SSI rates in this setting.
Objective: To evaluate the effectiveness of iNPWT in reducing the rate of SSI in adults undergoing emergency laparotomy with primary skin closure.
Dig Dis Sci
January 2025
Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India.
Background: This two-stage individual patient data meta-analysis (IPD-MA) compared the efficacy of a shorter duration (≤ 2 days) of vasoactive (VA) drug therapy to standard duration (3-5 days) after acute variceal bleeding (AVB) in patients with liver cirrhosis.
Patients And Methods: Randomized clinical trials on patients with cirrhosis and AVB undergoing endoscopic band ligation which compared a short duration versus the standard duration of VA therapy were included. The primary outcome was 5-day rebleeding rate.
Clin Chem Lab Med
January 2025
School of Dentistry and Medical Science, Faculty of Science and Health, 110481 Charles Sturt University, Wagga Wagga, NSW, Australia.
This scoping review focuses on the evolution of pre-analytical errors (PAEs) in medical laboratories, a critical area with significant implications for patient care, healthcare costs, hospital length of stay, and operational efficiency. The Covidence Review tool was used to formulate the keywords, and then a comprehensive literature search was performed using several databases, importing the search results directly into Covidence (n=379). Title, abstract screening, duplicate removal, and full-text screening were done.
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