To describe the scope and outcomes of elective pediatric surgical procedures performed during combat operations. Consistent with all active Quality Programs of the American College of Surgeons, hospital operative volume appears to be an important metric of surgical quality for older patients undergoing emergency operations. Survival rates for geriatric patients were improved substantially when emergency operations were performed at hospitals with higher operative volumes. More than 50% of hospitals did not meet the threshold benchmarks, representing 22% of patients. Hospital volume thresholds, which optimize to 95% probability of survival, varied by procedure, with a mean of 14 operations over 2 years. For each operation, mortality decreased as hospital emergency operative volume increased (p < 0.001 for each operation) for every standardized increase in volume (meaning +1 natural logarithm of volume), the reduction in mortality ranged from 14% for colectomy to 61% for appendectomy. There were 41,860 operations evaluated at 299 hospitals. Hospital operative volume thresholds to optimize probability of survival were defined. β-Logistic generalized linear regression was used, with the hospital as the unit of analysis, to investigate the relationship between hospital operative volume and in-hospital riskv-adjusted mortality. Retrospective cohort study of geriatric patients (aged 65 years and older) who underwent 1 of 10 EGS operations identified from the California State Inpatient Database (2010 to 2011). First, to what degree does hospital emergency operative volume impact mortality for geriatric patients undergoing emergency general surgery (EGS) operations? Second, at what procedure-specific hospital volume will geriatric patients undergoing an emergency operation achieve at or better than average mortality risk? To investigate this, the current study sought to answer 2 questions. Optimizing outcomes can require a structured system of surgical care based on key quality indicators. Within the growing geriatric population, there is an increasing need for emergency operations. However, this study suggests that there is justification for nonsurgical management and a role for selective surgical resection as treatment for AI. It is still unclear as to the etiology of such low rates. The malignancy rates between CI and EI patients were lower than previously reported percentages.
We show differences in demography, comorbidities, and potential causes between CI and EI. This was a large study on surgical AI patients conducted in the United States. The classic presentation of intussusception in the pediatric population, which includes a mass, abdominal pain, and blood per rectum, is rarely found in the adult population. It is postulated to involve some irritant within the lumen of the intestine that affects normal peristaltic activity, causing invagination of the proximal bowel into the distal lumen. Intussusception is the telescoping of 1 proximal portion of the intestine into the other with the exact mechanism unknown. In terms of race those individuals who went on to have surgery were mostly Caucasian, with 329 (71.83%) undergoing a Comments Most patients were female in both groups, 59.81% and 55.82%, respectively. The mean age for those with colonic resections was 47.2 years whereas those with small-bowel resections had a mean age of 51.5 years. The inclusion criterion was patients with ResultsĪ total of 1,178 surgical intussusception patients were identified, including 634 (53.82%) with colonic resections and 544 (46.18%) with small-bowel resections (Table 2). Information during this time period contained data from up to 38 states and it is approximately a 20%-stratified sample of all US community hospitals. It contains data from approximately 8 million hospital stays each year. The NIS is the largest all-payer inpatient care database in the United States. Adhesive Capsulitis Arthritis Arthritis of the Finger Arthritis of the Hand Arthritis of the Wrist Avulsion Fracture Bennett's Fracture Carpal Fractures Carpal Tunnel Syndrome Colles' Fracture Complex Fractures Compound Fracture Compression Fracture Cyst De Quervain's Disease Distal Radius Fracture Dupuytren's Contracture Extra-Articular Fracture Fracture Fracture of Hand (incl.A retrospective study was conducted using data from the Healthcare Cost and Utilization Project-National Inpatient Sample (NIS) from 1998 to 2006.
0 kommentar(er)
