Surgery/Specialties 
Editor's Note Researchers at Wake Forest University, Winston-Salem, North Carolina, have developed a tool that helps predict the possibility of survival and independence at discharge for elderly patients with traumatic brain injury. The tool, which accounts for variables such as age, gender, and severity of brain injury, was evaluated in…
Editor's Note Selective nonoperative management of abdominal gunshot wounds is an acceptable and effective treatment for patients with less severe injuries that do not involve major organ damage or significant blood loss, this study finds. Of 922 patients with abdominal gunshot wounds analyzed, 707 had an immediate laparotomy and 215…
Editor's Note Even mild postoperative pulmonary complications (PPCs) are associated with increased early postoperative mortality, ICU admission, and length of stay, finds this study. Of 1,202 ASA physical status 3 patients from seven academic medical centers included in the analysis, at least one PPC occurred in 401 patients. All patients…
Editor's Note In this study of patients undergoing total hip or knee replacement, smoking was associated with an increased risk of infectious complications that required further surgery. In addition, the amount that a patient had smoked, regardless of current smoking status, significantly contributed to increased risk of readmission. A total…
Editor's Note In hospitals that care for a lower volume of frail patients, frail surgical patients have increased postoperative mortality and failure to rescue, finds this study. Of 63,381 frail patients analyzed, 30-day mortality in the lowest volume quintile was 1.1%, compared to 0.9% in the highest. Adjusted analysis found…
Editor's Note Patients whose surgeons had large numbers of patient complaints about rude and disrespectful behavior had a significantly increased risk of postoperative complications and being readmitted, this study finds. Of 32,125 patients included in the study, 3,501 (11%) had a postoperative complication (5.5% surgical, 7.5% medical). The adjusted rate…
Editor's Note In hospital delay of appendectomy in children was not associated with an increased rate of perforated appendix, this study from Sweden finds. Of 2,756 children who had an appendectomy for acute appendicitis, 661 (24%) had a histopathologic diagnosis of perforated appendix. In multivariate analysis, increased time to surgery…
Editor's Note Advances in critical care have made it possible for critically ill children to undergo liver transplantation with the same survival benefits as children who are stable before surgery, this study finds. At Texas Children’s Hospital, 65 of 354 patients who had liver transplantation between 2002 and 2015 were…
Editor's Note In this study, Medicare’s Comprehensive Care for Joint Replacement bundled payment model resulted in a decrease of $5,577 in total spending per episode. Most hospital savings came from implants and supplies, and most postacute care savings came from decreased use of inpatient rehabilitation and skilled nursing facility care.…
Editor's Note The American College of Surgeons (ACS) in collaboration with Johns Hopkins has launched a new multimillion dollar surgical quality improvement initiative funded and guided by the Agency for Healthcare Research and Quality. The new program will enable hospitals to implement Enhanced Recovery after Surgery (ERAS) protocols, which have…
