Surgery/Specialties 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…
Editor's Note The American College of Surgeons (ACS) on January 31 opened enrollment for participation in its Children’s Surgery Verification Quality Improvement Program. The program was developed to improve the quality of children’s surgical care by creating a system to match each child’s individual surgical needs with a care environment…
Editor's Note Nerve blocks in total knee patients were associated with statistically significant reductions in length of stay and readmissions, but no difference in emergency department visits or in-hospital falls, this Canadian study finds. In the analysis of 178,214 patients, adjusted: mean hospital stay was 4.7 days for patients with…
Editor's Note Advances in diagnostic imaging technology have resulted in more trauma patients being diagnosed with blunt cerebrovascular injuries, which has resulted in a significant decline in stroke and mortality, this study finds. From 1985 to the end of 2015, the percentage of blunt trauma patients diagnosed with blunt cerebrovascular…
