JAMA surgery最新文献

{"title":"Practical Guide to Remote Patient Monitoring in Surgical Patients.","authors":"Yuman Fong, Laleh Melstrom, Heather L Evans","doi":"10.1001/jamasurg.2024.6015","DOIUrl":"10.1001/jamasurg.2024.6015","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"457-458"},"PeriodicalIF":15.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reoperative Interval and Perioperative Mortality Risk in Cardiac Surgery.","authors":"Richard Ramsingh, Mariana Kawalet, Joshua E Insler, Jules J Bakhos, Abhishek Sharma, Penny L Houghtaling, Marijan Koprivanac, Patrick R Vargo, Michael Z Tong, Haytham Elgharably, Edward G Soltesz, Nicholas G Smedira, Eric E Roselli, Shinya Unai, Gösta B Pettersson, Eugene H Blackstone, A Marc Gillinov, Lars G Svensson, Faisal G Bakaeen","doi":"10.1001/jamasurg.2024.5499","DOIUrl":"10.1001/jamasurg.2024.5499","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"463-465"},"PeriodicalIF":15.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing Pregnancy Loss in Surgical Residency-A Call for Policy Protection.","authors":"Cleo Siderides, Caitlin J Cain-Trivette, Kelly A Garrett","doi":"10.1001/jamasurg.2024.6045","DOIUrl":"10.1001/jamasurg.2024.6045","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"363-364"},"PeriodicalIF":15.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Error in Abstract.","authors":"","doi":"10.1001/jamasurg.2025.0658","DOIUrl":"https://doi.org/10.1001/jamasurg.2025.0658","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":"160 4","pages":"471"},"PeriodicalIF":15.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Error in Byline.","authors":"","doi":"10.1001/jamasurg.2025.0523","DOIUrl":"10.1001/jamasurg.2025.0523","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"471"},"PeriodicalIF":15.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical Guide to Image-Based Big Data Research.","authors":"Elsie Gyang Ross, Shipra Arya, Marc L Melcher","doi":"10.1001/jamasurg.2024.6012","DOIUrl":"10.1001/jamasurg.2024.6012","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"455-456"},"PeriodicalIF":15.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor Deposits-A Blind Spot in Colon Cancer Staging.","authors":"Alizeh Abbas, Daniel I Chu","doi":"10.1001/jamasurg.2024.6708","DOIUrl":"10.1001/jamasurg.2024.6708","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"414"},"PeriodicalIF":15.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facility Medicaid Payer Burden and Nonelective Admission for Chronic Limb-Threatening Ischemia.","authors":"Steven Medvedovsky, Sherene E Sharath, Panos Kougias","doi":"10.1001/jamasurg.2024.6394","DOIUrl":"10.1001/jamasurg.2024.6394","url":null,"abstract":"<p><strong>Importance: </strong>Chronic limb-threatening ischemia (CLTI) is a major public health issue that requires considerable human and physical resources to provide optimal patient care. It is essential to characterize the disease severity and resource needs of patients with CLTI presenting to facilities of varying resource capacities.</p><p><strong>Objective: </strong>To investigate the association between facility-level Medicaid payer proportions and the incidence of nonelective admissions among patients admitted for CLTI.</p><p><strong>Design, setting, and participants: </strong>In this retrospective multicenter cohort study, 876 026 CLTI-related inpatient admissions at 8769 US facilities from January 1, 1998, through October 31, 2020, were identified in the National Inpatient Sample. Facilities were ranked into quintiles according to increasing Medicaid burden, defined as the annualized proportion of Medicaid patient discharges for all hospitalizations. Inpatient admissions for CLTI were identified using International Classification of Diseases codes for rest pain, foot ulcers, and gangrene. Patients younger than 18 years or older than 100 years were excluded, as were those with missing admission type. Statistical analysis was conducted from January to August 2024.</p><p><strong>Exposure: </strong>Facility-level Medicaid burden quintiles.</p><p><strong>Main outcomes and measures: </strong>Emergency and urgent admissions defined as nonelective admissions.</p><p><strong>Results: </strong>The study included 876 026 CLTI-related admissions (mean [SD] patient age, 68.6 [14.5] years; 54.3% men). Increasing nonelective admission rates were associated with increasing facility Medicaid burden (low Medicaid burden, 59.7%; low-moderate Medicaid burden, 62.2%; moderate Medicaid burden, 63.6%; moderate-high Medicaid burden, 63.6%; and high Medicaid burden, 66.8%; P < .001). This trend persisted across all CLTI-related diagnoses (patients with rest pain: low Medicaid burden, 29.8%; high Medicaid burden, 36.1%; patients with lower-limb ulceration: low Medicaid burden, 63.5%; high Medicaid burden, 71.5%; and patients with gangrene: low Medicaid burden, 61.2%; high Medicaid burden, 67.4%; P < .001). In the adjusted model, odds of nonelective admission for CLTI indications increased progressively among facilities as Medicaid burden increased from low to high (adjusted odds ratio for low-moderate Medicaid burden, 1.05 [95% CI, 1.00-1.11]; P = .06; adjusted odds ratio for high Medicaid burden, 1.44 [95% CI, 1.36-1.52]; P < .001).</p><p><strong>Conclusions and relevance: </strong>High Medicaid burden facilities were associated with increased nonelective admissions for CLTI. This highlights an important mismatch: that resource-constrained facilities are at greater odds of seeing more resource-intensive admissions. Facility-level patient cohort characteristics should be considered when planning for resource allocation to achieve equitable patient care.</p>","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"442-449"},"PeriodicalIF":15.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early vs Delayed Bypass Surgery in Patients With Acute Coronary Syndrome Receiving Ticagrelor: The RAPID CABG Randomized Open-Label Noninferiority Trial.","authors":"Derek Y F So, George A Wells, Marie Lordkipanidzé, Aun Yeong Chong, Marc Ruel, Louis P Perrault, Michel R Le May, Louise Sun, Diem Tran, Marino Labinaz, Christopher Glover, Juan Russo, Mélanie Welman, Vincent Chan, Lily Chen, Jordan Bernick, Fraser Rubens, Jean-Francois Tanguay","doi":"10.1001/jamasurg.2024.7066","DOIUrl":"10.1001/jamasurg.2024.7066","url":null,"abstract":"<p><strong>Importance: </strong>Perioperative bleeding is a major concern in patients receiving ticagrelor for acute coronary syndromes (ACS) when coronary artery bypass graft (CABG) surgery is required.</p><p><strong>Objective: </strong>To evaluate whether early CABG surgery at 2 to 3 days after ticagrelor cessation is noninferior to waiting 5 to 7 days.</p><p><strong>Design, setting, and participants: </strong>RAPID CABG was a noninferiority, open-label randomized trial with 6 months of follow-up. Participants were patients with ACS who had received ticagrelor and required CABG. Patients were enrolled in tertiary centers in Canada between January 2016 and March 2021. Data were analyzed from March 2021 to December 2023.</p><p><strong>Intervention: </strong>Early or delayed CABG.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was based on noninferiority comparison of class 3 or 4 universal definition of perioperative bleeding (UDPB). Noninferiority was prespecified as 8% between groups. Twelve-hour chest tube drainage was reported as a noninferiority comparison. Other bleeding, ischemic, and length-of-stay outcomes were assessed for superiority.</p><p><strong>Results: </strong>Among 143 randomized patients, the median (IQR) age was 65 (58-72) years; there were 117 male patients (82%) and 26 female (18%). Of these, 123 patients (86.0%) underwent surgery in the allocated time frame (per protocol). The median (IQR) time to surgery was 3 (2-3) days in the early group and 6 (5-7) days in the delayed group (P < .001). In a per-protocol analysis, severe or massive UDPB occurred in 3 of 65 early-group patients (4.6%) and 3 of 58 patients (5.2%) in the delayed group (between-group difference, -0.6%; 95% CI, -8.3% to 7.1%; P = .03 for noninferiority). Median (IQR) chest tube drainage was 470 (330-650) mL vs 495 (380-610) mL (between-group difference -25 mL; 95% CI, -111.25 to 35; P = .01 for noninferiority). Median (IQR) hospital stay was 9 (7-13) days and 12 (10-15) days for the early and delayed groups (P < .001).</p><p><strong>Conclusion and relevance: </strong>This study found that an early surgical strategy, 2 to 3 days after ticagrelor cessation, was noninferior in incurring perioperative bleeding. The data support a reduction in the delay between ticagrelor cessation and CABG surgery and may decrease hospital length of stay.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT02668562.</p>","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"387-394"},"PeriodicalIF":15.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Faculty Characteristics and Surgery Trainee Attrition.","authors":"Haley Harris, Isabelle M C Tan, Yuqing Qiu, Julianna Brouwer, Julie Ann Sosa, Heather Yeo","doi":"10.1001/jamasurg.2025.0274","DOIUrl":"10.1001/jamasurg.2025.0274","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}