JAMA surgery最新文献

{"title":"Postdocs Focus on Research-Surgeons Provide Patient Care.","authors":"Isain Zapata","doi":"10.1001/jamasurg.2024.6583","DOIUrl":"https://doi.org/10.1001/jamasurg.2024.6583","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":"48 1","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056905","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":"Benzodiazepines Not Main Suspect in Cardiac Surgery Delirium.","authors":"Amanda M Kleiman,Michael P Calgi,John S McNeil","doi":"10.1001/jamasurg.2024.6603","DOIUrl":"https://doi.org/10.1001/jamasurg.2024.6603","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":"23 1","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056907","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":"Postdocs Focus on Research-Surgeons Provide Patient Care-Reply.","authors":"Jennifer E B Harman,David C Linehan,Anusha Naganathan","doi":"10.1001/jamasurg.2024.6586","DOIUrl":"https://doi.org/10.1001/jamasurg.2024.6586","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":"53 1","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056903","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":"Technique for Laparoscopic Fluorescence–Guided Retroperitoneal Lymph Node Dissection","authors":"Luigi Boni, Elisa Cassinotti, Ludovica Baldari","doi":"10.1001/jamasurg.2024.4110","DOIUrl":"https://doi.org/10.1001/jamasurg.2024.4110","url":null,"abstract":"This Surgical Innovation describes a technique to identify the retroperitoneal lymph using ICG fluorescence, enabling a clear visualization of lymphatics, and nodes that need to be dissected from the surrounding structures.","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":"13 1","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056295","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":"Machine Perfusion and Liver Transplantation-The Future Is Now.","authors":"Daniel Borja-Cacho,Zachary Dietch,Satish N Nadig","doi":"10.1001/jamasurg.2024.6529","DOIUrl":"https://doi.org/10.1001/jamasurg.2024.6529","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":"20 1","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056902","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":"Mixed Results With Oral Antibiotics for Fracture-Related Infections.","authors":"Kamal M F Itani, William G Henderson","doi":"10.1001/jamasurg.2024.6440","DOIUrl":"https://doi.org/10.1001/jamasurg.2024.6440","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005731","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":"Disparities in Access to Time-Sensitive Emergency Trauma Care.","authors":"Cherisse Berry","doi":"10.1001/jamasurg.2024.6411","DOIUrl":"https://doi.org/10.1001/jamasurg.2024.6411","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005722","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":"https://doi.org/10.1001/jamasurg.2024.6045","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-01-22","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":"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":"https://doi.org/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":""},"PeriodicalIF":15.7,"publicationDate":"2025-01-22","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":"Racial and Ethnic Disparities in Use of Helicopter Transport After Severe Trauma in the US.","authors":"Christian Mpody, Maíra I Rudolph, Alexandra Bastien, Ibraheem M Karaye, Tracey Straker, Felix Borngaesser, Matthias Eikermann, Olubukola O Nafiu","doi":"10.1001/jamasurg.2024.6402","DOIUrl":"https://doi.org/10.1001/jamasurg.2024.6402","url":null,"abstract":"<p><strong>Importance: </strong>In the US, traumatic injuries are a leading cause of mortality across all age groups. Patients with severe trauma often require time-sensitive, specialized medical care to reduce mortality; air transport is associated with improved survival in many cases. However, it is unknown whether the provision of and access to air transport are influenced by factors extrinsic to medical needs, such as race or ethnicity.</p><p><strong>Objective: </strong>To examine the current trends of racial and ethnic disparities in air transport use for patients who sustain severe trauma.</p><p><strong>Design, setting, and participants: </strong>This population-based cohort study used data from the National Trauma Data Bank from 2016 to 2022. Participants were patients older than 15 years who sustained a severe injury and required an urgent surgical procedure or intensive care unit (ICU) admission at level I or II trauma centers with helicopter service.</p><p><strong>Exposure: </strong>Severe injury requiring treatment at a level I or II trauma center.</p><p><strong>Main outcomes and measures: </strong>The primary mode of transport, categorized as either helicopter ambulance or ground ambulance. A multifaceted approach was used to narrow the observed racial and ethnic disparities in helicopter deployment. The secondary outcome was mortality after helicopter transport vs ground ambulance transport.</p><p><strong>Results: </strong>Data were included for 341 286 patients at 458 level I or II trauma centers with helicopter service. Their mean (SD) age was 47 (20) years; 243 936 patients (71.6%) were male and 96 633 (28.4%) female. Asian individuals were less likely to receive helicopter transport compared with White individuals (6.8% vs 21.8%; aRR, 0.38; 95% CI, 0.30-0.48; P < .001), driven by lower use for Asian patients in teaching hospitals (aRR, 0.29; 95% CI, 0.21-0.40; P < .001) and level I trauma centers (aRR, 0.33; 95% CI, 0.24-0.44; P < .001). In addition, Black patients were less likely to receive helicopter transport (8.7% vs 21.8%; aRR, 0.42; 95% CI, 0.36-0.49; P < .001), particularly in teaching hospitals (aRR, 0.41; 95% CI, 0.33-0.50; P < .001) and level I trauma centers (aRR, 0.40; 95% CI, 0.34-0.49; P < .001). A similar but less pronounced disparity was noted for Hispanic patients. Helicopter transport was associated with a lower mortality risk compared with ground transport (37.7% vs 42.6%; adjusted relative risk [aRR], 0.87; 95% CI, 0.85-0.89; P < .001).</p><p><strong>Conclusion and relevance: </strong>This study found that racial and ethnic minority patients, particularly Asian and Black patients, and notably those treated at level I teaching hospitals were less likely to receive airlift services compared with White patients. The current expansion of helicopter emergency medical services has yet to translate into equitable care for patients of all races and ethnicities.</p>","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005648","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}