Journal of Surgical Research最新文献

{"title":"From STEP to MAGIC: Patient-Inspired Surgical Innovation.","authors":"Donna C Koo, Megan Z Chiu, Heung Bae Kim","doi":"10.1016/j.jss.2025.02.038","DOIUrl":"https://doi.org/10.1016/j.jss.2025.02.038","url":null,"abstract":"<p><strong>Introduction: </strong>Much of the current standard of care in surgery was, at some time, thought by many to be radical ideas that would \"never work\". This paper describes my personal journey in surgical innovation that was largely inspired by the pioneering parents of very sick children who pushed me to consider why there were not better solutions to difficult problems.</p><p><strong>Innovations: </strong>My path in surgical innovation began with the development of serial transverse enteroplasty, a novel approach for treating children with short bowel syndrome by repurposing traditional surgical methods. Through my clinical practice treating midaortic syndrome, we developed the Tissue Expander-Stimulated Lengthening of Arteries procedure, inspired by the experiment of nature observed when arteries are lengthened by stretching over growing tumors. When confronted with extensive midaortic syndrome too long for Tissue Expander-Stimulated Lengthening of Arteries, we identified the meandering mesenteric artery as an ideal conduit with potential to grow when used as an autologous vessel bypass graft, resulting in the Mesenteric Growth Improves Circulation procedure.</p><p><strong>Conclusions: </strong>From serial transverse enteroplasty to Mesenteric Growth Improves Circulation, I learned the importance of patient-centered care, interdisciplinary collaboration, curiosity across fields, persistent and iterative testing, and supportive mentors and colleagues. Each of these clinical challenges have allowed me the opportunity to question current standards and work to develop a better solution. As the field of surgery continues to grow and evolve, innovation is critical for advancement. I encourage you all, especially the young and aspiring surgeons, to keep your eyes open, keep your minds open, and to never lose your imagination.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selecting Treatments for Peripheral Artery Disease: Differences Between Registry and a Randomized Controlled Trial Population","authors":"Niveditta Ramkumar PhD, MPH ,&nbsp;Philip P. Goodney MD, MS ,&nbsp;Kayla Moore MPH ,&nbsp;Adam J. Goodney ,&nbsp;Aravind S. Ponukumati MD ,&nbsp;Matthew Menard MD ,&nbsp;Alik Farber MD, MBA ,&nbsp;Douglas Staiger PhD","doi":"10.1016/j.jss.2025.02.040","DOIUrl":"10.1016/j.jss.2025.02.040","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients enrolled in randomized trials are carefully selected and may have different comorbidities than patients treated in everyday practice.</div></div><div><h3>Methods</h3><div>We compared characteristics of 1815 patients enrolled in the Best Endovascular or Surgical Treatment for Critical Limb Ischemia (BEST-CLI, NCT02060630) with 104,877 patients receiving endovascular treatment and 32,120 patients undergoing bypass in the Vascular Quality Initiative's (VQI) registry from 2014 to 2020 using descriptive statistics. We studied mortality by treatment type among patients in both the trial and registry using Cox regression. We adjusted for differences in patient characteristics using inverse probability weighting with propensity scores.</div></div><div><h3>Results</h3><div>Compared to the BEST-CLI participants, patients in the VQI registry were commonly older, female, and of non-Hispanic ethnicity. Chronic obstructive pulmonary disease and congestive heart failure were more prevalent in VQI, while coronary artery disease and diabetes rates were higher in BEST-CLI. The unadjusted 1-y mortality in VQI was 12.5% following endovascular treatment and 10.2% following bypass. After weighting VQI patients to represent the BEST-CLI sample, the cumulative 5-y mortality was higher in those undergoing endovascular treatment <em>versus</em> bypass (26.3% <em>versus</em> 23.7%, <em>P</em> &lt; 0.001). Bypass was associated with an 8% lower mortality than endovascular treatment (hazard ratio = 0.92, 95% CI:0.87-0.98, <em>P</em> = 0.005). This effect remained across all weighting schemes, even when limiting to patients treated at a BEST-CLI site.</div></div><div><h3>Conclusions</h3><div>Patients enrolled in BEST-CLI differ from patients treated in VQI. However, reweighting VQI data to represent BEST-CLI yields similar estimates of treatment effects in VQI data, supporting a role for registry-based analytic models in answering comparative, real-world clinical questions.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 286-294"},"PeriodicalIF":1.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twice Harmed: A Descriptive Analysis of Illinois Crime Victim Compensation After Sexual Assault and Domestic Violence","authors":"Ezra F. Moos ,&nbsp;Charlotte Kvasnovsky MD, PhD ,&nbsp;Rachel Nordgren PhD ,&nbsp;Marion C. Henry MD, MPH ,&nbsp;Carmelle Romain MD ,&nbsp;Kylie Callier MD ,&nbsp;Joy Ayemoba MD, MSc ,&nbsp;Fatima Bouftas BS ,&nbsp;Clarice Robinson MSW ,&nbsp;Myles Francis BA ,&nbsp;Carla Galvan BA ,&nbsp;Franklin Cosey-Gay PhD, MPH ,&nbsp;Tanya L. Zakrison MD, MPH ,&nbsp;Phillip M. Dowzicky MD, MSHP","doi":"10.1016/j.jss.2025.02.036","DOIUrl":"10.1016/j.jss.2025.02.036","url":null,"abstract":"<div><h3>Introduction</h3><div>Trauma centers are often the first access portal for victims of sexual assault (SA) and domestic violence (DV), with many requiring surgery or long-term follow-up. In Illinois, crime victim compensation (CVC) offers up to $45,000 to cover victim medical expenses. We hypothesized that CVC claims in Illinois following SA and DV result in significant delays, high rejection rates, and small rewards.</div></div><div><h3>Methods</h3><div>Illinois CVC data (2012-2024) was obtained via a Freedom of Information Act request. CVC data related to SA and DV, including claim types and awards, was compared between genders using descriptive statistics and the Wilcoxon rank-sum test. Award rates were compared to the most recent publicly available set of potential cases from 2012 to 2020.</div></div><div><h3>Results</h3><div>Of 46,792 CVC claims, 45.1% were for assault/battery. Females filed 18,657 claims, of which significantly more were for DV (18.8% <em>versus</em> 2.3%; <em>P</em> &lt; 0.001) and SA (6.8% <em>versus</em> 0.4%; <em>P</em> &lt; 0.001) compared to male claims. Median SA awards were similar for females and males ($947.7 <em>versus</em> $1079.4; <em>P</em> = 0.78). SA claims took a median of 272 ds (&gt;8 mos) to process. In 2020, despite 4733 publicly-reported SA cases in Illinois, 113 (2.4%) SA-related CVC claims were filed with 14 (0.3%) awarded. SA and DV-related claims were most frequently denied for “failure to substantiate” across both genders (67.8% female <em>versus</em> 60.9% male).</div></div><div><h3>Conclusions</h3><div>CVC is underutilized to support SA and DV victims in Illinois. Frontline trauma providers should include CVC education and application assistance as part of wraparound care to better assist patients in their global injury recovery.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 279-285"},"PeriodicalIF":1.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operative Mortality for Male Versus Female Surgeons: A Systematic Review and Meta-Analysis","authors":"Emily J.R. Carter BS ,&nbsp;Matthew S. Linz MD ,&nbsp;Lea C. George MD ,&nbsp;Aleena Dar MD ,&nbsp;Vivienne Qie MD ,&nbsp;Melissa M. Alvarez-Downing MD ,&nbsp;David Howard MD, PhD","doi":"10.1016/j.jss.2025.02.007","DOIUrl":"10.1016/j.jss.2025.02.007","url":null,"abstract":"<div><h3>Introduction</h3><div>This systematic review synthesizes published data concerning whether there is a difference in mortality rate for patients operated on by female surgeons compared to patients operated on by male surgeons. Several studies have attempted to compare surgical outcomes, including operative mortality, of male surgeons <em>versus</em> female surgeons. These studies include many different surgical subspecialties and surgery types. Despite current research on this topic, there has yet to be a published systematic review and meta-analysis quantitatively synthesizing these studies’ findings on operative mortality. This systematic review objectively synthesizes the current published data regarding mortality rate for patients operated on by female surgeons as compared to male surgeons.</div></div><div><h3>Methods</h3><div>The study included patients of any age and sex undergoing any kind of surgical procedure in North America. This review considered all studies that evaluated the performance of any type of surgical procedure by female <em>versus</em> male surgeons and included intraoperative or postoperative mortality as outcomes. Eligible studies were appraised for risk of bias using the Newcastle–Ottawa Scale and for quality using standardized instruments from Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information. Studies were pooled for raw outcomes for statistical meta-analysis including operative mortality counts and rates. Heterogeneity was assessed using Cochran’s Q test. Statistical analyses were performed using a random effects model. A forest plot was created to compare study associations and significance.</div></div><div><h3>Results</h3><div>The search yielded five retrospective cohort studies published between 2000 and 2018 including various surgical subspecialties. In total, 1,055,122 operations were included, performed by 6139 female surgeons and 47,666 male surgeons. There were 4176 deaths among patients operated on by female surgeons and 55,666 among patients operated on by male surgeons, respectively. Forest plot analysis found no evidence of a difference between male and female surgeon mortality rate among the studies (pooled odds ratio 0.96 [0.88-1.05]).</div></div><div><h3>Conclusions</h3><div>All five studies provided odds ratios for mortality and four of five provided counts for mortality. There was no statistical difference in mortality between male and female surgeons among the studies.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 270-278"},"PeriodicalIF":1.8,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Tale of Two Sides: Exploring Faculty and Resident Perspectives on Feedback by Qualitative Analysis","authors":"Christine Wu MD, MMSc ,&nbsp;Wendy Williams JD ,&nbsp;Amanda J. Reich PhD, MPH ,&nbsp;Stephanie L. Nitzschke MD, MS, FACS","doi":"10.1016/j.jss.2025.02.023","DOIUrl":"10.1016/j.jss.2025.02.023","url":null,"abstract":"<div><h3>Introduction</h3><div>Feedback is an essential yet challenging process to operationalize among surgical faculties and residents. It remains a frequently cited area of dissatisfaction by residents. Furthermore, there is a discrepancy between faculty and resident perceptions of feedback being given and received. With the transition to competency-based education, optimizing feedback practices is of paramount importance. We aimed to explore the surgical faculty and resident perspectives on feedback to better understand the challenges and culture surrounding feedback.</div></div><div><h3>Methods</h3><div>We conducted semistructured interviews with faculty and focus groups with residents at a single academic institution’s general surgery residency program. Interviews were transcribed, coded by two reviewers independently, and then reconciled by consensus. A thematic analysis approach was used to capture emerging concepts.</div></div><div><h3>Results</h3><div>A total of 16 faculties and 15 residents from all five postgraduate years participated. Nearly half of participants were women (<em>n</em> = 15, 48.4%), with seven faculty (43.8%) and eight residents (53.3%). Faculties and residents had different perspectives on feedback, and three major themes were identified: (1) faculty frustration, fatigue, and uncertainty; (2) interpersonal dynamics for different levels of training; and (3) structural refinement of the learning environment.</div></div><div><h3>Conclusions</h3><div>Substantial differences exist between surgical faculty and resident perspectives on the feedback. Further feedback development is warranted, and targeted interventions for residents tailored to training levels may be effective in strengthening feedback experiences and learning opportunities. Aligning faculty and resident mindsets with shared mental models and expectations will meaningfully support resident advancement toward entrustment as competent surgeons.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 233-242"},"PeriodicalIF":1.8,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Scoping Review of Trauma-Informed Language in the Care of Injured Patients","authors":"Lucy D. Hart MD ,&nbsp;Prema Kallepali BS ,&nbsp;Christine A. Castater MD, MBA ,&nbsp;Manuela Ochoa MD ,&nbsp;Mia White MILS ,&nbsp;Jasmin Strong BS ,&nbsp;John N. Bliton MD ,&nbsp;Randi N. Smith MD, MPH","doi":"10.1016/j.jss.2025.02.037","DOIUrl":"10.1016/j.jss.2025.02.037","url":null,"abstract":"<div><h3>Introduction</h3><div>Trauma-informed care is a healthcare model that mitigates traumatic stress and avoids patient retraumatization. Trauma-informed language (TIL) promotes safety and autonomy to injured patients by using patient-centered language. This scoping review evaluates the literature on the education, guidance, and outcomes associated with TIL when caring for injured patients.</div></div><div><h3>Methods</h3><div>Cochrane CENTRAL, CINAHL, Embase, PubMed, and Web of Science were searched using terms associated with TIL, gun, gunshot, violent injury, residency, education, and emergency department. Results included studies with a focus on TIL. Case reports, commentaries, editorials, meta-analyses, and systematic reviews were excluded. Two team members reviewed records and a third resolved conflicts. The search yielded 3960 records. After 1599 duplicates were removed, 2401 studies were reviewed for abstract screening. Of the 20 studies selected for full-text review, three were eligible for this study.</div></div><div><h3>Results</h3><div>Included studies suggest that TIL is rarely utilized when managing injured patients. This leads to communication challenges between trauma patients and providers. When taught, TIL improves trainee communication skills. When utilized in the health-care setting, TIL improves patient satisfaction and mitigates post-traumatic symptoms in patients and physicians.</div></div><div><h3>Conclusions</h3><div>Understanding the impact TIL has on victims of violent injury remains elusive due to the paucity of literature. Education on TIL is essential for all clinicians to improve patient outcomes and promote health equity. Future studies should focus on evaluating pedagogical approaches to integrating TIL into trauma care with an end goal of increasing comprehensive empathy practices and enhancing patient outcomes.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 264-269"},"PeriodicalIF":1.8,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Dedicated Outbound Scheduler Is Associated With Improved Clinic Utilization and Access to Care","authors":"Meridiana Mendez BS ,&nbsp;Gemima Nanizao (BS candidate) ,&nbsp;Amy C. Taylor RN, BSN ,&nbsp;Callie Krewson BA, DO ,&nbsp;Kathleen Kieran MD, MS, MME","doi":"10.1016/j.jss.2025.02.015","DOIUrl":"10.1016/j.jss.2025.02.015","url":null,"abstract":"<div><h3>Introduction</h3><div>Differential access to care for patients living in more disadvantaged areas has been well-documented, though the specific factors underlying these disparities have not been well-described. We undertook this study to describe how clinic utilization and patient demographics differed before and after the utilization of a dedicated scheduler making outbound calls for scheduling.</div></div><div><h3>Methods</h3><div>We identified all new patients seen in a single pediatric urology outreach clinic in March and April 2021 (before the scheduler being hired); July and October 2021; and April, July, and October 2022 (after the scheduler was hired). We recorded the overall clinic utilization for each fiscal year and also demographic data (including Area Deprivation Index) on the new patients seen in clinic. Data before and after the hiring of the dedicated scheduler were compared.</div></div><div><h3>Results</h3><div>Scheduled clinic utilization increased from 93.6% in FY2021 to 95.2% in FY2022 and to 98.9% in early FY2023. Missed appointments were relatively stable at 7.4% in FY2021, 7.8% in FY2022, and 6.8% in early FY2023. There was a 39.1% increase in the number of new patients seen per clinic shortly after the addition of an outbound clinic-embedded scheduler (8.63 <em>versus</em> 12), which was sustained and slightly increased to 43.8% (8.63 <em>versus</em> 12.4) 1 y later. The proportion of new patients living in the most disadvantaged areas (Area Deprivation Index 8-10) rose 35.3% (from 49.3% to 66.7%; <em>P</em> = 0.04) shortly after the outbound clinic-embedded scheduler was hired and remained 27.7% higher (49.3% <em>versus</em> 62.9%; <em>P</em> = 0.07) 1 y later. The proportion of new patients speaking a language other than English increased from 8.7% before the outbound clinic-embedded scheduler to 13.9% (<em>P</em> = 0.48) shortly after the outbound clinic-embedded scheduler, and 21.0% (<em>P</em> = 0.03) 1 y later.</div></div><div><h3>Conclusions</h3><div>Addition of a dedicated clinic scheduler making outbound calls was associated with a durable increase in clinic utilization and improved access primarily for patients living in the most disadvantaged areas. Further research is needed to identify what aspects of outbound scheduling are most helpful to the most vulnerable patients.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 250-256"},"PeriodicalIF":1.8,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Socioeconomic Disadvantage and Deceased Donor Kidney Transplant Graft Function","authors":"Matthew M. Byrne MD ,&nbsp;Jenny Ganay-Vasquez BA ,&nbsp;Marie L. Jacobs MD ,&nbsp;Korry Wirth MD ,&nbsp;Peter Hendzlik BS ,&nbsp;John Martens MPH ,&nbsp;M. Katherine Dokus MPH ,&nbsp;Jennifer I. Melaragno PharmD ,&nbsp;Hafsa Tariq MD ,&nbsp;Jeremy Taylor MD ,&nbsp;David DeWolfe MD ,&nbsp;Amit Nair MBBS ,&nbsp;Randeep Kashyap MD ,&nbsp;Roberto Hernandez-Alejandro MD ,&nbsp;Paula Cupertino PhD ,&nbsp;Nicole A. Wilson PhD, MD ,&nbsp;Karen Pineda-Solis MD","doi":"10.1016/j.jss.2025.02.030","DOIUrl":"10.1016/j.jss.2025.02.030","url":null,"abstract":"<div><h3>Introduction</h3><div>The study of social determinants of health in kidney transplantation has historically focused on equitable access, with limited evidence on the short- and long-term outcomes beyond graft loss and mortality. Our purpose is to identify and assess factors to ensure equitable outcomes after kidney transplant by identifying targets for health-care interventions in the posttransplant phase of care.</div></div><div><h3>Methods</h3><div>This is a single institution, cohort study of adults who received deceased donor kidney transplantation at a high-volume transplant center. Transplant recipients were stratified by social deprivation index (SDI) at the population mean of 60. The primary outcome is change in estimated glomerular filtration rate (eGFR).</div></div><div><h3>Results</h3><div>A total of 236 recipients were included, 48% (<em>n</em> = 113) were from higher deprivation neighborhoods (SDI &gt;60). These recipients were younger, more likely to be black, and had lower estimated posttransplant survival scores. Both groups received grafts with similar kidney donor profile index scores. Despite similar discharge eGFR, recipients from high SDI neighborhoods had significantly lower eGFRs at all follow-up points, confirmed with mixed-effect analysis.</div></div><div><h3>Conclusions</h3><div>Recipients from neighborhoods with higher deprivation index have worse short- and long-term graft function, despite being younger, having lower estimated posttransplant survival scores, and similar graft kidney donor profile index at transplantation. This unexplained compromise in graft function is an opportunity for community-based interventions after recipients receive deceased donor kidney transplantation.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 243-249"},"PeriodicalIF":1.8,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Pediatric Urology Patients With Same-Day Surgery Cancellations: Who Is at Risk?","authors":"Meridiana Mendez BS ,&nbsp;Sarah K. Holt PhD ,&nbsp;Gemima Nanizao BS candidate ,&nbsp;Aiden Hoefer BS ,&nbsp;Megan Girard BA ,&nbsp;Brianna Vorsburgh ,&nbsp;Amy C. Taylor RN, BSN ,&nbsp;Kathleen Kieran MD, MS, MME","doi":"10.1016/j.jss.2025.02.029","DOIUrl":"10.1016/j.jss.2025.02.029","url":null,"abstract":"<div><h3>Introduction</h3><div>Day-of-surgery cancellations (DOSC) negatively impact patients, health-care providers, and systems. We assessed whether patient demographics, level of community disadvantage, and travel distance are associated with DOSC.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed all elective outpatient urology surgery from January 2021 to June 2023. We collected patients' demographics, travel distance, diagnosis, and level of community disadvantage using the Area Deprivation Index (ADI). Patients with and without DOSC were compared.</div></div><div><h3>Results</h3><div>Of 516 scheduled surgeries, 26 cases (5.0%) were DOSC. One patient had two DOSC. Children with completed and canceled surgeries were similar in age (2.85 <em>versus</em> 1.89 ys, <em>P</em> = 0.71). Reasons for DOSC included: medical problem (9/26; 34.6%), no longer desired surgery (4/26; 15.4%), needed more information (2/26; 7.7%); confused about logistics (2/26; 7.7%); did not arrive (7/26; 26.9%); insufficient fasting (2/26; 7.7%). Patients using a language other than English for care were equally likely to cancel compared to patients who spoke English (5.9% <em>versus</em> 5.0%, adjusted odds ratio [OR] = 2.06, 95% confidence interval [CI]: 0.53-7.98; <em>P</em> = 0.29). Children living in most disadvantaged areas (ADI 9-10) and children living in the least disadvantaged areas (ADI 1-2) were equally likely to have surgery canceled, though 6.1% of patients with DOSC lived in ADI 9-10, and no children living in ADI 1-2 canceled. Compared with White non-Hispanic patients (10/226 [4.4%] DOSC), Black patients had similar DOSC (2/14 [14.3%], adjusted OR = 2.91, 95% CI: 0.55-15.36, <em>P</em> = 0.26), though Hispanic patients had a lower likelihood of DOSC (6/190 [3.2%], adjusted OR = 0.45, 95% CI: 0.13-1.54, <em>P</em> = 0.02). The likelihood of DOSC was similar for patients living more than 45 miles away (3.9% [10/258]) compared with those living within 20 miles (14/214 [6.5%]; adjusted OR = 0.49, 95% CI: 0.2-1.19, <em>P</em> = 0.51).</div></div><div><h3>Conclusions</h3><div>Patients living further away or speaking languages other than English are not more likely to have DOSC. Further investigation may identify patient- and community-specific factors influencing DOSC.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 257-263"},"PeriodicalIF":1.8,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter Regarding: An In-Depth Analysis of the State Laws That License International Medical Graduates Without American Residency Training.","authors":"Praveen Meka","doi":"10.1016/j.jss.2025.02.032","DOIUrl":"https://doi.org/10.1016/j.jss.2025.02.032","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}