Journal of Surgical Research最新文献

筛选
英文 中文
Association Between Blood Type and Mortality Among Severely Injured Patients Enrolled in the Pragmatic Randomized Optimal Platelet and Plasma Ratios Trial. 在实用的随机最佳血小板和血浆比率试验中登记的严重损伤患者中,血型与死亡率的关系。
IF 1.8 3区 医学
Journal of Surgical Research Pub Date : 2025-01-16 DOI: 10.1016/j.jss.2024.12.030
Emily W Baird, Daniel T Lammers, Peter J Abraham, Zain G Hashmi, Russell L Griffin, Shannon W Stephens, Jessica C Cardenas, Jillian R Richter, Jan O Jansen, John B Holcomb
{"title":"Association Between Blood Type and Mortality Among Severely Injured Patients Enrolled in the Pragmatic Randomized Optimal Platelet and Plasma Ratios Trial.","authors":"Emily W Baird, Daniel T Lammers, Peter J Abraham, Zain G Hashmi, Russell L Griffin, Shannon W Stephens, Jessica C Cardenas, Jillian R Richter, Jan O Jansen, John B Holcomb","doi":"10.1016/j.jss.2024.12.030","DOIUrl":"https://doi.org/10.1016/j.jss.2024.12.030","url":null,"abstract":"<p><strong>Introduction: </strong>Previous studies suggested that type O blood may be associated with increased mortality and/or thrombotic complications among trauma patients. The purpose of this analysis was to evaluate the relationship between endogenous blood type, mortality, and complications among patients receiving massive transfusions, using data from the Pragmatic Randomized Optimal Platelet and Plasma Ratios trial.</p><p><strong>Materials and methods: </strong>This was a secondary analysis of the Pragmatic Randomized Optimal Platelet and Plasma Ratios trial that included patients with the reported blood type (A, AB, B, or O) data. Outcomes were early and late mortality and clinical complications. Endogenous von Willebrand Factor (vWF) antigen levels, vWF activity, and factor VIII levels were measured with admission labs and compared. Logistical regression was used to assess associations between mortality and blood type.</p><p><strong>Results: </strong>Among 680 patients, 655 who had admission blood type data were included. 322 (49.2%) were type O, 186 (28.4%) were type A, 27 (4.1%) were type AB, and 120 (18.3%) were type B. The mean age, gender distribution, mechanism of injury, injury severity, and injury patterns were similar between blood types. There were significant racial and ethnic differences (P < 0.001 and P < 0.0018, respectively), and patients with endogenous type O blood had decreased levels of vWF activity and vWF antigen (P = 0.022 and P = 0.016, respectively). Logistical analyses showed no significant associations between blood type and complications, and type O blood was not associated with increased mortality.</p><p><strong>Conclusions: </strong>We found that endogenous blood type was not associated with increased mortality or clinical complications in severely injured patients requiring massive transfusion based on the data from a large multicenter trial.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"306 ","pages":"283-289"},"PeriodicalIF":1.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007373","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}
引用次数: 0
A Step Beyond Mortality: Identifying Factors of Prolonged Hospital Stay for Emergency General Surgery Conditions in a Low- and Middle-Income Country. 超越死亡率的一步:确定低收入和中等收入国家急诊普通外科住院时间延长的因素。
IF 1.8 3区 医学
Journal of Surgical Research Pub Date : 2025-01-16 DOI: 10.1016/j.jss.2024.12.024
Asma Altaf Hussain Merchant, Komal Abdul Rahim, Namra Qadeer Shaikh, Noreen Afzal, Saad Bin Zafar Mahmood, Saqib Kamran Bakhshi, Mushyada Ali, Shayan Ali Shah, Zainab Samad, Adil H Haider
{"title":"A Step Beyond Mortality: Identifying Factors of Prolonged Hospital Stay for Emergency General Surgery Conditions in a Low- and Middle-Income Country.","authors":"Asma Altaf Hussain Merchant, Komal Abdul Rahim, Namra Qadeer Shaikh, Noreen Afzal, Saad Bin Zafar Mahmood, Saqib Kamran Bakhshi, Mushyada Ali, Shayan Ali Shah, Zainab Samad, Adil H Haider","doi":"10.1016/j.jss.2024.12.024","DOIUrl":"https://doi.org/10.1016/j.jss.2024.12.024","url":null,"abstract":"<p><strong>Introduction: </strong>While various factors leading to prolonged length of stay (LOS) have been identified for emergency general surgery (EGS), there is limited literature on specific factors for individual emergent specialties. This study aimed to identify patient factors and in-hospital complications associated with prolonged LOS for gastrointestinal (GI) and non-GI-related EGS presentations in a low-resource setting.</p><p><strong>Methods: </strong>Data from 2010 to 2019 were retrieved from one of the largest tertiary care centers in Pakistan. We included adult patients (≥18 y) with index admissions for primary EGS conditions mapped to surgical areas defined by the American Association for Surgery of Trauma. Multivariable linear regression models were created to ascertain factors associated with prolonged LOS for 11 American Association for Surgery of Trauma -defined surgical areas.</p><p><strong>Results: </strong>The mean age of 31,499 patients was 48.87 ± 16.82 y, where 23,198 (73.65%) patients underwent surgery. Undergoing emergency surgery was independently associated with increased LOS for all surgical areas (all P values < 0.05), except for hepatic-pancreatic-biliary. Sepsis and septic shock were the most common complications for both operated and nonoperated patients and were significantly associated with increased LOS for most of the surgical areas. For non-GI-related surgical areas, uninsured patients had significantly greater LOS for soft tissue conditions only (β: 0.85; 95% CI: 0.49, 1.21).</p><p><strong>Conclusions: </strong>Different specialties have different drivers for prolonged hospital stay in EGS. This underscores the need to identify and address patient factors and in-hospital complications early on, according to individual specialties. Specific strategies catered to these factors will optimize preoperative care and reduce complications, ultimately decreasing patients' stay after an EGS presentation.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"306 ","pages":"272-282"},"PeriodicalIF":1.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007371","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}
引用次数: 0
The Role of Patient-Controlled Epidural Analgesia in the Short-Term Outcomes of Laparoscopic-Assisted Gastrectomy in Elderly Gastric Cancer Patients. 患者自控硬膜外镇痛对老年胃癌患者腹腔镜胃切除术近期疗效的影响。
IF 1.8 3区 医学
Journal of Surgical Research Pub Date : 2025-01-13 DOI: 10.1016/j.jss.2024.11.008
Junjian Yu, Taohua Zheng, Antai Yuan, Wei Wang, Zequn Li, Shougen Cao
{"title":"The Role of Patient-Controlled Epidural Analgesia in the Short-Term Outcomes of Laparoscopic-Assisted Gastrectomy in Elderly Gastric Cancer Patients.","authors":"Junjian Yu, Taohua Zheng, Antai Yuan, Wei Wang, Zequn Li, Shougen Cao","doi":"10.1016/j.jss.2024.11.008","DOIUrl":"https://doi.org/10.1016/j.jss.2024.11.008","url":null,"abstract":"<p><strong>Introduction: </strong>Patient-controlled intravenous analgesia (PCIA) and patient-controlled epidural analgesia (PCEA) constitute two major advances in pain management after major abdominal surgery. However, the role of PCIA or PCEA has not been particularly studied in elderly patients with gastric cancer. The aim of this study is to make a comparison between PCIA and PCEA in terms of their performance on short-term outcomes in elderly patients undergoing laparoscopic-assisted gastrectomy.</p><p><strong>Methods: </strong>This single-center, retrospective study included 254 elderly patients (≥70 y) who underwent laparoscopic radical gastrectomy for gastric cancer. Patients received either general anesthesia combined with epidural anesthesia followed by PCEA (PCEA group, n = 123) or general anesthesia alone followed by PCIA (PCIA group, n = 131). The primary endpoint was pain intensity-tested using a 100-mm visual analog scale on postoperative days 1, 2, and 3. Demographics, comorbidities, perioperative data, postoperative short-term outcomes, and analgesia-related side effects were also assessed.</p><p><strong>Results: </strong>The visual analog scale scores at rest were lower in the PCEA group compared to the PCIA group on postoperative day 1, 2, and 3 (27.8 ± 13.9 versus 33.1 ± 15.0, P = 0.004; 25.2 ± 11.3 versus 30.1 ± 14.3, P = 0.002; 16.9 ± 7.1 versus 20.9 ± 9.5, P < 0.001, respectively). The postoperative hospital stay was shorter in the PCEA group than in the PCIA group (11 versus 12 d, P = 0.018). The times to postoperative first flatus, semifluid diet, independent ambulation, and tracheal extubation after surgery in the PCEA group were significantly shorter than in the PCIA group. Overall morbidity, mortality, hospital readmission rate, and reoperation rate were not significantly different between the two groups. Regarding side-effects related to analgesia, there were no significant differences in terms of the rates of postoperative nausea and vomiting, urinary retention, or oxygen saturation <90% between the two groups. However, PCEA was associated with a higher incidence of postoperative hypotension compared to PCIA (10.6% versus 3.8%, P = 0.036).</p><p><strong>Conclusions: </strong>In elderly patients undergoing laparoscopic radical gastrectomy, epidural anesthesia and analgesia may convey superior pain relief, faster restoration of gastrointestinal motility, and shorter hospitalization.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"306 ","pages":"257-265"},"PeriodicalIF":1.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983826","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}
引用次数: 0
A Single-Institution Analysis of Surveillance Practice for Low-Risk Neuroblastic Tumors. 低风险神经母细胞肿瘤监测实践的单机构分析。
IF 1.8 3区 医学
Journal of Surgical Research Pub Date : 2025-01-13 DOI: 10.1016/j.jss.2024.12.021
Shachi Srivatsa, Dana Schwartz, Sara A Mansfield, Josh Bricker, Grace Mallampalli, Keri Streby, Nilay Shah, Mark Ranalli, Kathleen Nicol, Jennifer English, Lindsay Cole, Jennifer H Aldrink
{"title":"A Single-Institution Analysis of Surveillance Practice for Low-Risk Neuroblastic Tumors.","authors":"Shachi Srivatsa, Dana Schwartz, Sara A Mansfield, Josh Bricker, Grace Mallampalli, Keri Streby, Nilay Shah, Mark Ranalli, Kathleen Nicol, Jennifer English, Lindsay Cole, Jennifer H Aldrink","doi":"10.1016/j.jss.2024.12.021","DOIUrl":"https://doi.org/10.1016/j.jss.2024.12.021","url":null,"abstract":"<p><strong>Introduction: </strong>Currently, few prospective guidelines exist for the surveillance of children with low-risk neuroblastic tumors (LRNBTs), including ganglioneuroma or ganglioneuroblastoma intermixed. This study aims to describe our institutional approach to LRNBT surveillance following surgical resection or nonoperative management. We hypothesize that length of surveillance can be reduced due to low recurrence risk.</p><p><strong>Methods: </strong>We conducted a retrospective review of patients diagnosed with LRNBT at our institution between January 1, 2010, and December 31, 2022. The majority of patients were followed in our multidisciplinary surgical oncology clinic. We summarized relevant patient data including follow-up imaging modalities and recurrences.</p><p><strong>Results: </strong>Thirty-eight patients met the inclusion criteria at a median age of diagnosis of 9 ys (interquartile range [IQR]: 5, 12.75). Thirty-seven patients underwent surgical resection, with tumors located in the posterior mediastinum (n = 18), retroperitoneum (n = 14), presacral space (n = 3), pelvis (n = 1), or combined thoracic or retroperitoneal location (n = 1). One patient underwent nonoperative management for a tumor located in the retroperitoneum. Histopathological results demonstrated 18 cases of ganglioneuroma and 20 cases of ganglioneuroblastoma intermixed. The median duration of postoperative follow-up was 27 mos (IQR: 14, 51) and the median clinical visits per year was 2.6 [IQR: 1.5, 3.4). Surveillance imaging was performed at a median frequency of 2.4 times per year (IQR: 1.6, 3.1). Chest radiographs were the most common modality used for thoracic locations (34% of all imaging) and ultrasound was used most commonly for abdominal location (24% of all imaging). During surveillance, one recurrent or residual ganglioneuroma was identified on magnetic resonance imaging at 6.7 mos from presacral resection. This patient underwent repeat surgical resection, and subsequent surveillance demonstrated no further recurrences.</p><p><strong>Conclusions: </strong>Recurrence was low in this cohort of LRNBT patients. Optimal surveillance strategies for this low-risk pathology would minimize radiation exposure and burden of health-care visits to patients. Further multi-institutional studies are warranted to determine the best imaging modality, as well as the frequency and duration of follow-up visits for LRNBT patients. Future studies should evaluate the acceptability of short-term surveillance for those who achieve complete resection.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"306 ","pages":"266-271"},"PeriodicalIF":1.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983800","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}
引用次数: 0
Sildenafil Attenuates Persistent Pulmonary Hypertension of the Newborn via Inhibiting the Growth and Migration of Pulmonary Artery Smooth Muscle Cells. 西地那非通过抑制肺动脉平滑肌细胞的生长和迁移来减轻新生儿持续性肺动脉高压。
IF 1.8 3区 医学
Journal of Surgical Research Pub Date : 2025-01-13 DOI: 10.1016/j.jss.2024.12.013
Lili Kang, Yujie Han, Chen Liu, Xianghong Liu, XiaoMei Li, Zilong Li, Xiaoying Li
{"title":"Sildenafil Attenuates Persistent Pulmonary Hypertension of the Newborn via Inhibiting the Growth and Migration of Pulmonary Artery Smooth Muscle Cells.","authors":"Lili Kang, Yujie Han, Chen Liu, Xianghong Liu, XiaoMei Li, Zilong Li, Xiaoying Li","doi":"10.1016/j.jss.2024.12.013","DOIUrl":"https://doi.org/10.1016/j.jss.2024.12.013","url":null,"abstract":"<p><strong>Introduction: </strong>Sildenafil, a selective phosphodiesterase 5 inhibitor, modulates vascular dysfunction, with hypoxia-induced pulmonary artery smooth muscle cells (PASMCs) proliferation, migration, and invasion closely implicated in vascular remodeling in persistent pulmonary hypertension of the newborn (PPHN). This study aimed to assess sildenafil's protective effects against PPHN and elucidate underlying molecular pathways.</p><p><strong>Methods: </strong>Cell Counting Kit-8, wound healing, and Transwell assays evaluated rat PASMC proliferation, migration, and invasion under hypoxia. A rat PPHN model assessed sildenafil's impact on right ventricular systolic pressure (RVSP), right ventricular hypertrophy (RVH), and vascular remodeling. JAK2/STAT3 signaling was analyzed via Western blotting.</p><p><strong>Results: </strong>Sildenafil significantly inhibited hypoxia-induced PASMC proliferation, migration, and invasion. In addition, sildenafil reduced RVSP, RVH, and vascular remodeling in PPHN. Further, sildenafil decreased JAK2 and STAT3 phosphorylation in hypoxia-exposed PASMCs and the PPHN rat model. The JAK2/STAT3 pathway agonist colivelin reversed sildenafil's suppressive effects on PASMC proliferation, migration, invasion, as well as RVSP, RVH, and vascular remodeling in PPHN.</p><p><strong>Conclusions: </strong>Sildenafil protects against PPHN by inhibiting PASMC proliferation, migration, and invasion via suppression of JAK2/STAT3 signaling, indicating its potential as a therapeutic target for PPHN and contributing to a more comprehensive understanding of PPHN pathogenesis.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"306 ","pages":"249-256"},"PeriodicalIF":1.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983801","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}
引用次数: 0
The Association of Care Fragmentation on Overall Survival for Early Stage Breast Cancer. 护理碎片化与早期乳腺癌总生存率的关系。
IF 1.8 3区 医学
Journal of Surgical Research Pub Date : 2025-01-13 DOI: 10.1016/j.jss.2024.11.044
Margaret Min, Kerri-Anne Crowell, Kristen Rhodin, Amanda Nash, Kendra J Modell Parrish, Hannah E Woriax, E Shelley Hwang
{"title":"The Association of Care Fragmentation on Overall Survival for Early Stage Breast Cancer.","authors":"Margaret Min, Kerri-Anne Crowell, Kristen Rhodin, Amanda Nash, Kendra J Modell Parrish, Hannah E Woriax, E Shelley Hwang","doi":"10.1016/j.jss.2024.11.044","DOIUrl":"https://doi.org/10.1016/j.jss.2024.11.044","url":null,"abstract":"<p><strong>Introduction: </strong>Optimal treatment of stage I-III breast cancer requires multimodal therapies. Patients can receive these therapies at one or multiple facilities. Herein, we evaluated the association of receiving treatment at more than one facility and distance to that facility on overall survival.</p><p><strong>Methods: </strong>The 2004-2019 National Cancer Database was queried for patients with stage I-III breast cancer who received at least two modalities of treatment. \"Coordinated care\" was designated when a patient received all modalities of treatment at the same facility and \"fragmented care\" was designated when a patient received treatment at two or more facilities. Multivariable logistic regression was performed to identify factors associated with fragmented care. Overall survival was compared using Kaplan-Meier and Cox proportional hazards methods.</p><p><strong>Results: </strong>A total of 536,896 patients met the study criteria, of which 317,038 (59.1%) patients received coordinated care and 219,848 (40.9%) patients received fragmented care. Decreased mortality was seen with fragmented care in stage II and III patients (hazard ratio (HR): 0.92 and 0.94 respectively; 95% confidence interval (CI): 0.88-0.97, 0.89-0.99; P < 0.001), and receipt of care at an Academic/Research Program (HR: 0.89; 95% CI: 0.84-0.93). Unexpectedly, living greater than 50 miles away from the treating facility was also associated with decreased mortality (HR: 0.85; 95% CI: 0.81-0.90]), although this represented a small minority of patients (N = 30,290, 6.5%).</p><p><strong>Conclusions: </strong>For patients with early-stage breast cancer, receipt of fragmented care and greater distance to treating facility were not associated with worse outcomes. These results support patients' receipt of some care locally, underscoring the need for effective communication across the clinical care team.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"306 ","pages":"239-248"},"PeriodicalIF":1.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983803","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}
引用次数: 0
Clinical and Demographic Factors Associated Suicide Risk in Patients With Colorectal Cancer. 结直肠癌患者自杀风险相关的临床和人口学因素
IF 1.8 3区 医学
Journal of Surgical Research Pub Date : 2025-01-10 DOI: 10.1016/j.jss.2024.12.026
Annmarie Butare, M Drew Honaker, Sydney Taylor, Rebecca A Snyder, Alexander A Parikh
{"title":"Clinical and Demographic Factors Associated Suicide Risk in Patients With Colorectal Cancer.","authors":"Annmarie Butare, M Drew Honaker, Sydney Taylor, Rebecca A Snyder, Alexander A Parikh","doi":"10.1016/j.jss.2024.12.026","DOIUrl":"https://doi.org/10.1016/j.jss.2024.12.026","url":null,"abstract":"<p><strong>Introduction: </strong>Mental health is adversely affected by a cancer diagnosis. As the incidence of colorectal cancer (CRC) is on the rise, data regarding mental health and suicide among CRC patients is lacking. The primary aim of this study is to investigate the incidence of suicide among CRC patients in comparison to the general population. The secondary aim is to identify factors that are associated with increased risk of suicide among patients with CRC.</p><p><strong>Methods: </strong>A cross-sectional study was conducted utilizing the Surveillance, Epidemiology, and End Results Program database from 2000 to 2018. Standardized Mortality Ratios (SMRs) were calculated for 5-y age groups. Cox's cause-specific hazards model was utilized to compare covariates that increased the risk of suicide.</p><p><strong>Results: </strong>A total of 530,711 patients were included. 289,363 (54%) were male. Overall, there were 782 (0.15%) suicides, of which 687 (88%) occurred in males. The SMR due to suicide was significantly higher in males (SMR 1.60, 95% confidence interval [CI] 1.481-1.722; P < 0.001) including ages 35-49 ys and over 60 ys, however, not in females (SMR 1.12, 95% CI 0.91-1.375; P = 0.276). Factors independently associated with increased suicide risk included distant disease (hazard ratio [HR] 2.57; CI 1.96, 3.39; P=<0.0001), radiation (HR 1.45; CI 1.16, 1.80; P = 0.0009), and increased age (HR 1.05 per 5-y increase; CI 1.02, 1.09; P = 0.0013). Factors associated with decreased risk of suicide included non-Hispanic Black race (HR 0.27; CI 0.18, 0.41; P= <0.0001), Hispanic race (HR 0.31; 95% CI 0.21, 0.45; P=<0.0001), being married (HR 0.56; CI 0.49, 0.65; P=<0.0001), living in metropolitan area (HR 0.74; CI 0.61, 0.90; P = 0.003), and receiving chemotherapy (HR 0.71; CI 0.58, 0.86; P = 0.0001).</p><p><strong>Conclusions: </strong>Male colorectal patients aged 35-49 ys and over 60 ys are at a higher risk of suicide than the general United States population. Understanding factors that increase a patient's risk for suicide will be important to develop strategies to mitigate this risk and improve overall mental health.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"306 ","pages":"217-223"},"PeriodicalIF":1.8,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971264","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}
引用次数: 0
Factors Contributing to Opioid Overprescribing at Surgical Discharge. 影响手术出院时阿片类药物过量处方的因素。
IF 1.8 3区 医学
Journal of Surgical Research Pub Date : 2025-01-10 DOI: 10.1016/j.jss.2024.11.034
Lindsey E Dayer, Cheng Peng, Adrian J Williams, Lisa Luciani, Joshua Lowery, Brittany Butterfield, Jacob T Painter
{"title":"Factors Contributing to Opioid Overprescribing at Surgical Discharge.","authors":"Lindsey E Dayer, Cheng Peng, Adrian J Williams, Lisa Luciani, Joshua Lowery, Brittany Butterfield, Jacob T Painter","doi":"10.1016/j.jss.2024.11.034","DOIUrl":"https://doi.org/10.1016/j.jss.2024.11.034","url":null,"abstract":"<p><strong>Introduction: </strong>Opioids remain the gold standard for treating acute pain, whereas overprescribing occurs regularly in the postoperative setting with little clinical guidance. The objective of this study is to examine whether the length of surgery is an independent risk factor for opioid overprescribing at discharge.</p><p><strong>Methods: </strong>We conducted a retrospective case-control study to determine if there is an association between the length of surgery and overprescribed opioids. The setting was an academic medical center located in the southern region of the United States - an adult level-one trauma center. It is a general medical and surgical facility and a teaching hospital. The study was determined not to be human subject research by the local institutional review board.</p><p><strong>Results: </strong>Our final sample consisted of 4367 patients that met the eligibility criteria. Of these patients, 1347 (30.84%) had been discharged on morphine equivalent daily dose (MEDD) greater than the previously administered 24-h MEDD. After adjusting for other covariates, the logistic regression analysis of the length of surgery showed that the risk of opioid overprescribing increased as the surgery lasted longer (adjusted odds ratio [AOR] 1.150, 95% confidence interval [CI] 1.099-1.202) and showed that older patients (AOR 1.010, 95% CI 1.006-1.015), males (AOR 1.168, 95% CI 1.006-1.356), non-White individuals (AOR 1.192, 95% CI 1.029-1.380), and patients who experienced lower average pain scores (AOR 0.789, 95% CI 0.757-0.823) had a significantly higher risk of opioid overprescribing.</p><p><strong>Conclusions: </strong>Overprescribing at discharge could result in unnecessary opioids in the community, which may, in turn, lead to opioid abuse, misuse, and diversion. Based on our study, opioid prescribing at discharge is often driven by factors other than inpatient opioid use. Therefore, considering patient-specific factors such as MEDD 24 h before discharge may be one of the most useful tools to help guide opioid prescribing.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"306 ","pages":"224-229"},"PeriodicalIF":1.8,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971420","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}
引用次数: 0
Factors Associated With Minority Patient Enrollment in a Gastric Cancer Biobank. 少数民族患者入组胃癌生物库的相关因素
IF 1.8 3区 医学
Journal of Surgical Research Pub Date : 2025-01-10 DOI: 10.1016/j.jss.2024.12.002
Morgan F Pettigrew, Amr I Al Abbas, Anida Southichack, Michelle R Ju, Suntrea T G Hammer, Yulun Liu, Matthew R Porembka, Sam C Wang
{"title":"Factors Associated With Minority Patient Enrollment in a Gastric Cancer Biobank.","authors":"Morgan F Pettigrew, Amr I Al Abbas, Anida Southichack, Michelle R Ju, Suntrea T G Hammer, Yulun Liu, Matthew R Porembka, Sam C Wang","doi":"10.1016/j.jss.2024.12.002","DOIUrl":"10.1016/j.jss.2024.12.002","url":null,"abstract":"<p><strong>Introduction: </strong>Human tissue samples are essential for translational cancer research. However, less than 20% of current biobank and genomic samples were obtained from minority patients, which may lead to biased understanding of cancer biology. The objective of this study was to identify factors associated with patient enrollment in our institution's gastric cancer biobank.</p><p><strong>Methods: </strong>Patients with suspected or confirmed gastric or gastroesophageal junction cancer undergoing surgical procedures at our institution were invited to enroll in a prospective gastric cancer biobank. We retrospectively reviewed patients who were invited to enroll from 2017 to 2023 at our safety-net and university hospitals. We compared patients who enrolled to those who declined to identify factors that predict enrollment.</p><p><strong>Results: </strong>Hispanic patients had similar odds of enrollment as non-Hispanic White patients (odds ratio (OR): 1.22, 95% confidence interval (CI): 0.54-2.73, P = 0.63). Non-Hispanic minorities (Black/African Americans and Asians) were less likely to enroll when compared to non-Hispanic Whites (OR: 0.41, 95% CI: 0.18-0.95, P = 0.04). Minority patients treated at our safety-net hospital had higher odds of enrollment than those treated at our university hospital (OR: 2.62, 95% CI: 1.11-5.99, P = 0.02).</p><p><strong>Conclusions: </strong>Efforts to improve diversity in biomedical research cannot consider minority patients as a monolithic cohort. Instead, targeted interventions that address diverse cultural concerns and improve access to enrollment at safety-net centers are requisite.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"306 ","pages":"230-238"},"PeriodicalIF":1.8,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971409","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}
引用次数: 0
Preferences for Inguinal Hernia Repair in Infants: A Survey of the Eastern Pediatric Surgery Network. 婴儿腹股沟疝修补的偏好:东部儿科外科网络调查。
IF 1.8 3区 医学
Journal of Surgical Research Pub Date : 2025-01-09 DOI: 10.1016/j.jss.2024.12.012
Zane J Hellmann, J Leslie Knod, Afif N Kulaylat, Cornelia Griggs, Jennifer R DeFazio, Stefan Scholz, Hanna Alemayehu, Jamie R Robinson, Shaun M Kunisaki, Matthew A Hornick
{"title":"Preferences for Inguinal Hernia Repair in Infants: A Survey of the Eastern Pediatric Surgery Network.","authors":"Zane J Hellmann, J Leslie Knod, Afif N Kulaylat, Cornelia Griggs, Jennifer R DeFazio, Stefan Scholz, Hanna Alemayehu, Jamie R Robinson, Shaun M Kunisaki, Matthew A Hornick","doi":"10.1016/j.jss.2024.12.012","DOIUrl":"https://doi.org/10.1016/j.jss.2024.12.012","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic inguinal hernia repair (IHR) is being performed more frequently in children, but few studies have evaluated surgical practice patterns in infants. In this study, we surveyed pediatric surgeons within a regional consortium to assess current preferences for IHR strategy in infants. We hypothesized that early-career pediatric surgeons would prefer laparoscopic IHR over open IHR in this patient population.</p><p><strong>Methods: </strong>A Qualtrics survey addressing surgeon preferences for IHR was distributed to 160 pediatric surgeons at 19 member institutions affiliated with the Eastern Pediatric Surgery Network. Surgeons were stratified by self-reported number of years in attending practice. Responses were compared using t-tests and chi-square tests wherever appropriate.</p><p><strong>Results: </strong>Ninety-eight surgeons responded to the survey (61% response rate; two incomplete responses were excluded). Forty respondents (41.7%) had 0-10 ys of experience, 26 (27.1%) had 10-20 ys of experience, and 30 (31.2%) had over 20 ys of experience. Over 90% of early-career surgeons reported a preference for laparoscopic IHR in infants, compared to less than 50% of mid-career surgeons and less than 20% of late-career surgeons (P < 0.001). Respondents preferring laparoscopic IHR most commonly cited inherent assessment of the contralateral side, confirmation of hernia before repair, and technical ease of the laparoscopic approach as factors contributing to their preference.</p><p><strong>Conclusions: </strong>The majority of early-career pediatric surgeons prefer laparoscopic IHR over open IHR in infants, representing a substantial shift away from what is traditionally regarded as the gold standard open technique. Larger studies are needed to compare long-term outcomes after laparoscopic and open IHR in infants.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"306 ","pages":"188-196"},"PeriodicalIF":1.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965586","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}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信