Journal of Surgical Research最新文献

{"title":"Validating the Epic Deterioration Index (DI) for First Episode Rapid Response Team Activation in Sepsis Patients","authors":"Olivia K. Hoy BS ,&nbsp;Allison R. Walker MD ,&nbsp;Charles Sonday DNP ,&nbsp;Aldo Carmona MD ,&nbsp;Anna Ng Pellegrino MD","doi":"10.1016/j.jss.2025.01.024","DOIUrl":"10.1016/j.jss.2025.01.024","url":null,"abstract":"<div><h3>Introduction</h3><div>The epic electronic medical records software's deterioration index (DI) is an artificial intelligence-driven algorithm, which quantifies the probability of patient deterioration. Our study aimed to assess the relationship between DI score and activation of a rapid response team (RRT) and to identify a cutoff score to screen for deterioration events.</div></div><div><h3>Materials and methods</h3><div>A retrospective case control study was performed on adult sepsis patients across a nonprofit regional health network composed of 15 hospitals between August 2021 and April 2022. Linear mixed regression modeling was used to evaluate the impact of RRT status on DI scores. We then quantified the performance of the DI score for predicting first-episode RRT events using a threshold of 40.</div></div><div><h3>Results</h3><div>A total of 138 patients were included in this study; sixty-five patients were in sepsis with RRT cohort, and 73 patients were in sepsis without RRT cohort. The average DI score was 50.8 (31,557 DI scores) for sepsis with RRT and 26.8 for sepsis without RRT (34,279 DI scores). Although the DI score changed significantly throughout hospitalization, linear mixed regression failed to distinguish between the two cohorts based on the RRT status (<em>P</em> = 0.33). Using DI &gt; 40 as a screening tool was 100% specific and 73% sensitive for predicting RRT in sepsis patients.</div></div><div><h3>Conclusions</h3><div>Despite higher average DI scores in RRT patients, there was no difference in DI score changes over time based on the RRT status; however, the DI score has the potential to serve as an effective screening tool for predicting deterioration events in sepsis patients.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"307 ","pages":"Pages 176-183"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549377","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":"ASC 2026 Save the Date Journal Ad","authors":"","doi":"10.1016/S0022-4804(25)00119-2","DOIUrl":"10.1016/S0022-4804(25)00119-2","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"307 ","pages":"Page IBC"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759064","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":"AAS Blog JSR Ad 2025 Print","authors":"","doi":"10.1016/S0022-4804(25)00118-0","DOIUrl":"10.1016/S0022-4804(25)00118-0","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"307 ","pages":"Page IFC"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759228","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":"Combined Breast and Lung Cancer Screening Among Dual-Eligible Women: A Descriptive Study","authors":"Tiffany Yue BS ,&nbsp;Lye-Yeng Wong MD ,&nbsp;Chinmay Jani MBBS ,&nbsp;Lipisha Agarwal MBBS ,&nbsp;Omar Al Omari MBBS ,&nbsp;Ghazal Aghagoli BS ,&nbsp;Alaaeldin Ahmed MD ,&nbsp;Padmanabh Bhatt MD ,&nbsp;Angela Lee NP ,&nbsp;Margaret Lotz PhD ,&nbsp;Hannah Marmor MD, MPH ,&nbsp;Giulia Paliotti BS ,&nbsp;Susan Pories MD ,&nbsp;Jennifer Richmond PhD, MSPH ,&nbsp;Laura Shula PA-C ,&nbsp;Kim L. Sandler MD ,&nbsp;Carey Conley Thomson MD, MPH ,&nbsp;Leah M. Backhus MD, MPH","doi":"10.1016/j.jss.2024.05.024","DOIUrl":"10.1016/j.jss.2024.05.024","url":null,"abstract":"<div><h3>Introduction</h3><div>Lung cancer is consistently the leading cause of cancer death among women in the United States, yet lung cancer screening<span> (LCS) rates remain low. By contrast, screening mammography rates are reliably high, suggesting that screening mammography can be a “teachable moment” to increase LCS uptake among dual-eligible women.</span></div></div><div><h3>Materials and methods</h3><div>This is a prospective survey study conducted at two academic institutions. Patients undergoing screening mammography were evaluated for LCS eligibility and offered enrollment in a pilot dual-cancer screening program. A series of surveys was administered to characterize participants’ knowledge, perceptions, and attitudes about LCS before and after undergoing dual screening. Data were descriptively summarized.</div></div><div><h3>Results</h3><div>Between August 2022 and July 2023, 54 LCS-eligible patients were enrolled. The study cohort was 100% female and predominantly White (81%), with a median age of 57 y and median of 36 pack-y of smoking. Survey results showed that 98% felt they were at risk for lung cancer, with most (80%) motivated by early detection of potential cancer. Regarding screening barriers, 58% of patients lacked knowledge about LCS eligibility and 47% reported concerns about screening cost. Prior to undergoing LCS, 87% of patients expressed interest in combined breast and lung screening. Encouragingly, after LCS, 84% were likely or very likely to undergo dual screening again and 93% found the shared decision-making visit helpful or very helpful.</div></div><div><h3>Conclusions</h3><div>Pairing breast and LCS is a feasible, acceptable intervention that, along with increasing patient and provider education about LCS, can increase LCS uptake and reduce lung cancer mortality.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"307 ","pages":"Pages 204-211"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306222","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":"On The Cover","authors":"","doi":"10.1016/S0022-4804(25)00117-9","DOIUrl":"10.1016/S0022-4804(25)00117-9","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"307 ","pages":"Page vii"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759434","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":"Cover 1: Update","authors":"","doi":"10.1016/S0022-4804(25)00112-X","DOIUrl":"10.1016/S0022-4804(25)00112-X","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"307 ","pages":"Page OFC"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759227","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":"Reducing Air Leak After Empyema Surgery: COPD’s Role and Patient Management","authors":"Daniel Scheese MD ,&nbsp;Devon C. Freudenberger MD ,&nbsp;Elizabeth Mastoloni BS ,&nbsp;Luke G. Wolfe MS ,&nbsp;Bhavishya Ramamoorthy MD ,&nbsp;Walker Julliard MD","doi":"10.1016/j.jss.2025.01.020","DOIUrl":"10.1016/j.jss.2025.01.020","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite medical advancements, the rise in pleural empyemas persists in the United States. Surgical decortication for pleural empyema subjects patients to the potential complication of a prolonged air leak (PAL). This study aims to uncover the incidence, predictors, and outcomes of PAL following surgical decortication for pleural empyemas within a single tertiary institution.</div></div><div><h3>Materials and methods</h3><div>Patients who underwent surgical decortication for plural empyema between 2011 and 2021 were identified in our single tertiary institution and divided into two groups: PAL and no PAL. Preoperative characteristics and postoperative outcomes were compared, and the results of the descriptive univariate analyses were reported.</div></div><div><h3>Results</h3><div>Among the 228 patients who met inclusion criteria, 7.5% undergoing surgical decortication for pleural empyema were diagnosed with PAL. While demographic differences were not significant between PAL and no PAL groups, PAL patients showed higher chronic obstructive pulmonary disease prevalence (82.4% <em>versus</em> 34.1%, <em>P</em> &lt; 0.001) and lifetime tobacco use. PAL cases had increased rates of reoperation (29.4% <em>versus</em> 8.1%, <em>P</em> = 0.015) and remained intubated at the conclusion of the case.</div></div><div><h3>Conclusions</h3><div>Patients with chronic obstructive pulmonary disease were significantly more likely to develop PAL, which is associated with higher rates of reoperation and extended hospital stays. These findings underscore the importance of preoperative identification of high-risk patients and the implementation of targeted preventive measures to improve surgical and postoperative outcomes, thereby reducing morbidity and healthcare costs.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"307 ","pages":"Pages 116-121"},"PeriodicalIF":1.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488310","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":"Racial Variability in Platelet Response Among Patients With Peripheral Artery Disease","authors":"Sasha P. Suarez Ferreira MD ,&nbsp;Adriana A. Rodriguez Alvarez MD ,&nbsp;Isabella Ferlini Cieri MD ,&nbsp;Shiv Patel BA ,&nbsp;Mounika Boya MD ,&nbsp;Kellie Machlus PhD ,&nbsp;Trisha Roy MD ,&nbsp;Anahita Dua MD, MBA, MSC","doi":"10.1016/j.jss.2025.01.022","DOIUrl":"10.1016/j.jss.2025.01.022","url":null,"abstract":"<div><h3>Introduction</h3><div>Peripheral artery disease (PAD) is prevalent among the elderly population, with Black Americans facing a higher incidence and complications than White Americans. Antiplatelet therapy is crucial for PAD. This observational study aims to discern racial variability in platelet function using viscoelastic assays in patients’ postrevascularization for PAD.</div></div><div><h3>Methods</h3><div>Patients with PAD who underwent revascularization between December 2020 and October 2023 were prospectively enrolled. The cohort was divided by race and antiplatelet therapy regimen. Serial perioperative Thromboelastography with Platelet Mapping assays were performed, and the platelet function was evaluated.</div></div><div><h3>Results</h3><div>A total of 42 patients met the study criteria, and 99 samples were analyzed. In the Thromboelastography with Platelet Mapping assay, the White-Americans cohort showed a significantly lower maximum amplitude (clot strength), lower percentage of platelet aggregation (platelet reactivity), and a significantly higher percentage of platelet inhibition than Black, Asian, and Hispanic Americans on the same antiplatelet regimen.</div></div><div><h3>Conclusions</h3><div>These findings suggest potential racial disparities in platelet response to standard medications, highlighting the critical need for personalized pharmacological approaches that account for genetic and physiological variations across different ethnic populations. Further research is essential to elucidate the underlying mechanisms of these differential platelet responses, which could have significant implications for precision medicine and targeted therapeutic strategies.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"307 ","pages":"Pages 107-115"},"PeriodicalIF":1.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143480236","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":"Effects of Different Treatment Modalities on Lung Injury in Experimental Pulmonary Contusion Model","authors":"Mustafa Kuzucuoğlu MD ,&nbsp;Cenk Balta MD ,&nbsp;Eren Altun MD ,&nbsp;Ali Cem Yekdeş ,&nbsp;Arkın Acar MD","doi":"10.1016/j.jss.2025.01.017","DOIUrl":"10.1016/j.jss.2025.01.017","url":null,"abstract":"<div><h3>Introduction</h3><div>The study experimentally evaluated the efficacies of different agents in treating pulmonary contusion.</div></div><div><h3>Methods</h3><div>In our study, 42 Wistar albino rats were divided into six groups of seven animals each. A model of lung contusion with blunt chest trauma was performed in five groups, except for the control group. One group with pulmonary contusion was considered an untreated group, and saline was administered. For other groups, prednisolone, tranexamic acid, N-acetylcysteine, and vitamin E were applied to determine their efficacy in treatment. The rats were sacrificed 24 h after trauma, and their injured lungs were collected for histopathological examination and blood samples for blood gas analysis. Histopathologically, bronchial damage, alveolar hemorrhage, emphysema, and leukocyte infiltration were assessed using the scoring system.</div></div><div><h3>Results</h3><div>In our study, statistically significant differences were detected between the rat groups in terms of intraalveolar hemorrhage, leukocyte infiltration, and bronchial damage. In post hoc analysis, intraalveolar hemorrhage was significantly higher in the untreated group compared to the control group (<em>P</em> = 0.012). A near-significant difference was observed between the untreated group and the N-acetylcysteine group (<em>P</em> = 0.061). Regarding leukocyte infiltration, the tranexamic acid group showed significantly higher values compared to both the prednisolone and control groups (<em>P</em> = 0.007; <em>P</em> = 0.016, respectively). For bronchial damage, the levels observed in the vitamin E and tranexamic acid groups were significantly higher than those in the control group (<em>P</em> = 0.08 and <em>P</em> = 0.037, respectively).</div></div><div><h3>Conclusions</h3><div>Many agents are used to treat pulmonary contusion, but no gold standard treatment exists. Prednisolone and N-acetylcysteine play significant roles in treatment. These two drugs contributed to the regression of the findings in pulmonary contusion treatment.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"307 ","pages":"Pages 100-106"},"PeriodicalIF":1.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143480235","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":"The Disproportionate Increase in Pediatric Laparoscopic Cholecystectomies During the COVID-19 Pandemic","authors":"Philip M. Lee BS ,&nbsp;Cameron Harvey DO ,&nbsp;Eli Snyder BS ,&nbsp;Sneha Singh MD ,&nbsp;Kaushal Desai MD, MPH ,&nbsp;Benjamin Tabak MD ,&nbsp;Sidney Johnson MD ,&nbsp;Devin Puapong MD ,&nbsp;Russell Woo MD","doi":"10.1016/j.jss.2025.01.008","DOIUrl":"10.1016/j.jss.2025.01.008","url":null,"abstract":"<div><h3>Introduction</h3><div>The COVID-19 pandemic limited many patients to an unhealthy, sedentary lifestyle, with literature specifically demonstrating an increasing trend of obesity in pediatric patients. The goal of this study is to assess the relationship between the COVID-19 pandemic and total number of laparoscopic cholecystectomies performed pre-COVID compared to during COVID.</div></div><div><h3>Methods</h3><div>Data between 2017 and 2021 were collected from the National Surgical Quality Improvement Program on patients ≤18 ys who underwent elective or urgent cholecystectomies. Data was categorized as pre-COVID (2017-2018) or during COVID (2020-2021). Analysis subcategories included case acuity (elective <em>versus</em> urgent <em>versus</em> emergent), wound classification, race, weight, and complications.</div></div><div><h3>Results</h3><div>There were 13,579 pediatric laparoscopic cholecystectomies from 2017 to 2021. The COVID group had 7605 (56.0%) cases, and pre-COVID group 5974 (44.0%). The COVID group had significantly greater average weight and body mass index (BMI) than pre-COVID group (<em>P</em> &lt; 0.001). Increased BMI was associated with increased case acuity and complication rates. Minorities including African Americans and Native American/Pacific Islanders had an increase in number of cholecystectomies performed during COVID. Undergoing a cholecystectomy during COVID was more likely to be classified as urgent or emergent than pre-COVID (<em>P</em> &lt; 0.0001). The COVID group overall had less favorable surgical wound classification as more were classified as class III or class IV cases.</div></div><div><h3>Conclusions</h3><div>There were increases in weight/BMI, case severity, and total laparoscopic cholecystectomies performed during COVID-19. A statistically significant difference in average weight may suggest a relationship between isolation during the COVID-19 pandemic and rates of cholecystectomy. Future research is encouraged to identify contributing factors in these trends.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"307 ","pages":"Pages 93-99"},"PeriodicalIF":1.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474331","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}