American journal of surgery最新文献

Social drivers of health and perioperative outcomes: Identifying domains and barriers with significant impact 健康和围手术期结果的社会驱动因素：确定具有重大影响的领域和障碍

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-06-01 Epub Date: 2026-02-28 DOI: 10.1016/j.amjsurg.2026.116890

Michael A. Edwards , Skye Buckner Petty , Kashmira Chawla , Sreya Pattipati , Ryan May , Erin Westfall , Mohanad R. Youssef , Nathan L. Delafield , Jaxon K. Quillen , Adam J. Milam

{"title":"Social drivers of health and perioperative outcomes: Identifying domains and barriers with significant impact","authors":"Michael A. Edwards , Skye Buckner Petty , Kashmira Chawla , Sreya Pattipati , Ryan May , Erin Westfall , Mohanad R. Youssef , Nathan L. Delafield , Jaxon K. Quillen , Adam J. Milam","doi":"10.1016/j.amjsurg.2026.116890","DOIUrl":"10.1016/j.amjsurg.2026.116890","url":null,"abstract":"<div><h3>Objectives</h3><div>This retrospective cohort of patients undergoing surgery from 2019 to 2023 evaluated the association between individual-level social drivers of health (SDoH) and postoperative outcomes (length of stay, 30-day mortality, 30-day readmission).</div></div><div><h3>Methods</h3><div>Patients from a multi-site health system who completed a SDoH questionnaire were categorized as high-risk or not high-risk across five SDoH domains (e.g., financial resources) and were stratified into 3 surgical cohorts (elective outpatient, inpatient and emergency surgery). Regression models, adjusted for potential confounders, assessed the association between SDoH and postoperative outcomes.</div></div><div><h3>Results</h3><div>Among 297,723 patients, 74% completed the SDoH questionnaire. High-risk transportation need was associated with higher unplanned 30-day readmission for all cohorts; for elective surgeries, high-risk transportation was also associated with higher mortality. The other SDoH domains were inconsistently associated with postoperative outcomes.</div></div><div><h3>Conclusions</h3><div>Individual-level SDoH, particularly transportation needs and financial strain, are linked to adverse postoperative surgical outcomes. Systematic SDoH interventions are crucial to addressing healthcare disparities.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"256 ","pages":"Article 116890"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388413","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

Decreased utilization of component separation techniques over time in complex abdominal wall reconstruction following introduction of preoperative botulinum toxin A 术前引入肉毒杆菌毒素A后，随着时间的推移，成分分离技术在复杂腹壁重建中的应用减少

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-06-01 Epub Date: 2026-03-06 DOI: 10.1016/j.amjsurg.2026.116919

Samantha W. Kerr , William R. Lorenz , Victoria L. Walker , Robert R. Lopez , Robert J. Raible , Lucy Hinton , Alexis M. Holland , Gregory T. Scarola , Kent W. Kercher , Vedra A. Augenstein , B. Todd Heniford , Sullivan A. Ayuso

{"title":"Decreased utilization of component separation techniques over time in complex abdominal wall reconstruction following introduction of preoperative botulinum toxin A","authors":"Samantha W. Kerr , William R. Lorenz , Victoria L. Walker , Robert R. Lopez , Robert J. Raible , Lucy Hinton , Alexis M. Holland , Gregory T. Scarola , Kent W. Kercher , Vedra A. Augenstein , B. Todd Heniford , Sullivan A. Ayuso","doi":"10.1016/j.amjsurg.2026.116919","DOIUrl":"10.1016/j.amjsurg.2026.116919","url":null,"abstract":"<div><h3>Introduction</h3><div>Component separation technique (CST) facilitates anterior fascial closure but can increase wound morbidity and alter abdominal wall anatomy. Preoperative Botulinum toxin A (BTA) relaxes the oblique musculature, potentially reducing CST. This study evaluated trends in CST utilization following the adoption of BTA.</div></div><div><h3>Methods</h3><div>A prospectively maintained database was reviewed for patients who underwent open AWR (2016-2024). Primary outcome was proportion of CST use over time; secondary analysis compared early (2016-2017) versus late (2023-2024) cohorts.</div></div><div><h3>Results</h3><div>Among 1484 patients (mean age 58.8 ± 12.3 years; BMI 31.0 ± 5.8 kg/m<sup>2</sup>; defect size 211.5 ± 165.6 cm<sup>2</sup>), fascial closure was achieved in 99.5%. CST decreased from 48.0% to 19.9% (OR: 0.88,95% CI: 0.813,0.946;<em>p</em> < 0.001). BTA increased (2.9% to 11.0%), though annual change was not significant (OR: 0.98,95% CI: 0.898,1.071;<em>p</em> = 0.670). Between early and late cohorts (n = 384 vs. 356), defect size was similar (219.1 ± 160.6 vs. 213.8 ± 181.3 cm<sup>2</sup>;<em>p</em> = 0.367). There was a reduction in wound breakdown (6.5% vs. 0.8%) and recurrence (2.9% vs. 0.6%)(<em>p</em> < 0.05).</div></div><div><h3>Conclusion</h3><div>Following the introduction of BTA, utilization of CST decreased and was accompanied by a reduction in wound morbidity.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"256 ","pages":"Article 116919"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388406","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

Teaching residents in the operating room: What driving lessons taught me about surgical judgment 在手术室教住院医师：驾驶课教会了我什么手术判断

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-06-01 Epub Date: 2026-02-26 DOI: 10.1016/j.amjsurg.2026.116878

David B. Hom MD FACS

引用次数: 0

Randomized pilot study of hybrid telemedicine and in-person pathways to metabolic bariatric surgery 混合远程医疗和亲自代谢性减肥手术途径的随机试点研究

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-06-01 Epub Date: 2026-02-26 DOI: 10.1016/j.amjsurg.2026.116897

Gretchen E. Ames , Jenna L. Pennella , Michael G. Heckman , Hanna J. Sledge , Scott A. Lynch , Enrique F. Elli

{"title":"Randomized pilot study of hybrid telemedicine and in-person pathways to metabolic bariatric surgery","authors":"Gretchen E. Ames , Jenna L. Pennella , Michael G. Heckman , Hanna J. Sledge , Scott A. Lynch , Enrique F. Elli","doi":"10.1016/j.amjsurg.2026.116897","DOIUrl":"10.1016/j.amjsurg.2026.116897","url":null,"abstract":"<div><h3>Objective</h3><div>We investigated the viability of offering a telemedicine pathway to patients seeking metabolic bariatric surgery (MBS).</div></div><div><h3>Methods</h3><div>Patients were randomized to receive hybrid telemedicine (HTM, n = 21) or face-to-face (F2F, n = 22) care. Patient characteristics, program visit completion, patient satisfaction with visits, time to surgery, and insurance payor collection ratio were compared between groups.</div></div><div><h3>Results</h3><div>The HTM group had a higher proportion of initial medical visits completed than the F2F group (100.0% vs 72.7%). Groups did not significantly differ in patient satisfaction with visits, time to surgery, or insurance payor collection ratio. In the HTM group, 42.9% of patients underwent MBS, whereas 27.3% underwent MBS in the F2F group. Overall, 30.2% of patients elected to initiate obesity management medications, and 34.8% discontinued the program.</div></div><div><h3>Conclusion</h3><div>MBS programs may improve treatment access by offering an HTM pathway. Larger investigations are needed to confirm the effect of telemedicine on MBS program access.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"256 ","pages":"Article 116897"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388412","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

Substance use screening and naloxone prescribing at discharge among injured adolescents 受伤青少年出院时的物质使用筛查和纳洛酮处方

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-06-01 Epub Date: 2026-03-04 DOI: 10.1016/j.amjsurg.2026.116910

Jenna S. Lee , Ryan G. Spurrier , Shadassa Ourshalimian , Jordan M. Rook , Emma Kirkpatrick , Pradip P. Chaudhari , Lorraine I. Kelley-Quon

{"title":"Substance use screening and naloxone prescribing at discharge among injured adolescents","authors":"Jenna S. Lee , Ryan G. Spurrier , Shadassa Ourshalimian , Jordan M. Rook , Emma Kirkpatrick , Pradip P. Chaudhari , Lorraine I. Kelley-Quon","doi":"10.1016/j.amjsurg.2026.116910","DOIUrl":"10.1016/j.amjsurg.2026.116910","url":null,"abstract":"<div><h3>Background</h3><div>Adolescent substance use is closely linked to traumatic injuries. Screening can identify at-risk youth, while naloxone prescribing can reduce fatal overdose. This study examined drug screening and naloxone prescribing among injured adolescents.</div></div><div><h3>Methods</h3><div>This single-center retrospective cohort study included injured adolescents 12-17y treated January 2021-June 2024. Sociodemographics, clinical factors, and substance use screening associated with naloxone prescribing were analyzed.</div></div><div><h3>Results</h3><div>Among 813 injured adolescents, 86 (10.6%) underwent biochemical drug screening and 530 (65.2%) underwent interview-based screening. Among those screened, 53 (61.2%) biochemical and 81 (15.3%) interview screenings were positive. Only 28 (3.4%) received naloxone, including three (5.7%) with positive biochemical and four (4.9%) with positive interview-based screens. Adolescents with interview-based screening (p = 0.006) and hospital stays >24 h (p < 0.001) were more likely to receive naloxone. Most (96.4%) naloxone prescriptions were co-prescribed with opioids and muscle relaxants, instead of substance use screening results.</div></div><div><h3>Conclusion</h3><div>Naloxone prescribing for injured adolescents remains infrequent and unrelated to substance use screening results.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"256 ","pages":"Article 116910"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388414","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

Reflux symptoms in patients with mini gastric bypass-one anastomotic bypass (MGB-OAGB) after failed laparoscopic gastric banding (LAGB) - Long-term follow-up and therapeutic options 腹腔镜胃束带（LAGB）失败后行小型胃旁路-一次吻合口旁路（MGB-OAGB）患者的反流症状-长期随访和治疗选择

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-06-01 Epub Date: 2026-02-28 DOI: 10.1016/j.amjsurg.2026.116893

Ingeborg Bohlmann, Werner Müller, Claudius Falch

{"title":"Reflux symptoms in patients with mini gastric bypass-one anastomotic bypass (MGB-OAGB) after failed laparoscopic gastric banding (LAGB) - Long-term follow-up and therapeutic options","authors":"Ingeborg Bohlmann, Werner Müller, Claudius Falch","doi":"10.1016/j.amjsurg.2026.116893","DOIUrl":"10.1016/j.amjsurg.2026.116893","url":null,"abstract":"<div><h3>Background</h3><div>Reflux after Mini-Gastric-Bypass - One-Anastomosis-Gastric-Bypass (MGB-OAGB) is well documented. Although uncommon after primary MGB-OAGB, affected patients may experience a significant reduction in quality of life.</div><div>In this study we provide a clinical evaluation of long-term, recurrent reflux symptoms and their impact on daily life in patients who underwent revisional OAGB-MGB after failed laparoscopic gastric banding (LAGB). The median follow-up period was 13 years.</div></div><div><h3>Material and methods</h3><div>From March 2004 to February 2008 18 patients underwent a revisional MGB-OAGB after failure of LAGB. The main reasons for LAGB failure were penetration, slipping, repeated leakage, intolerance, insufficient weight loss/weight regain. The MGB-OAGB was performed according to Robert Rutledge, the procedure was carried out as a one-step surgery.</div><div>In 2017 we conducted a telephone survey with a median of 13 years after revision to MGB-OAGB. We used the standardized GERD- Health Related Quality of Life Questionnaire (GERD-HRQL).</div></div><div><h3>Results</h3><div>We could reach out to 15 of the 18 patients. The maximum score of the GERD-HRQL is 30, the cut-off for severe reflux symptoms is 12 points. 2/3 of our patients showed a score considerably above 12 points.</div><div>Approximately 1/3 of the patients above had to go through a second revision surgery to RYGB.</div></div><div><h3>Conclusion</h3><div>Based on the results of our survey and clinical symptoms we discontinued to use MGB-OAGB as a revisional option after LAGB. The outcome of this highly selective group of patients cannot be generally applied to revisional bariatric surgery.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"256 ","pages":"Article 116893"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388408","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

Active surveillance for low-grade ductal carcinoma in situ: A mixed-methods systematic review of patient, clinician, and health-system perspectives 低级别导管原位癌的主动监测：对患者、临床医生和卫生系统观点的混合方法系统回顾

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-06-01 Epub Date: 2026-03-02 DOI: 10.1016/j.amjsurg.2026.116898

Daniella Hui Xin Poh , Cristal Li Yi Tan , Yaoyi Ng , Kevin Xiang Zhou , Qin Xiang Ng , Serene Si Ning Goh

{"title":"Active surveillance for low-grade ductal carcinoma in situ: A mixed-methods systematic review of patient, clinician, and health-system perspectives","authors":"Daniella Hui Xin Poh , Cristal Li Yi Tan , Yaoyi Ng , Kevin Xiang Zhou , Qin Xiang Ng , Serene Si Ning Goh","doi":"10.1016/j.amjsurg.2026.116898","DOIUrl":"10.1016/j.amjsurg.2026.116898","url":null,"abstract":"<div><h3>Background</h3><div>Low-grade ductal carcinoma in situ (DCIS) is increasingly detected through breast screening, raising concerns about overtreatment. Active surveillance (AS) has emerged as an alternative to immediate surgery. We synthesized patient, clinician, and health-system perspectives relevant to AS adoption.</div></div><div><h3>Methods</h3><div>We conducted a mixed-methods systematic review (MMSR) following PRISMA, integrating quantitative, qualitative, and mixed-methods studies using a convergent integrated synthesis approach (PROSPERO CRD420250656621). PubMed, Embase, and the Cochrane Library were searched from 2000 to 2025. Risk of bias (RoB) was assessed using standardized tools.</div></div><div><h3>Results</h3><div>Fourteen studies were included. Patient preferences varied widely and were influenced by anxiety, terminology, perceived risk, and trust. Clinicians highlighted concerns about progression risk, pathology variability, medicolegal exposure, and limited long-term evidence. Institutional readiness was constrained by gaps in surveillance pathways, risk-stratification tools, and implementation support. Overall RoB was low to moderate.</div></div><div><h3>Conclusion</h3><div>Adoption of AS for low-grade DCIS depends not only on clinical evidence but also on psychological, communication, and organizational factors that shape decision-making across patients, clinicians, and health systems.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"256 ","pages":"Article 116898"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388410","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

Investigating optimal warming techniques for hypothermia in a swine model of ischemia 研究猪缺血模型中低温的最佳加热技术

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-06-01 Epub Date: 2026-03-03 DOI: 10.1016/j.amjsurg.2026.116912

Hannah Palmerton , Brooklyn Williams , Grace Pak , Bobby Zhang , Beau Prey , Andrew Francis , James Williams , Luke Pumiglia , Erik Roedel , Mike Lallemand , John McClellan , Nicholas Ieronimakis , Jason Bingham

{"title":"Investigating optimal warming techniques for hypothermia in a swine model of ischemia","authors":"Hannah Palmerton , Brooklyn Williams , Grace Pak , Bobby Zhang , Beau Prey , Andrew Francis , James Williams , Luke Pumiglia , Erik Roedel , Mike Lallemand , John McClellan , Nicholas Ieronimakis , Jason Bingham","doi":"10.1016/j.amjsurg.2026.116912","DOIUrl":"10.1016/j.amjsurg.2026.116912","url":null,"abstract":"<div><h3>Introduction</h3><div>With trauma, hypothermia is associated with increased bleeding and worse outcomes yet the pace of rewarming is unproven and its influence unclear. We hypothesized that the rate of rewarming influences outcomes and evaluated its impact in a porcine model of trauma.</div></div><div><h3>Methods</h3><div>Pigs underwent controlled hemorrhage and hypothermia to 32 °C for 1 h, followed by rapid or slow rewarming for 3 h. Hemodynamics and coagulation were compared along with liver gene expression.</div></div><div><h3>Results</h3><div>The mean temperature reached between fast (37.9±0.13 °C) and slow groups (34.5±1.2 °C) was significantly different (p < 0.01). The slow group had a lower heart rate and the mean arterial pressure (MAP) was lower with both slow and fast. No major differences in lactate, pH, coagulation or gene expression were observed.</div></div><div><h3>Conclusion</h3><div>Our study supports rapid rewarming for reversing hypothermia post hemorrhage. Further research is needed to evaluate long-term outcomes within clinical settings.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"256 ","pages":"Article 116912"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388405","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

Axillary lymph node dissection is not routinely indicated in patients with sentinel lymph node residual micrometastases following neoadjuvant systemic therapy 腋窝淋巴结清扫不是常规指在新辅助全身治疗后前哨淋巴结残留微转移的患者

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-06-01 Epub Date: 2026-03-03 DOI: 10.1016/j.amjsurg.2026.116901

Kinan Mokbel , Kefah Mokbel

{"title":"Axillary lymph node dissection is not routinely indicated in patients with sentinel lymph node residual micrometastases following neoadjuvant systemic therapy","authors":"Kinan Mokbel , Kefah Mokbel","doi":"10.1016/j.amjsurg.2026.116901","DOIUrl":"10.1016/j.amjsurg.2026.116901","url":null,"abstract":"<div><h3>Background</h3><div>The clinical relevance of residual micrometastatic nodal disease (ypN1mi) detected in the sentinel lymph node (SLN) or following targeted axillary dissection (TAD) after neoadjuvant systemic therapy (NST) remains uncertain, particularly regarding the need for completion axillary lymph node dissection (cALND).</div></div><div><h3>Methods</h3><div>This narrative review summarizes evidence from registry-based and international cohort studies evaluating axillary recurrence and oncological outcomes in patients with ypN1mi managed with or without cALND after NST.</div></div><div><h3>Results</h3><div>Analyses from the SEER registry and the OPBC-07/microNAC cohort demonstrate a low incidence of axillary recurrence and no significant differences in oncological outcomes between SLNB alone and cALND. In subgroup analyses of triple-negative breast cancer, microNAC reported lower axillary recurrence rates with cALND; however, no difference in invasive recurrence was observed between groups.</div></div><div><h3>Conclusions</h3><div>Routine cALND appears unnecessary in most patients with ypN1mi after NST. Future studies should evaluate whether regional nodal irradiation can also be safely omitted.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"256 ","pages":"Article 116901"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388409","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

Patients living with HIV in the modern era: Postoperative outcomes and healthcare utilization 现代艾滋病患者：术后结果和医疗保健利用

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-06-01 Epub Date: 2026-03-06 DOI: 10.1016/j.amjsurg.2026.116918

Michael Guo , Michael Budu , Jason Trigg , Tian Shen , Robert Hogg , Sam M. Wiseman

{"title":"Patients living with HIV in the modern era: Postoperative outcomes and healthcare utilization","authors":"Michael Guo , Michael Budu , Jason Trigg , Tian Shen , Robert Hogg , Sam M. Wiseman","doi":"10.1016/j.amjsurg.2026.116918","DOIUrl":"10.1016/j.amjsurg.2026.116918","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite advances in antiretroviral therapy (ART), surgical outcomes in people with HIV (PWH) remain poorly understood. This study compared postoperative outcomes and healthcare use between PWH and matched people without HIV (non-PWH) undergoing general surgery in British Columbia, Canada.</div></div><div><h3>Methods</h3><div>Linked HIV-related and health administrative data (Jan 2008–Mar 2020) identified PWH and matched non-PWH. Outcomes included 30-day readmissions, 30-day re-operations, 30-day mortality, one-year mortality, and healthcare utilization.</div></div><div><h3>Results</h3><div>Among 1252 PWH and 5008 non-PWH, HIV status was not associated with odds of 30-day readmissions, re-operations, or deaths. However, PWH had higher odds of mortality within one year post op (OR 1.75, 95% CI: 1.12–2.73), shorter hospital stays (RR 0.64, 95% CI: 0.55–0.73), higher likelihood of lab (RR 2.11, 95% CI: 1.86–2.39), and specialist visits (RR 1.16, 95% CI: 1.01–1.35) compared to non-PWH.</div></div><div><h3>Conclusion</h3><div>PWH experienced similar short-term outcomes but higher one-year mortality and distinct care patterns, suggesting factors beyond perioperative care influence outcomes.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"256 ","pages":"Article 116918"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388411","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