American journal of surgery最新文献_第6页

Household income is independently associated with overall and cancer-specific survival after proctectomy for rectal cancer: A surveillance, epidemiology, and end results-based analysis. 家庭收入与直肠癌直肠切除术后的总体生存率和癌症特异性生存率独立相关：一项监测、流行病学和最终结果分析。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-01-09 DOI: 10.1016/j.amjsurg.2025.116191

Sameh Hany Emile, Nir Horesh, Zoe Garoufalia, Rachel Gefen, Justin Dourado, Anjelli Wignakumar, Steven D Wexner

{"title":"Household income is independently associated with overall and cancer-specific survival after proctectomy for rectal cancer: A surveillance, epidemiology, and end results-based analysis.","authors":"Sameh Hany Emile, Nir Horesh, Zoe Garoufalia, Rachel Gefen, Justin Dourado, Anjelli Wignakumar, Steven D Wexner","doi":"10.1016/j.amjsurg.2025.116191","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116191","url":null,"abstract":"Background: We assessed association among household income, overall survival (OS), and cancer-specific survival (CSS) after proctectomy for rectal cancer.Methods: Population-based cohort study included stage I-III rectal adenocarcinoma patients who underwent proctectomy (2010-2020), subdivided by household income at diagnosis [low (<$50,000), average ($50,000-74,999), above-average (≥$75,000)] and compared.Results: Of 39,185 patients (59 % male; mean age 60.4), 12.5 % had low, 48.1 % had average, and 39.4 % had above-average income. Low-income patients were more often Black, rural dwellers, and undergone total proctectomy (OR: 1.49, p < 0.001). Income <$50,000 patients had shorter restricted mean OS (p < 0.001) and CSS (p < 0.001) than the other groups. 5-year OS (70.5 % vs. 73.6 % vs. 82.3 %, p < 0.001) and CSS (78.3 % vs. 80.6 % vs. 87.2 %, p < 0.001) were significantly lower in the low-income group than the average and above-average income groups. Adjusted for other factors, low-income was an independent predictor of OS (HR: 1.31, 95%CI: 1.22-1.41) and CSS (HR: 1.31, 95%CI: 1.21-1.43), compared to above-average.Conclusions: Black patients and rural dwellers more often had <$50,000 income. Low-income increased odds of undergoing non-restorative surgery for rectal cancer and reduced OS and CSS.","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"242 ","pages":"116191"},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998772","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

Association of non-English as primary language on clinical outcomes for arteriovenous fistula creation within a safety net system. 非英语作为主要语言与安全网系统中动静脉瘘形成的临床结果的关联。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-01-09 DOI: 10.1016/j.amjsurg.2025.116192

Isabela Sandigo-Saballos, Micaela Torres, Mark Archie, Maria Valadez, Anibal La Riva, Laura Perez, Ashkan Moazzez, Sarah Weber, Sara Rashidi, Christian de Virgilio

{"title":"Association of non-English as primary language on clinical outcomes for arteriovenous fistula creation within a safety net system.","authors":"Isabela Sandigo-Saballos, Micaela Torres, Mark Archie, Maria Valadez, Anibal La Riva, Laura Perez, Ashkan Moazzez, Sarah Weber, Sara Rashidi, Christian de Virgilio","doi":"10.1016/j.amjsurg.2025.116192","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116192","url":null,"abstract":"Approximately 22 % of the United States population communicates in a non-English language, potentially impacting healthcare communication and outcomes. Few studies have examined the association between non-English primary language (NEPL) and surgical outcomes and none to our knowledge in patients undergoing arteriovenous fistula creation within a safety net system. In this study, we conducted a retrospective analysis on adults who underwent AVF creation for hemodialysis access between January 1, 2014, and December 31, 2019. We employed a bivariate logistic regression analysis to assess the relationship between primary language and 30-day ED visits and readmissions, both for all-cause after AVF surgery and those specifically related to arteriovenous fistula (AVF) complications and a multivariate logistic regression to adjust for any cofounders. Among the study population of 1502 patients, 70 % were NEPL and predominantly self-identified as Hispanic/Latino. Despite the older age and higher prevalence of diabetes among NEPL patients, there was no statistically significant association of NEPL with 30-day readmission or ED visits post-AVF creation. The availability of certified translators and diverse array of healthcare professionals may have contributed to these findings. Nonetheless, further investigation is warranted to elucidate the impact of language discordance on post-surgical outcomes.","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"244 ","pages":"116192"},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982505","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

Adjuvant radiation therapy is not associated with a survival benefit after R0 resection in non-metastatic adrenocortical carcinoma. 辅助放射治疗与非转移性肾上腺皮质癌R0切除术后的生存获益无关。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-01-09 DOI: 10.1016/j.amjsurg.2025.116194

Benjamin C Greenspun, Yeon J Lee-Saxton, Caitlin E Egan, Teagan E Marshall, Abhinay Tumati, Bradley Pearson, Toni Beninato, Rasa Zarnegar, Thomas J Fahey, Brendan M Finnerty

{"title":"Adjuvant radiation therapy is not associated with a survival benefit after R0 resection in non-metastatic adrenocortical carcinoma.","authors":"Benjamin C Greenspun, Yeon J Lee-Saxton, Caitlin E Egan, Teagan E Marshall, Abhinay Tumati, Bradley Pearson, Toni Beninato, Rasa Zarnegar, Thomas J Fahey, Brendan M Finnerty","doi":"10.1016/j.amjsurg.2025.116194","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116194","url":null,"abstract":"The benefit of adjuvant radiation therapy (RT) in adrenocortical carcinoma (ACC) is not well characterized for those who undergo initial R0 surgical resection. Patients in the NCDB who underwent R0 resection were placed into two cohorts - those who underwent adjuvant RT and those who did not. 388 patients were identified with 51 receiving RT. No difference was observed between Kaplan-Meier survival estimates of the two cohorts (p = 0.54). After adjusting for age, sex, co-morbidity index, race, receipt of chemotherapy, tumor size, grade, stage, and nodal stage, RT was not associated with improved OS. However, tumor size ≥6 cm (HR 1.54, [1.03-2.32], p = 0.04), high tumor-grade (HR 3.46, [1.83-6.55], p < 0.001), and N1-stage (HR 2.30, [1.06-4.94], p = 0.03) were associated with worse OS, without benefit of RT on subgroup analysis of these factors. Treatment with adjuvant RT in patients with ACC who underwent R0 resection was not associated with an OS benefit.","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"242 ","pages":"116194"},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998771","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

Mediation analysis identifies causal factors that lead to increased rates of kidney transplant failure in patients with peripheral vascular disease. 中介分析确定了导致周围血管疾病患者肾移植失败率增加的原因因素。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-01-07 DOI: 10.1016/j.amjsurg.2025.116190

Johnathan Torikashvili, Melissa A Kendall, Tyler Zander, Rajavi Parikh, Paul C Kuo, Emily A Grimsley

{"title":"Mediation analysis identifies causal factors that lead to increased rates of kidney transplant failure in patients with peripheral vascular disease.","authors":"Johnathan Torikashvili, Melissa A Kendall, Tyler Zander, Rajavi Parikh, Paul C Kuo, Emily A Grimsley","doi":"10.1016/j.amjsurg.2025.116190","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116190","url":null,"abstract":"Background: This study aims to identify causal mediators of one-year kidney transplant failure in patients with peripheral vascular disease.Methods: Standard Transplant Analysis and Research database was queried for adults who underwent kidney transplantation from 1987 to 2021. Multi-organ transplant, prior transplant, and living donor kidneys were excluded. Causal mediation analysis with 2000 percentile bootstrapping interactions identified mediators of one-year kidney transplant failure.Results: 212,259 patients were included: 16,215 with and 196,044 without peripheral vascular disease. Causal mediators of one-year kidney transplant failure are Kidney Donor Profile Index (proportionate mediation [PM] 17 %, p < 0.01, E-value = 1.20), pre-transplant dialysis (PM 19 %, p < 0.001, E-value = 1.17), recipient total serum albumin (PM 2 %, p = 0.003, E-value = 1.05), and donor hypertension (PM 1 %, p = 0.017, E-value = 1.04).Conclusions: Several causal mediators increase rates of one-year kidney transplant failure in patients with peripheral vascular disease. Understanding these mediators can improve pre-transplant assessments and post-transplant outcomes.","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"241 ","pages":"116190"},"PeriodicalIF":2.7,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982504","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

Medicare advantage and equity in surgical access and quality: A growing program with potentially growing problems. 医疗保险在手术准入和质量方面的优势和公平性：一个不断发展的项目，潜在的问题也越来越多。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-01-06 DOI: 10.1016/j.amjsurg.2025.116189

Mark Pedersen, Jillian Timperley, Bonnie Simpson Mason, Waddah Al-Refaie

引用次数: 0

Outpatient surgical institutions in the rural United States: Trends from 2010 to 2020. 美国农村门诊外科机构：2010 - 2020年趋势

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-01-06 DOI: 10.1016/j.amjsurg.2025.116188

Vineeth Amba, Shawn Izadi, Tarun Ramesh, Hao Yu

{"title":"Outpatient surgical institutions in the rural United States: Trends from 2010 to 2020.","authors":"Vineeth Amba, Shawn Izadi, Tarun Ramesh, Hao Yu","doi":"10.1016/j.amjsurg.2025.116188","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116188","url":null,"abstract":"Background: The volume and proportion of surgeries occurring in outpatient settings has increased. However, the growth and distribution of outpatient surgical institutions, namely ambulatory surgery centers (ASCs) and hospital-based outpatient surgical departments (HOPDs), remains understudied in rural areas.Methods: We used descriptive statistics and a multivariate logistic regression to assess the growth and distribution of ASCs and HOPDs in rural areas from 2010 to 2020, leveraging the Area Health Resources Files and American Community Survey.Results: From 2010 to 2020, the number of ASCs in rural counties decreased by 4.9 % (410 vs. 390), and rural HOPDs decreased by 14.3 % (1400 vs. 1200). Completely rural counties were over five times likelier to lack both ASCs and HOPDs (AOR = 5.32; 95 % CI = [4.82-5.89]); p < 0.001).Conclusions: Outpatient surgical institution access in rural America declined. Policymakers should protect rural HOPDs, promote the creation of ASCs in rural communities, and incentivize surgeons to enter rural practice.","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"242 ","pages":"116188"},"PeriodicalIF":2.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998774","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 canaries in the coal mine: Medical and surgical trainees. 煤矿中的金丝雀：医学和外科实习生。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-01-06 DOI: 10.1016/j.amjsurg.2024.116173

M Tariq, K E Kopecky

引用次数: 0

A study of internal structure validity for the American board of surgery in training examination. 美国外科委员会培训考试内部结构效度研究。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-01-03 DOI: 10.1016/j.amjsurg.2025.116184

Taylor M Carter, Ting Sun, Andrew Jones, Brigitte K Smith

{"title":"A study of internal structure validity for the American board of surgery in training examination.","authors":"Taylor M Carter, Ting Sun, Andrew Jones, Brigitte K Smith","doi":"10.1016/j.amjsurg.2025.116184","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116184","url":null,"abstract":"Background: As principles of competency-based medical education are implemented into graduate medical education [GME] programs, it is imperative that the assessments employed are reliable and valid. Internal structure is a core component of validity evidence that has been under studied. In this study, we examined elements of the internal structure for the American Board of Surgery In-Training Examination [ABSITE].Methods: This national retrospective cohort study utilized performance data for general surgery residents from 2018 to 2023 to determine aspects of the internal structure for the ABSITE. The item difficulty, item discrimination, internal consistency, and dimensionality of the exam were calculated.Results: 55,986 unique test results were obtained in the study. The ABSITE exhibits strong reliability, (Cronbach's alpha >0.9), and appropriate item difficulty (0.66) and item discrimination index (>0.2) for a formative examination. Results of the exploratory factor analysis reveals that the ABSITE is unidimensional.Conclusions: The ABSITE is a unidimensional examination with strong reliability. Furthermore, the item difficulty and item discrimination levels of the exam are appropriate for a formative test. Future studies utilizing consensus methods could be employed to determine what specific construct is measured by the ABSITE.","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"242 ","pages":"116184"},"PeriodicalIF":2.7,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998769","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

Read one, write one, dictate one. 读一本，写一本，口述一本。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-01-03 DOI: 10.1016/j.amjsurg.2025.116179

Natalie M Liu, Michael J Campbell, Claire E Graves

引用次数: 0

The scalpel or the scope? Balancing Prudence and Practicality for endoscopic submucosal dissection in early colorectal cancer. 手术刀还是瞄准镜？早期结直肠癌内镜下粘膜下清扫术的审慎性与实用性的平衡。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-01-02 DOI: 10.1016/j.amjsurg.2024.116171

Bhuwan Giri

引用次数: 0