American journal of surgery最新文献_第8页

Examining the racial and ethnic disparities in pediatric surgery using the surgical Desirability of Outcome Ranking (DOOR). 使用手术结果排序（DOOR）检查儿科外科的种族和民族差异。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-14 DOI: 10.1016/j.amjsurg.2025.116580

Ikemsinachi C Nzenwa, Michael A Kochis, Alyssa Stetson, Carolyn J Reuland, Maimouna O Sy, David C Chang, Tawakalitu O Oseni, Cornelia L Griggs

{"title":"Examining the racial and ethnic disparities in pediatric surgery using the surgical Desirability of Outcome Ranking (DOOR).","authors":"Ikemsinachi C Nzenwa, Michael A Kochis, Alyssa Stetson, Carolyn J Reuland, Maimouna O Sy, David C Chang, Tawakalitu O Oseni, Cornelia L Griggs","doi":"10.1016/j.amjsurg.2025.116580","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116580","url":null,"abstract":"<p><strong>Introduction: </strong>The Desirability of Outcome Ranking (DOOR) ranks multiple postoperative outcomes, potentially enhancing detection of risks influenced by social determinants of health. We examined the relationship between race, ethnicity, and DOOR scores in pediatric surgical patients.</p><p><strong>Methods: </strong>Using NSQIP-Pediatric 2012-2022, we identified patients (≤18 years) who underwent general, urological, and gynecological surgery. DOOR scores range from 1 (most desirable) to 6 (least desirable). Ordinal logistic regression assessed associations with race, ethnicity and DOOR scores.</p><p><strong>Results: </strong>Among 368,190 patients (64.3 % non-Hispanic White, 18.2 % Hispanic, 13.4 % non-Hispanic Black, 3.7 % non-Hispanic Asian, and 0.4 % non-Hispanic Native), Black patients had increased odds of higher DOOR scores (OR 1.06, 95 % CI 1.04-1.10), while Hispanic patients had decreased odds of high DOOR scores (OR 0.89, 95 % CI 0.86-0.92). In general and non-elective surgery, Black race was still significantly associated with higher DOOR scores.</p><p><strong>Conclusions: </strong>Black children faced greater odds of undesirable outcomes. Future work may inform equitable, targeted interventions.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116580"},"PeriodicalIF":2.7,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939449","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

Breast cancer trends and outcomes among young Black Women: A national cancer database analysis. 年轻黑人女性的乳腺癌趋势和结果：国家癌症数据库分析。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-13 DOI: 10.1016/j.amjsurg.2025.116577

Danielle M Thompson, Kristine Kuchta, Sandra Simovic, Katharine A Yao

{"title":"Breast cancer trends and outcomes among young Black Women: A national cancer database analysis.","authors":"Danielle M Thompson, Kristine Kuchta, Sandra Simovic, Katharine A Yao","doi":"10.1016/j.amjsurg.2025.116577","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116577","url":null,"abstract":"<p><strong>Introduction: </strong>This study examined recent trends and outcomes in breast cancer among Black women under age forty.</p><p><strong>Methods: </strong>Breast cancer incidence data from the National Cancer Database (2010-2022) were analyzed using U.S. Census data population estimates.</p><p><strong>Results: </strong>Among 188,311 women under forty, 16.4 % were Black, compared to 11.3 % in older Black women. From 2010 to 2022, incidence in young Black women rose 5.3 %, compared to 19.9 % in White, 27.7 % in Hispanic, and 18.9 % in Asian/Pacific Islander women. Triple-negative breast cancer was more common in young Black women (16.3 %) vs. young Non-Black women (12.1 %). Black women under forty had 50 % higher odds of death (OR 1.50; 95 % CI: 1.46-1.55, p < .0001) compared to their Non-Black peers after adjusting for age, tumor characteristics, and treatment.</p><p><strong>Conclusions: </strong>Young Black women have more aggressive breast cancers and worse overall survival than Non-Black young women, though incidence has remained stable over the past decade.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116577"},"PeriodicalIF":2.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939472","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

Two Hands 两只手。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-13 DOI: 10.1016/j.amjsurg.2025.116576

Arati Bendapudi BS

引用次数: 0

Performance of molecular testing for indeterminate thyroid nodules in Black patients 黑人患者不确定甲状腺结节的分子检测性能。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-13 DOI: 10.1016/j.amjsurg.2025.116569

Zhixing Song , Ramsha Akund , Christopher Wu, Jessica Fazendin, Brenessa Lindeman, Herbert Chen, Andrea Gillis

{"title":"Performance of molecular testing for indeterminate thyroid nodules in Black patients","authors":"Zhixing Song , Ramsha Akund , Christopher Wu, Jessica Fazendin, Brenessa Lindeman, Herbert Chen, Andrea Gillis","doi":"10.1016/j.amjsurg.2025.116569","DOIUrl":"10.1016/j.amjsurg.2025.116569","url":null,"abstract":"<div><h3>Introduction</h3><div>Current molecular testing of thyroid nodules assesses malignancy risk without considering racial genetic variations, possibly introducing bias.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of 2905 patients who underwent fine needle aspiration (FNA) for thyroid nodules from 2015 to 2023. Indeterminate nodules were classified as Bethesda III and IV. The performance of molecular testing was assessed by comparing Afirma test results with histopathological findings.</div></div><div><h3>Results</h3><div>Among 662 patients with indeterminate FNA results, 173 (26.7 %) were Black and 474 (73.3 %) were White. The benign call rate was higher in Black patients (45.7 % vs. 34.7 %, p = 0.035). Malignancy rates based on surgical pathology were 16.7 % for nodules classified as benign by molecular testing in Black patients and 7.7 % in White patients (p = 0.574). There was a trend toward lower sensitivity (88.5 % vs. 96.1 %, p = 0.349) and negative predictive value (84.6 % vs. 90 %, p = 0.492) in molecular testing for Black patients.</div></div><div><h3>Conclusions</h3><div>Molecular testing might miss thyroid cancers in Black patients, potentially impacting prognosis. Surgeons should carefully interpret molecular testing results as part of holistic thyroid nodule treatment.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116569"},"PeriodicalIF":2.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298092","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

An evaluation of emergency general surgery 30-day readmissions: Are they preventable? 急诊普通外科30天再入院的评估：是否可以预防？

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-13 DOI: 10.1016/j.amjsurg.2025.116553

Halen Turner, Danielle Wilson, Alexandra Johnson, Morgan Tentis, Colleen Trevino, Rachel Morris, Daniel Holena, Patrick Murphy

{"title":"An evaluation of emergency general surgery 30-day readmissions: Are they preventable?","authors":"Halen Turner, Danielle Wilson, Alexandra Johnson, Morgan Tentis, Colleen Trevino, Rachel Morris, Daniel Holena, Patrick Murphy","doi":"10.1016/j.amjsurg.2025.116553","DOIUrl":"10.1016/j.amjsurg.2025.116553","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients admitted to Emergency General Surgery (EGS) services suffer from increased morbidity and mortality compared to patients undergoing elective surgery. Unplanned readmissions occur in 15 % of EGS admissions; however, the preventability of these readmissions remains largely unknown.</div></div><div><h3>Methods</h3><div>We conducted a single-center, retrospective study of patients admitted to the EGS service from 2021 to 2023 who were readmitted within 30 days. The primary outcome was the percentage of preventable readmissions, defined as those with actionable outpatient interventions.</div></div><div><h3>Results</h3><div>1,655 patients were admitted to the EGS service, with 224 (14.1 %) readmitted within 30 days. The leading reason for readmission was the need for additional management of the initial diagnosis (38.4 %). Of the readmitted patients, only 11 (4.9 %) were identified as preventable due to issues such as inadequate pain control or education.</div></div><div><h3>Conclusions</h3><div>Readmission patterns showed that most patients returned due to the progression of the initial diagnosis or complications, suggesting that many readmissions may be unavoidable.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116553"},"PeriodicalIF":2.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889021","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

Impact of frailty on outcomes after multiple rib fractures and flail chest undergoing surgical stabilization of rib fractures: a propensity score-matched analysis of the Nationwide Inpatient Sample 2005–2020 虚弱对多处肋骨骨折和连枷胸术后肋骨骨折手术稳定后预后的影响：2005-2020年全国住院患者样本的倾向评分匹配分析

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-12 DOI: 10.1016/j.amjsurg.2025.116572

Chi Li , Yu-Shan Juan , Hong-Liang Hu , Guan-Bo Tung

{"title":"Impact of frailty on outcomes after multiple rib fractures and flail chest undergoing surgical stabilization of rib fractures: a propensity score-matched analysis of the Nationwide Inpatient Sample 2005–2020","authors":"Chi Li , Yu-Shan Juan , Hong-Liang Hu , Guan-Bo Tung","doi":"10.1016/j.amjsurg.2025.116572","DOIUrl":"10.1016/j.amjsurg.2025.116572","url":null,"abstract":"<div><h3>Background</h3><div>This study examined the impact of frailty on in-hospital outcomes in patients undergoing surgical stabilization of multiple rib fractures and flail chest (SSRF).</div></div><div><h3>Methods</h3><div>This retrospective study used U.S. Nationwide Inpatient Sample data (2005–2020) to analyze patients ≥20 years old who underwent SSRF for multiple rib fractures. In-hospital outcomes (mortality, discharge status, complications) were compared between frail and non-frail groups using 1:4 propensity score matching (PSM).</div></div><div><h3>Results</h3><div>After PSM, 2690 patients were included in the analyses. Frail patients had a higher likelihood of being transferred to SNF or ICF (adjusted odds ratio [aOR] = 1.88; 95 % confidence interval [CI]: 1.46–2.43), higher total hospital costs (144.56 thousand USD; 95 % CI: 140.66–148.47), and increased risks of postoperative complications (aOR = 1.59; 95 % CI: 1.24–2.05), including tracheostomy, respiratory failure, and pneumonia.</div></div><div><h3>Conclusions</h3><div>Frailty increases the risk of adverse outcomes after SSRF, highlighting the importance of incorporating frailty assessment into perioperative care.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"249 ","pages":"Article 116572"},"PeriodicalIF":2.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863524","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

Outcomes of liver transplants utilizing donors from outside the contiguous United States 使用美国本土以外的供体进行肝移植的结果

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-12 DOI: 10.1016/j.amjsurg.2025.116568

Reed T. Jenkins , Binuri L. Hapuarachchy , Manuj M. Shah, Emily L. Larson, Alice L. Zhou, David J. Farhat, Jessica M. Ruck, Helene Rached, Elizabeth A. King, Benjamin Philosophe, Al-Faraaz Kassam

{"title":"Outcomes of liver transplants utilizing donors from outside the contiguous United States","authors":"Reed T. Jenkins , Binuri L. Hapuarachchy , Manuj M. Shah, Emily L. Larson, Alice L. Zhou, David J. Farhat, Jessica M. Ruck, Helene Rached, Elizabeth A. King, Benjamin Philosophe, Al-Faraaz Kassam","doi":"10.1016/j.amjsurg.2025.116568","DOIUrl":"10.1016/j.amjsurg.2025.116568","url":null,"abstract":"<div><h3>Purpose</h3><div>Expanding the liver donor pool includes reconsidering geographic characteristics. We evaluated demographics, trends, and outcomes of transplants from donors outside the contiguous US.</div></div><div><h3>Methods</h3><div>Adult liver-only transplants from 2010 to 2022 were categorized by donor location (mainland US vs. non-mainland) using national registry data. Post-transplant survival was evaluated using time-to-event analysis, univariate and multivariable Cox regression.</div></div><div><h3>Results</h3><div>1531 (1.5 %) liver transplants utilized non-mainland organs (991 performed in mainland US). Non-mainland to mainland donors were older, smoked less, had a lower BMI, and less steatosis (all p < 0.05). Non-mainland organs traveled further (1241 vs. 84 miles,p < 0.01) with longer ischemic times (8.6 vs. 5.9 h,p < 0.01). Length of stay (p = 0.80) and acute rejection (p = 0.14) did not differ. Non-mainland recipients had similar survival at 1-(aHR 1.02, p = 0.85), 5-(aHR 0.93, p = 0.38), and 10-years (aHR 0.96, p = 0.56).</div></div><div><h3>Conclusion</h3><div>Non-mainland recipients had similar LOS and survival despite longer distance and cold ischemic time, emphasizing further consideration for non-mainland transplantation.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"249 ","pages":"Article 116568"},"PeriodicalIF":2.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887472","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

Operating theatre efficiency: spend money to make money. 手术室效率：花钱才能赚钱。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-11 DOI: 10.1016/j.amjsurg.2025.116574

Mina Sarofim

引用次数: 0

Emeritus Editorial Board 名誉编辑委员会

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-11 DOI: 10.1016/j.amjsurg.2025.116561

引用次数: 0

The common language. 通用语言。

IF 2.7 3区医学