American Surgeon最新文献_第4页

Effectiveness of a Regionalized Care Model in Treating Fournier's Gangrene. 区域化护理模式在治疗 Fournier 坏疽中的效果。

IF 1 4区医学

American Surgeon Pub Date : 2025-04-01 DOI: 10.1177/00031348251331287

Sai Allu, Kamil Malshy, Borivoj Golijanin, Martus Gn, Emma Waddell, John Morgan, Benjamin Ahn, Amir Farah, Rebecca Ortiz, Raymond Che, Kennon Miller, Madeline Cancian

{"title":"Effectiveness of a Regionalized Care Model in Treating Fournier's Gangrene.","authors":"Sai Allu, Kamil Malshy, Borivoj Golijanin, Martus Gn, Emma Waddell, John Morgan, Benjamin Ahn, Amir Farah, Rebecca Ortiz, Raymond Che, Kennon Miller, Madeline Cancian","doi":"10.1177/00031348251331287","DOIUrl":"https://doi.org/10.1177/00031348251331287","url":null,"abstract":"ObjectivesTo evaluate the impact of transferring patients with Fournier's gangrene (FG) to a tertiary referral hospital (TRH) on survival and outcomes.MethodsWe conducted a retrospective analysis of FG cases treated at our TRH from January 2015 to January 2022. Clinicodemographic, laboratory, perioperative, and mortality data were collected. Patients were categorized into two groups: those directly presented (DP) to TRH and those transferred for treatment (TT) from other hospitals. Primary outcome was 30-day mortality. Secondary outcomes included 90-day, 180-day, 1-year and 2-year mortality. We employed chi-square, T-tests, and Fisher's exact tests for significance assessment. Survival was evaluated using Kaplan-Meier.Results136 patients (77.9% males) were analyzed: 66.9% in the TT group (n = 91), 33.1% in DP group (n = 45), with median ages of 59.2 and 56.4, respectively, P = 0.06. Median transfer distance: 10.6 miles, travel time: 16 minutes. No significant differences were observed in time from presentation to initial debridement (8.45 hours for TT, 7.3 hours for DP, P = 0.57), comorbidities, or FG Severity Index. No significant differences in 30-day mortality (TT: 5.5%, DP: 4.4%, [HR = 1.53, 95% CI: 0.31, 7.57], P = 0.6), or other mortality rates (90-day: 7.7% vs 6.6%, 180-day: 14.3% vs 8.9%, 1-year: 18.7% vs 15.6%, 2-year: 20.9% vs 15.6%, P > 0.05). DP had a higher rate of fast door-to-operation room (<6 hours) than TT (46.7% vs 18.7%, P = 0.06), although 30-day mortality was not affected.ConclusionsTransfer of FG patients to a TRH was not associated with increased mortality. Due to the rarity and complexity of this disease, centralizing care might be the preferred approach in cases of regional primary presentation.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348251331287"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Long-Term Reoperation Rates Following Pancreatoduodenectomy for Pancreatic Adenocarcinoma. 胰腺癌行胰十二指肠切除术后长期再手术率。

IF 1 4区医学

American Surgeon Pub Date : 2025-04-01 Epub Date: 2024-11-29 DOI: 10.1177/00031348241304021

Chi Zhang, Lauren Lu, Kristine Hanson, Ahmer Sultan, Patrick Starlinger, Rory Smoot, Michael L Kendrick, Mark Truty, Susanne G Warner, Cornelius Thiels

{"title":"Long-Term Reoperation Rates Following Pancreatoduodenectomy for Pancreatic Adenocarcinoma.","authors":"Chi Zhang, Lauren Lu, Kristine Hanson, Ahmer Sultan, Patrick Starlinger, Rory Smoot, Michael L Kendrick, Mark Truty, Susanne G Warner, Cornelius Thiels","doi":"10.1177/00031348241304021","DOIUrl":"10.1177/00031348241304021","url":null,"abstract":"BackgroundShort-term outcomes after pancreatoduodenectomy (PD) are well-studied, but long-term reoperation rates and their indications remain poorly characterized.MethodsA single-center retrospective chart review was performed on patients who underwent PD for pancreatic adenocarcinoma between 1/2011 and 12/2021. Reoperations occurring >90 days after PD were dichotomized to being related or unrelated to the index PD or pancreatic adenocarcinoma. The Kaplan-Meier analysis estimated the incidence of long-term reoperation at 1 and 5 years postoperatively.ResultsSix-hundred twenty-eight patients were included. The 5-year incidence of any additional operation >90 days after PD was 30.0% (95% CI 23.2-36.2%), and the 5-year incidence of any long-term related reoperation was 21.2% (95% CI 15.0-26.8%). The most common indications for reoperations by 5-year incidence were cancer recurrence (12.8%, 95% CI 7.6-17.7%), incisional hernia (6.2%, 95% CI 2.6-9.7%), small bowel obstruction (1.3%, 95% CI 0.2-2.4%), and leak, fistula, or infection (1.0%, 95% CI 0.1-2.0%). Of the examined risk factors, only 90-day reoperation was found to be predictive of long-term related reoperations (P = 0.02). Additionally, the 5-year incidence of endoscopic or interventional radiology procedures was 20.2% (95% CI 14.5-25.4%). However, 40.9% (95% CI 33.6-47.3%) of patients required additional surgery or procedures of any kind between 90 days and 5 years after PD.DiscussionWithin 5 years of PD, one in three patients required additional surgery, and one in five had operations for related indications. Related reoperative indications included recurrence, hernia, PD-specific complications, and small bowel obstruction. However, the rates of each of these reoperations were relatively low.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"518-527"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Efficacy and Validity of Percutaneous Transhepatic Gallbladder Drainage as a Bridge to Surgery for Octogenarian and Older Patients With Acute Cholecystitis: A Single-Center Retrospective Observational Study in Japan. 经皮经肝胆囊引流术作为八旬和高龄急性胆囊炎患者手术前的过渡治疗的有效性和有效性：日本单中心回顾性观察研究。

IF 1 4区医学

American Surgeon Pub Date : 2025-04-01 Epub Date: 2024-11-25 DOI: 10.1177/00031348241304047

Satoshi Nishiwada, Tetsuya Tanaka, Teruyuki Hidaka, Yuki Kirihataya, Takeshi Takei, Tomomi Sadamitsu, Takuma Morimoto, Kengo Hata, Masaru Enoki, Yui Osaki, Kazusuke Matsumoto, Hazuki Horiuchi, Yasushi Okura, Masayoshi Sawai, Atsushi Yoshimura

{"title":"Efficacy and Validity of Percutaneous Transhepatic Gallbladder Drainage as a Bridge to Surgery for Octogenarian and Older Patients With Acute Cholecystitis: A Single-Center Retrospective Observational Study in Japan.","authors":"Satoshi Nishiwada, Tetsuya Tanaka, Teruyuki Hidaka, Yuki Kirihataya, Takeshi Takei, Tomomi Sadamitsu, Takuma Morimoto, Kengo Hata, Masaru Enoki, Yui Osaki, Kazusuke Matsumoto, Hazuki Horiuchi, Yasushi Okura, Masayoshi Sawai, Atsushi Yoshimura","doi":"10.1177/00031348241304047","DOIUrl":"10.1177/00031348241304047","url":null,"abstract":"BackgroundJapan currently has a super-aged society, with a rapid increase in elderly patients in need of medical care. Determining treatment strategies for acute cholecystitis (AC) in very elderly patients with various comorbidities is often difficult. Although percutaneous cholecystostomy (PC) is a less-invasive treatment option, its impact on subsequent surgery remains debatable. This study investigated the validity of PC as a bridge to surgery in very elderly patients with AC.MethodsOf 215 patients who underwent cholecystectomy for AC at our hospital, we retrospectively investigated 83 patients aged ≥80 years-53 and 30 who underwent upfront surgery (US) and PC before surgery, respectively-to assess the treatment strategies and clinical course.ResultsThe PC group had a significantly worse systemic status at diagnosis than the US group, including age, severity grading, comorbidities, performance status, systemic inflammatory status, and blood coagulation abnormalities, which improved after PC. The elective surgery rate was significantly higher in the PC group than in the US group. Despite the high number of severe cases in the PC group, surgical quality indicators, including the conversion rate to open surgery, operative time, blood loss, and critical view of safety achievement rate, tended to be better in the PC group, without severe perioperative complications.DiscussionPC followed by cholecystectomy improves preoperative conditions, including systemic inflammation status and blood coagulation abnormalities, in very elderly patients, allowing safe elective surgical treatment while securing the quality of surgery and clinical outcomes.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"482-493"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Gun Violence in the COVID-19 Era: Using Multiple Databases to Describe the Experience in Buffalo, NY. 2019冠状病毒病时代的枪支暴力：使用多个数据库描述纽约州布法罗的经历。

IF 1 4区医学

American Surgeon Pub Date : 2025-04-01 Epub Date: 2024-12-24 DOI: 10.1177/00031348241300363

Joseph C L'Huillier, Andrew B Nordin, Veer V Nair, Brittany L Cantor, Bryan Tadlock, Brianna Friend, Joseph D Boccardo, Jihnhee Yu, James Lukan, Denise F Lillvis, Kathryn D Bass

{"title":"Gun Violence in the COVID-19 Era: Using Multiple Databases to Describe the Experience in Buffalo, NY.","authors":"Joseph C L'Huillier, Andrew B Nordin, Veer V Nair, Brittany L Cantor, Bryan Tadlock, Brianna Friend, Joseph D Boccardo, Jihnhee Yu, James Lukan, Denise F Lillvis, Kathryn D Bass","doi":"10.1177/00031348241300363","DOIUrl":"10.1177/00031348241300363","url":null,"abstract":"ObjectivesIn 2020, the public health crises of gun violence and novel coronavirus (COVID-19) collided and interventions to decrease COVID-19 transmission displaced millions of Americans from normal activity. We analyzed the effects of COVID-19 and its resultant shutdowns on gun violence in Buffalo, NY.MethodsWe queried the Gun Violence Archive (GVA) and the hospital databases from the 2 level 1 trauma centers which serve Buffalo firearm victims between March 15th and June 24th, 2020 (\"COVID\") and the same time period for years 2013 (hospital data)/2014 (GVA data) through 2019 (\"pre-COVID\") and 2021 through 2022 (\"post-COVID\"). Data points collected included number of daily victims, victim age, gender, and morbidity/mortality. Bivariate and multivariate analyses were used to compare gun violence in these 3 periods.ResultsThere were 518 and 913 victims in the GVA and hospital data sets, respectively. Bivariate analyses showed fewer incidents on Saturdays during the pandemic in both data sets (P < 0.05). Multivariate analyses demonstrated no association between number of gun violence victims and time period in either data set (P > 0.05).ConclusionsThere was no change in number of gun violence victims during the COVID-19 shutdowns compared to pre-COVID and post-COVID periods in Buffalo, NY. However, there was a change in the weekly temporality of gun violence during the COVID pandemic. Multiple databases are needed to accurately capture gun violence from an epidemiologic perspective.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"593-599"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142880820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 After Duodenoduodenostomy for Superior Mesenteric Artery Syndrome. 肠系膜上动脉综合征十二指肠十二指肠造口术后的疗效。

IF 1 4区医学

American Surgeon Pub Date : 2025-04-01 Epub Date: 2024-11-20 DOI: 10.1177/00031348241300361

Darwin Ang, Alana Hofmann, Abdelrahman Attili, Whiyie Sang, Tandis Soltani, Winston Richards, Laurence Ferber, Dana Taylor

{"title":"Outcomes After Duodenoduodenostomy for Superior Mesenteric Artery Syndrome.","authors":"Darwin Ang, Alana Hofmann, Abdelrahman Attili, Whiyie Sang, Tandis Soltani, Winston Richards, Laurence Ferber, Dana Taylor","doi":"10.1177/00031348241300361","DOIUrl":"10.1177/00031348241300361","url":null,"abstract":"BackgroundSuperior Mesenteric Artery Syndrome (SMAS) is a very rare disease that causes starvation and malnutrition secondary to a mechanical obstruction of the 3rd portion of the duodenum between the superior mesenteric artery and aorta. Long-term outcomes following surgery for SMAS by current methods have a high failure rate of 21%-67%. We report the 3-year outcomes of a novel operation for SMAS described as the duodenoduodenostomy (DD).MethodsThis is a longitudinal case series of 12 patients who underwent the DD operation for SMAS, comparing pre-surgery to post-surgery 3-year outcomes. Weight, Body Metabolic Index (BMI), iron levels, and subjective data were collected to assess restoration of nutrition, correction of malabsorption, and lifestyle. The Wilcoxon signed-rank test was applied to nonparametric matched or dependent samples, with statistical significance set at P < 0.05.ResultsAt the end of 3 years, there was a significant increase in median weight and BMI, at 108 lbs vs 123.1 lbs (P-value 0.0156) and a BMI of 18.57 vs 20.59 (P-value 0.0161). At 3 months, iron levels normalized after surgery and stayed normal at 45 mcg/dL vs 130 mcg/dL (P-value = 0.046). After 3 years, 75% of patients gained weight and BMI while 83% were able to maintain their BMI to a normal range.ConclusionOur study demonstrates that DD surgery leads to significant increases in weight and BMI, accompanied by improved iron levels. The DD procedure emerges as a promising surgical option in the definitive treatment for SMAS.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"561-569"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

What, When, and Why: Viscoelastic Hemostatic Assays and Their Uses in Trauma Resuscitation. 什么，何时，为什么：粘弹性止血测定及其在创伤复苏中的应用。

IF 1 4区医学

American Surgeon Pub Date : 2025-04-01 Epub Date: 2024-12-18 DOI: 10.1177/00031348241309563

Jennaye G Burkhart, Ross P Smith, Terra M Hill, Robert D Winfield

引用次数: 0

Letter re: Defining Types of Leadership Within an Academic Surgery Department to Promote Change for Decreasing Rates of Burnout. 信件内容：定义外科学术部门的领导类型，促进改革，降低职业倦怠率。

IF 1 4区医学

American Surgeon Pub Date : 2025-04-01 Epub Date: 2024-12-20 DOI: 10.1177/00031348241309564

Rebecca E Glavin, Julie K Silver

引用次数: 0

A Randomized Non-Inferiority Clinical Trial of 14Fr Thal versus 28Fr Tube Thoracostomy for Traumatic Hemothorax. 14Fr Thal与28Fr管开胸术治疗外伤性血胸的随机非效性临床试验

IF 1 4区医学

American Surgeon Pub Date : 2025-04-01 Epub Date: 2024-12-19 DOI: 10.1177/00031348241308907

Jason McCartt, Samuel Wade Ross, Kyle W Cunningham, Huaping Wang, Leslie Sealey, Julia Brake, Ashley Christmas, Gaurav Sachdev, John Green, Bradley W Thomas

{"title":"A Randomized Non-Inferiority Clinical Trial of 14Fr Thal versus 28Fr Tube Thoracostomy for Traumatic Hemothorax.","authors":"Jason McCartt, Samuel Wade Ross, Kyle W Cunningham, Huaping Wang, Leslie Sealey, Julia Brake, Ashley Christmas, Gaurav Sachdev, John Green, Bradley W Thomas","doi":"10.1177/00031348241308907","DOIUrl":"10.1177/00031348241308907","url":null,"abstract":"BackgroundThe traditional treatment of traumatic hemothorax (HTX) is large bore chest tubes (CT) ≥28Fr. Recent evidence shows 14Fr pigtail catheters are as effective in drainage of HTX as larger CT. However, this has not been shown in 14Fr Thal tubes, a straight chest tube placed utilizing Seldinger technique.MethodsA single center, prospective randomized controlled trial was performed at an ACS verified Level 1 trauma center comparing 14Fr Thal CT (14CT) to 28Fr CT (28CT) between May 2017 and September 2021. The primary outcome was failure of drainage of hemothorax requiring additional intervention. Secondary outcomes included duration of chest tube placement, length of stay, tube-specific complications, and 90-day hospital readmission. Farrington-Manning approach was used for non-inferiority tests. Wilcoxon 2-samples test or t test was used for continuous variables, and Pearson chi-square or Fisher exact test was used for categorical variables.Results109 patients were included in the randomized trial. There were 54 patients in the 14CT cohort, and 55 patients in the 28CT cohort. The primary outcome of drainage failure was similar between groups (8.3% 14CT vs 3.9% 28CT). Using a 15% non-inferiority margin 14CT is non-inferior to 28CT. No differences were identified in secondary outcomes.Conclusion14Fr Thal tubes have similar efficacy in drainage of traumatic hemothorax when compared with 28Fr chest tubes with similar complication rates (NCT03167723).","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"579-586"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Early Routine Lung Cancer Screening Leads to Improved Treatment Options and Survival.

IF 1 4区医学

American Surgeon Pub Date : 2025-04-01 DOI: 10.1177/00031348251331280

Jessica L Schweigert, Andrew J Borgert, Barbara A Bennie, Brenda L Rooney, Alec J Fitzsimmons, C Isaiah Fitzmaurice, Venki Paramesh

{"title":"Early Routine Lung Cancer Screening Leads to Improved Treatment Options and Survival.","authors":"Jessica L Schweigert, Andrew J Borgert, Barbara A Bennie, Brenda L Rooney, Alec J Fitzsimmons, C Isaiah Fitzmaurice, Venki Paramesh","doi":"10.1177/00031348251331280","DOIUrl":"https://doi.org/10.1177/00031348251331280","url":null,"abstract":"BackgroundLung cancer is the second-most common cancer and leading cause of cancer-related deaths. American adults aged 55 to 80 years are at heightened risk for lung cancer; only 4.5% underwent screening history by computed tomography. The hypothesis is that lung cancers diagnosed on screening were an earlier stage which broadens treatment options and improves survival.MethodsThe electronic health record (EHR) was retrospectively queried to identify patients with lung cancer from 2017 to 2020. Kaplan-Maier curves were used to compare survival based on screening history.Results764 patients with lung cancer were included. 14.7% (112/764) had a history of lung cancer screening. Patients with a history of screening were significantly more likely to be diagnosed at early stages (66/112, 59% vs 215/652, 33%; P < .0001). They were significantly more likely to have surgery (46/112, 41% vs 97/652, 15%, respectively; P < 0.0001). Patients diagnosed in late stages were significantly more likely than those diagnosed at early stages to receive chemotherapy (318/483, 66% vs 76/281, 27%, respectively; P < .0001). Three-year survival was higher with screening (P < .0001). Survival rates at 3 years after initial diagnosis with screening history is 47.4% (95% CI, 34.8-59.0) while the rate without screening is 25.2% (95% CI, 21.2-29.4).DiscussionLung cancer diagnosed via screening was more likely to be earlier stages. Patients diagnosed at early stages were more likely to undergo surgery. Those diagnosed via screening had a higher 3-year survival. These findings indicate that early routine screening leads to improved treatment options and survival.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348251331280"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Risk Factors and Timing of Fasciotomy for Isolated Pediatric Lower Extremity Trauma.

IF 1 4区医学

American Surgeon Pub Date : 2025-04-01 DOI: 10.1177/00031348251331292

Mennatalla Hegazi, Jeffry Nahmias, Michael Lekawa, Matthew Dolich, Allen Kong, Cristobal Barrios, Areg Grigorian

{"title":"Risk Factors and Timing of Fasciotomy for Isolated Pediatric Lower Extremity Trauma.","authors":"Mennatalla Hegazi, Jeffry Nahmias, Michael Lekawa, Matthew Dolich, Allen Kong, Cristobal Barrios, Areg Grigorian","doi":"10.1177/00031348251331292","DOIUrl":"https://doi.org/10.1177/00031348251331292","url":null,"abstract":"BackgroundPrevious single-center reports have demonstrated a longer time from traumatic leg injury to fasciotomy in pediatric trauma patients (PTPs) with compartment syndrome. We hypothesized most fasciotomies in isolated pediatric lower extremity trauma (LET) are delayed (>6 hours from admission) and sought to investigate risk factors for pediatric fasciotomy.MethodsThe 2017-2020 TQIP database was queried for PTPs <17 years old with isolated injury to the leg. The primary outcome was fasciotomy. A multivariable logistic regression analysis was performed to identify associated risk factors for fasciotomy.ResultsFrom 97,217 PTPs, 358 (0.4%) underwent a fasciotomy, with a majority being delayed (60.3%); the median time to fasciotomy was 9.6 hours. Patients undergoing fasciotomy were older (median age 14 vs 12 years, P < 0.001), had a higher rate of severe LET (4.9% vs 1.2%, P < 0.001), and had tibial fracture (70.7% vs 27.6%, P < 0.001). They also had increased rates of in-hospital complications (14.2% vs 0.6%, P < 0.001), limb loss (1.1% vs <0.1%, P < 0.001), and longer median length of stay (LOS) (5 vs 2 days, P < 0.001). The most injured vessel in those undergoing fasciotomy was the popliteal artery (9.9%). Independent risk factors associated with fasciotomy included injuries to the popliteal vein (OR 30.72, CI 11.06-85.29, P < 0.001), femoral vein (OR 18.19, CI 6.40-51.69, P < 0.001), and popliteal artery (OR 13.74, CI 8.45-22.34, P < 0.001) and tibial fracture (OR 7.46, CI 5.57-10.00, P < 0.001).DiscussionMost fasciotomies were delayed for PTPs with isolated lower extremity injury. Popliteal vein injury increases the risk for fasciotomy 30-fold. Patients undergoing fasciotomy tend to have more complications and longer LOS.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348251331292"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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