American Surgeon最新文献

{"title":"Leaders and Leadership in Surgery.","authors":"Sandra L Wong","doi":"10.1177/00031348251329491","DOIUrl":"10.1177/00031348251329491","url":null,"abstract":"","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1585-1586"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962290","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}

{"title":"Outcomes Following Colectomy at For-Profit Hospitals: A National Analysis.","authors":"Sara Sakowitz, Syed Shahyan Bakhtiyar, Amulya Vadlakonda, Esteban Aguayo, Hanjoo Lee, Peyman Benharash","doi":"10.1177/00031348251337162","DOIUrl":"10.1177/00031348251337162","url":null,"abstract":"<p><p>BackgroundOne of the most commonly performed operations in the US, colectomy remains associated with a substantial incidence of postoperative complications. While there is increasing recognition that hospital for-profit financial structure may be linked with variation in morbidity, the impact of care at for-profit (FP) hospitals on outcomes following colectomy remains to be elucidated.MethodsAll adults undergoing elective/emergent colectomy for diverticular disease, inflammatory bowel disease, benign colonic neoplasms, or colon cancer, ≤2days of admission, were tabulated from the Nationwide Readmissions Database. Patients were stratified by care at FP centers into the FP and Non-FP cohorts. Following entropy balancing, multivariable models were developed to consider the independent association of FP status with key outcomes.ResultsOf ∼1,130,803 admissions for colectomy, 862 495 (76.3%) were elective. Among electively admitted patients, 74 933 (8.7%) were grouped as FP. After risk adjustment, care at FP institutions was associated with greater odds of major morbidity (AOR 1.27, CI 1.22-1.32), non-home discharge (AOR 1.20, CI 1.13-1.27), and non-elective readmission (AOR 1.26, CI 1.12-1.32), but lower per-patient expenditures (β-$2430/patient, CI -2,860, -2010). Considering the 268 308 emergent cases, 38 568 (14.4%) were managed at FP hospitals. Following multivariable adjustment, treatment at FP hospitals remained associated with increased morbidity (AOR 1.16, CI 1.11-1.21) and decreased costs (β-$5,630, CI -6,210, -5,050).DiscussionUndergoing colectomy at FP hospitals was associated with greater complications and readmissions, but reduced per-patient expenditures. Future research should consider the factors contributing to inferior clinical outcomes at these centers. Best practices should be shared across institutions, irrespective of financial structure.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1650-1657"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075537","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}

{"title":"Development of an Acute Femoral Hernia Treatment Algorithm: Insights From the ACHQC National Database.","authors":"Ian Kim, Galinos Barmparas, Shirin Towfigh","doi":"10.1177/00031348251353074","DOIUrl":"10.1177/00031348251353074","url":null,"abstract":"<p><p>BackgroundDue to the rarity of femoral hernias (FH), mastery of surgical decision-making can be challenging. Current guidelines address only elective treatment of FH, without guidance for the acute setting.ObjectiveTo review current surgical management of FH, and to determine a modern-day treatment algorithm for FH in the acute setting.MethodsThe Abdominal Core Health Quality Collaborative (ACHQC) was surveyed for adult patients undergoing elective (EFH) or acute (AFH) FH repair from 2016 to 2023.ResultsOf 2563 FH repairs, 61 (2.4%) were AFH. Patients with AFH were more likely to be female (68.9% vs 31.1%, <i>P</i> < 0.01), older (median age 76 vs 64.5 years, <i>P</i> < 0.01), have greater comorbidity (ASA III or higher, 58% vs 30%, <i>P</i> < 0.01), and larger hernia defects (≥1.5 cm, 51% vs 34%, <i>P</i> < 0.01). Open surgery was the predominant approach for AFH (61% vs 14%, <i>P</i> < 0.01), while EFH was mostly repaired robotically (54% vs 10%, <i>P</i> < 0.01). Over time, robotic surgery increased for both AFH and EFH. AFH were less likely to have mesh implanted (72% vs 97%, <i>P</i> < 0.01), though permanent synthetic mesh remained the dominant choice in both groups (89% vs 98%, <i>P</i> < 0.01).DiscussionOpen surgery with mesh dominates for AFH, but robotic techniques are increasingly utilized. A treatment algorithm is proposed to optimize management of patients with AFH to determine the safest approach based on clinical scenarios.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1735-1741"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526100","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}

{"title":"Outcomes in REBOA by Sex: Results From the American Association of Surgery for Trauma (AAST) Aortic Occlusion and Resuscitation for Trauma and Acute Care Surgery (AORTA) Trial.","authors":"Joanna F Shaw, Kosuke Kawai, Nikhil L Chervu, Megan L Brenner","doi":"10.1177/00031348251341954","DOIUrl":"10.1177/00031348251341954","url":null,"abstract":"<p><p><b>Background:</b> Female patients have smaller diameter femoral vessels than men and higher rates of procedural complications for elective vascular surgeries. We investigated sex differences in REBOA outcomes including vascular access complications. <b>Methods:</b> Retrospective data query from the AORTA database for 779 patients who underwent REBOA from 2013 to 2023. Demographics, physiology, and outcomes were examined. Univariable and multivariate analyses were performed. <b>Results:</b> Among 779 patients who received REBOA, 22.6% (n=176) were female, and the mean age was 43.0 (+/-18.0) years. The mean Injury Severity Score (ISS) was 34.0 (±15.0). The mean admission Glasgow Coma Scale (GCS) was 8.2 (±5.3) and systolic blood pressure (SBP) at the time of aortic occlusion (AO) was 66.0 (±33.7) mmHg. Female patients were more likely to sustain blunt trauma (91.1% vs. 74.9%; p<0.001) and had marginally higher ISS (36.5 [±15.7] vs. 33.3 [±14.7]; p=0.06). Female patients had lower GCS at admission (7.3 [±5.1] vs. 8.4 [±5.3]; p=0.019). There were no significant differences in vascular complications including pseudoaneurysm, hematoma, traumatic AV fistula, or distal embolism. Acute kidney injury was more common among males (29.4% vs. 13.6%; p<0.001). Hospital length of stay did not differ significantly (15.6 [±18.3] vs. 18.7 [±24.6] days; p=0.43). There was no difference in hospital mortality (52.3% vs. 47.1%) after accounting for clinical factors in the multivariable regression model (adjusted OR 1.07; 95% CI 0.66-1.73; p=0.78). <b>Discussion:</b> Patients who receive REBOA are critically ill. Female patients who receive REBOA do not have significantly more access-related complications than male patients.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1714-1719"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332339","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}

{"title":"The Impact of Delayed Intubation on Outcomes and Resource Utilization of Patients Sustaining Multiple Rib Fractures.","authors":"Junsik Kwon, Bishoy Zakhary, Navpreet Dhillon, Bruno C Coimbra, Babak Sarani, Raul Coimbra","doi":"10.1177/00031348251351008","DOIUrl":"10.1177/00031348251351008","url":null,"abstract":"<p><p>BackgroundPatients with multiple rib fractures may require mechanical ventilation due to respiratory insufficiency. We hypothesized that delayed intubation leads to worse outcomes compared to early intubation.MethodsWe analyzed data from the Trauma Quality Improvement Program database (2017-2021) for adults with ≥ 3 rib fractures requiring intubation. Patients were divided into groups of early and delayed intubation (after 24 hours from admission). Outcomes included in-hospital mortality, complications, and tracheostomy need. Resource utilization metrics were compared. Groups were balanced using inverse probability of treatment weighting, and complex samples logistic regression was used to evaluate the effect of delayed intubation on outcomes while controlling for covariates.ResultsOut of 191,816 patients with ≥3 rib fractures, 5339 underwent early intubation and 4004 underwent delayed intubation. Delayed intubation patients were older, more often female, less severely injured, had fewer bilateral fractures and flail chest, but higher tracheostomy need. Factors associated with delayed intubation included age > 60, ISS < 16, absence of bilateral fractures, smoking, and COPD. After adjustment, delayed intubation was associated with higher mortality (19.7% vs 13.7%), longer hospital and ICU stays, increased mechanical ventilation duration, and fewer ICU- and ventilator-free days. Additionally, delayed intubation was linked to increased ARDS, pulmonary embolism, severe sepsis, and acute kidney injury. It independently increased mortality odds (OR 1.584).DiscussionDelayed intubation in patients with multiple rib fractures is associated with worse clinical outcomes and increased resource utilization. This link between delayed intubation and worse outcomes highlights the importance of recognizing at-risk individuals and considering early intubation.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1690-1697"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301031","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}

{"title":"Disaggregation of Asian American Data Reveals Disparities in Pathologic Complete Response After Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer.","authors":"Sarah W Yuen, Jenny Zhu, Kari J Kansal, Karen T Lane, Erin H Lin, Holly M Yong","doi":"10.1177/00031348251359118","DOIUrl":"10.1177/00031348251359118","url":null,"abstract":"<p><p>IntroductionBreast cancer literature traditionally evaluated the Asian American Pacific Islander (AAPI) population in aggregate, masking its heterogeneity. This study evaluates the pathologic complete response (pCR) of disaggregated AAPI subgroups with triple-negative breast cancer (TNBC) to identify and address disparities within this population.MethodsThe 2018-2020 National Cancer Database identified women with TNBC who received neoadjuvant chemotherapy and surgical excision. pCR was compared amongst White, AAPI, and non-White non-Asian (NWNA) patients.ResultsOf 19,809 women, 71.6% were White, 4.1% were AAPI, and 24.3% were NWNA. Compared to White and NWNA, AAPI patients had the highest pCR (AAPI 43.0% vs White 39.5% vs NWNA 37.1%, <i>P</i> < 0.001). However, disaggregation revealed Koreans to have significantly lower pCR than all subgroups, including both White and NWNA patients, while Japanese and South Asians had the highest pCR of all subgroups. Notably, Koreans and Japanese patients had similar presentations of advanced disease, favorable demographics, and relatively short intervals to chemotherapy but demonstrated pCR rates on opposite extremes.ConclusionWhile AAPI patients with TNBC had a higher pCR than White and NWNA patients, disaggregation of AAPI subgroups reveals poorer pCR for specific subgroups than that of White and NWNA patients. While socioeconomic characteristics may partially explain these differences, the contrasting rates of pCR between Koreans and South Asians despite presenting with similar rates of advanced disease, demographics, and treatment characteristics highlight the contribution of tumor biology to treatment response and the importance of disaggregated data and targeted interventions to address disparities among unique ethnic subpopulations.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1758-1769"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574667","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}

{"title":"Impact of Systemic Anticoagulation During Traumatic Peripheral Arterial Repair on Re-Intervention and Amputation: An Analysis of 11 Years of PROOVIT Data.","authors":"Negar Nekooei, Ajay N Prasad, Justin L Wang, Danielle E Brabender, Anaar E Siletz, Kazuhide Matsushima, Kenji Inaba, Joseph J DuBose, Matthew J Martin","doi":"10.1177/00031348251337158","DOIUrl":"10.1177/00031348251337158","url":null,"abstract":"<p><p>IntroductionSystemic anticoagulation (SAC) is widely used during peripheral arterial repair (PAR) to mitigate thrombotic risks, but its efficacy in trauma patients remains unclear. This study evaluated the association of SAC with re-intervention and amputation rates in traumatic PAR.MethodsThis retrospective study queried the Prospective Observational Vascular Injury Treatment (PROOVIT) database (2012-2023) for traumatic PAR cases. Patients were grouped by SAC use during repair. Outcomes included re-intervention, amputation, thrombotic complications, packed red blood cell (PRBC) transfusion within 24 hours, and length of stay (LOS). Multivariable analysis adjusted for age, sex, injury mechanism, Injury Severity Score (ISS), and mangled extremity severity score (MESS).ResultsOf 1182 cases, 713 (60%) received SAC. Median age was 30 years, and 83.6% were male. In univariable analysis, amputation rates were similar between SAC (4.8%) and no-SAC (4.7%) groups (<i>P</i> = 0.970), as were thrombotic complications (4.8% vs 3.4%, <i>P</i> = 0.257). However, SAC was associated with higher re-intervention rates (14.4% vs 9.6%, <i>P</i> = 0.014), increased PRBC transfusion (median 2 vs 0 units, <i>P</i> < 0.001), and longer LOS (median 8 vs 5 days, <i>P</i> < 0.001). Multivariable analysis found no significant association between SAC and re-intervention (aOR 1.128, <i>P</i> = 0.643), or amputation (aOR 0.671, <i>P</i> = 0.200).ConclusionSAC during traumatic peripheral arterial repair did not reduce amputation rates and was associated with increased re-intervention. However, multivariable analysis revealed no significant difference in outcomes, suggesting SAC neither provides universal benefit nor introduces harm. These findings highlight the need for future research to identify specific trauma populations that may benefit from individualized SAC use.Level of EvidenceLevel III, Prognostic/Epidemiological.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1603-1612"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952219","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}

{"title":"Minimally Invasive Right Hemicolectomy With Intracorporeal Anastomosis-Eliminating the Painful 12 mm Port Paradox.","authors":"Eduardo Alvarez, Adeel Ashfaq, Jocelyn Di Nolfi, Nathan Aminpour, Motahar Basam, Vikram Attaluri, Elisabeth C McLemore","doi":"10.1177/00031348251341963","DOIUrl":"10.1177/00031348251341963","url":null,"abstract":"<p><p>BackgroundMinimally invasive right hemicolectomy with intracorporeal anastomosis (ICA) with relocation of the 12 mm port to the Pfannenstiel specimen incision is associated with reduced length of stay and postoperative ileus while preserving surgical and oncologic outcomes when compared to extracorporeal anastomosis (ECA).MethodsAn institutional review board (IRB)-approved retrospective review was conducted at a single center for all patients who underwent elective laparoscopic or robotic right hemicolectomy from 2015 to 2023. The 12 mm port for anastomosis stapler was placed in the planned Pfannenstiel specimen extraction site in all patients undergoing ICA.Results112 patients underwent minimally invasive right hemicolectomy (33 laparoscopic ECA, 1 robotic ECA, 51 laparoscopic ICA, 27 robotic ICA). Median operative times for ECA vs ICA were 149.8 and 183.1 minutes, respectively (<i>P</i> < .01). The median length of stay was shorter for ICA (2 vs 3 days, <i>P</i> < .01). Postoperative ileus was greater in the ECA group (8.8% vs 2.6%, <i>P</i> = .140). Hospital readmissions were higher in the ECA group (3 vs 1, <i>P</i> = .048). The rate of no evidence of disease at time of last oncology follow-up was in the ECA group (93.6%) vs in the ICA group (98.5%), <i>P</i> = .092. Recurrence rate was not significantly different when comparing the ECA group vs the ICA group (6.45% vs 4.55%, <i>P</i> = .708).DiscussionMinimally invasive right hemicolectomy with ICA is associated with a lower rate of postoperative ileus and shorter length of stay. Relocating the 12-mm port for the bowel stapler to the Pfannenstiel extraction site eliminates the painful 12-mm port paradox.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1635-1642"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960312","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}

{"title":"Great Debates: Undergoing the Knife versus Pill-Popping-The Comparative Efficacy and Cost-Effectiveness of Bariatric Surgery and GLP-1 Receptor Agonists in the Management of Obesity.","authors":"Paul Brosnihan, M Siobhan Luce, Amy K Yetasook, Christian Perez, Keith R Scharf, Sherif Aly","doi":"10.1177/00031348251337145","DOIUrl":"10.1177/00031348251337145","url":null,"abstract":"<p><p>Bariatric surgery has long been the most effective intervention for obesity, providing significant and durable weight loss, with procedures like sleeve gastrectomy and gastric bypass achieving 10-year total weight loss (TWL) rates of 23.4% and 26.9%, respectively. More complex procedures, such as duodenal switch, result in even greater TWL. Recently, glucagon-like peptide-1 receptor agonists (GLP-1 RA) have emerged as a promising pharmacological alternative, demonstrating up to 25.3% TWL with tirzepatide. However, GLP-1 RA efficacy remains inferior to bariatric surgery, with high discontinuation rates due to adverse effects, cost, and limited insurance coverage. While surgery offers superior long-term outcomes and cost-effectiveness, it is underutilized, with less than 1% of eligible patients undergoing surgical intervention annually. GLP-1 RA can expand access to obesity treatment, particularly for patients hesitant or ineligible for surgery, and may serve as a bridge to surgery or an adjunct for postoperative weight regain. Despite their benefits, GLP-1 RAs require sustained adherence, and weight regain is common upon discontinuation. A multidisciplinary approach integrating surgical, pharmacological, and lifestyle interventions is essential for optimizing obesity management. Future research should focus on long-term GLP-1 RA efficacy, combination therapy strategies, and improving access to both surgical and medical obesity treatments.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1587-1593"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972992","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}

{"title":"Association of Tracheostomy Timing With Outcomes Following Traumatic Cervical Spinal Cord Injury.","authors":"Syed Shaheer Ali, Troy Coaston, Konmal Ali, Saad Mallick, Esteban Aguayo, Areti Tillou, Peyman Benharash, Galinos Barmparas","doi":"10.1177/00031348251337147","DOIUrl":"10.1177/00031348251337147","url":null,"abstract":"<p><p>BackgroundPatients with cervical spinal cord injury (CSCI) often require tracheostomy due to a prolonged ventilator dependence. However, optimal time for tracheostomy remains controversial.MethodsAll adult patients (≥18 years) with CSCI who underwent tracheostomy were identified in the 2018-2021 Trauma Quality Improvement Program database. The median time to tracheostomy of the entire sample was found in which patients were categorized into <i>Early</i> (≤10 days) and <i>Delayed</i> (>10 days) cohorts based on whether they were below or above the median. Multivariable regression models were developed to examine the association between tracheostomy timing and clinical outcomes including pneumonia, unplanned intubation, decubitus ulcer, deep vein thrombosis, and in-hospital mortality.ResultsOf 3545 patients, 43.0% underwent tracheostomy within 10 days of admission. Compared to <i>Delayed, Early</i> was more commonly younger (51 [32-65] vs 58 years [40-77]; <i>P</i> < 0.001) and privately insured (38.6 vs 37.8%, <i>P</i> < 0.001). Upon adjustment, severe facial injury and a greater injury severity score (ISS) were associated with increased odds of early tracheostomy. Additionally, early tracheostomy was linked with reduced odds of pneumonia (Adjusted Odds Ratio [AOR] 0.70, 95% 0.62-0.82), decubitus ulcer (AOR 0.61, 95% CI 0.53-0.71), and unplanned intubation (AOR 0.43, 95% CI 0.37-0.49). Tracheostomy timing did not alter risk of in-hospital mortality (<i>Early</i>: AOR 1.08, 95% CI 0.86-1.35).DiscussionEarly tracheostomy in CSCI patients was associated with lower risk of complications, without differences in adjusted mortality rate. These findings suggest that early tracheostomy may improve acute outcomes in CSCI patients. Further prospective research is warranted to inform standardized care pathways.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1613-1619"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958714","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}