American Surgeon最新文献

筛选
英文 中文
A Single-Center Evaluation of a Novel Hollow Viscus Injury Prediction Score for Abdominal Seatbelt Sign. 腹部安全带征像的新型空心内脏损伤预测评分的单中心评价。
IF 0.9 4区 医学
American Surgeon Pub Date : 2025-10-01 Epub Date: 2025-05-16 DOI: 10.1177/00031348251343619
Elaha Noori, Alexander T Lee, Jeffrey W Santos, Areg Grigorian, Matthew O Dolich, Sigrid K Burruss, Catherine M Kuza, Jeffry T Nahmias
{"title":"A Single-Center Evaluation of a Novel Hollow Viscus Injury Prediction Score for Abdominal Seatbelt Sign.","authors":"Elaha Noori, Alexander T Lee, Jeffrey W Santos, Areg Grigorian, Matthew O Dolich, Sigrid K Burruss, Catherine M Kuza, Jeffry T Nahmias","doi":"10.1177/00031348251343619","DOIUrl":"10.1177/00031348251343619","url":null,"abstract":"<p><p><b>Background:</b> The diagnosis of hollow viscus injury (HVI) following blunt trauma presents a challenge in the acute clinical setting. The recently derived HVI score uses clinical and imaging findings to predict HVI with scores ranging from 0-17 (low risk: 0-5, moderate risk: 6-9, and high risk: 10-17). This study aimed to determine how frequently the use of the HVI score would change management in a cohort of patients with an abdominal seat belt sign (SBS). <b>Methods:</b> This was a retrospective, single-center study including all adult (18 years and older) patients with abdominal SBS. Patients were assigned risk categories based on HVI score. We compared the patients' actual management with management recommended by the HVI score (low risk: observation; moderate risk: CT or diagnostic laparoscopy/laparotomy; high risk: diagnostic laparoscopy/laparotomy). <b>Results:</b> In total, 239 patients were included. The HVI score had a 98.3% NPV and 12.4% PPV for the low-risk cutoff score (HVI ≤5), while the NPV and PPV for the high-risk cutoff (HVI score ≥10) were 97.7% and 50%, respectively. Within the moderate-risk category, 97.9% did not originally follow HVI score recommendations, and among these patients, 2.1% were later found to have an HVI. Out of all patients, 2.1% had delayed diagnoses of HVI and may have benefitted from earlier identification with the HVI score. <b>Discussion:</b> Thus, the HVI score appears capable of detecting HVI in patients with abdominal SBS. An HVI score ≤5 nearly excludes HVI, while an HVI score ≥10 helps predict need for intervention in a timelier manner.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1658-1664"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075535","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
Ten-Year Analysis of Mastectomy in Stage IV Breast Cancer: Practice Patterns and Outcomes. 四期乳腺癌乳房切除术的十年分析:实践模式和结果。
IF 0.9 4区 医学
American Surgeon Pub Date : 2025-10-01 Epub Date: 2025-06-26 DOI: 10.1177/00031348251355933
Anup Y Parikh, Daniil Sokolov, Hadley D Freeman, Jukes P Namm, Naveenraj Solomon, Sharon Lum, Halley Vora
{"title":"Ten-Year Analysis of Mastectomy in Stage IV Breast Cancer: Practice Patterns and Outcomes.","authors":"Anup Y Parikh, Daniil Sokolov, Hadley D Freeman, Jukes P Namm, Naveenraj Solomon, Sharon Lum, Halley Vora","doi":"10.1177/00031348251355933","DOIUrl":"10.1177/00031348251355933","url":null,"abstract":"<p><p>BackgroundCurrently no level 1 data clearly demonstrates a survival benefit from operative therapy in patients with de novo metastatic breast cancer (dnMBC); thus, NCCN guidelines reserve mastectomy for palliation only. However, as multimodal therapies improve, disease management over a longer period may benefit certain patients who are on the continuum between curative and palliative intent.MethodsA retrospective review was performed of all female patients with dnMBC treated between 2014-2024 at our institution. The cohort was divided into 2 groups: those patients who underwent mastectomy and those who did not. Clinicopathologic factors and patient outcomes of both groups were analyzed.ResultsOf the 92 patients meeting inclusion criteria, total mastectomy was performed in 37 (40%) patients. Surgical resection was more commonly associated with oligometastatic bone disease (11.5% vs 0%, <i>P</i> < .01) and not with widespread metastasis involving multiple systems (24.3% vs 50.9%, <i>P</i> = 0.02). Surgical patients had significantly higher rates of complete response and stable disease after upfront systemic therapy (32.4% vs 12.7% and 18.9% vs 3.6%, respectively) while nonsurgical patients had a significantly higher rate of disease progression (32.7% vs 2.7%). The median OS was higher in surgical patients (NR vs 3.95 years, <i>P</i> < .01).DiscussionPrimary site surgery played an important role as part of a multimodal disease management paradigm in dnMBC patients at our institution. Future studies should evaluate which patients on the continuum between curative and palliative intent may benefit the most from this strategy, which may help standardize surgical care in these clinically challenging patients.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1742-1748"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504541","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
Impact of Psychosocial Risk Factors on Acute Clinical Outcomes Following Colectomy: A National Perspective. 心理社会风险因素对结肠切除术后急性临床结果的影响:一个国家视角。
IF 0.9 4区 医学
American Surgeon Pub Date : 2025-10-01 Epub Date: 2025-06-21 DOI: 10.1177/00031348251353072
Sara Sakowitz, Syed Shahyan Bakhtiyar, Konmal Ali, Amulya Vadlakonda, Jeffrey Balian, Hanjoo Lee, Peyman Benharash
{"title":"Impact of Psychosocial Risk Factors on Acute Clinical Outcomes Following Colectomy: A National Perspective.","authors":"Sara Sakowitz, Syed Shahyan Bakhtiyar, Konmal Ali, Amulya Vadlakonda, Jeffrey Balian, Hanjoo Lee, Peyman Benharash","doi":"10.1177/00031348251353072","DOIUrl":"10.1177/00031348251353072","url":null,"abstract":"<p><p>BackgroundA growing body of work has considered the significance of patients' psychosocial support and surrounding socioeconomic milieu on surgical outcomes. The presence of such psychosocial risk factors (PSRFs) may define both access to and engagement with care, particularly for access-sensitive conditions, such as colon resection. Yet, the impact of PSRF on outcomes following colectomy remains to be delineated.MethodsWe queried the Nationwide Readmissions Database for all adults undergoing elective/emergent colectomy for benign neoplasms, colon cancer, diverticular disease, or inflammatory bowel disease from 2016 to 2022. The presence of PSRF across 5 domains (low-income or uninsured status, substance use, psychiatric disease, and cognitive limitations) was identified using validated administrative codes. Patients with ≥1 PSRF comprised the <i>At-Risk</i> cohort (others: <i>Not-At-Risk</i>).ResultsAmong ∼1,130,803 records, 497,336 (44.0%) had ≥1 documented PSRF. The <i>At-Risk</i> cohort was younger and of greater comorbidity burden, and more frequently underwent open resection at non-metropolitan centers. Following comprehensive risk adjustment, the presence of PSRF remained associated with greater likelihood of in-hospital mortality (AOR 1.17, CI 1.11-1.22) and any major complication (AOR 1.09, CI 1.07-1.11), as well as non-home discharge (AOR 1.41, CI 1.37-1.44) and non-elective readmission within 30 days (AOR 1.10, CI 1.08-1.12). These associations persisted when evaluating only patients treated at high colectomy volume hospitals.DiscussionIn this national study, the presence of PSRF was associated with significantly inferior outcomes following colectomy. Notably, this association was not mitigated by care at high volume hospitals. Psychosocial risk factors should be considered as part of risk stratification and care optimization efforts across institutions.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1704-1713"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339839","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
Prehospital CPR for Traumatic Arrest: Can Prehospital Variables Help Identify Futile Transport? 院前心肺复苏术治疗创伤性骤停:院前变量能否帮助识别无效转运?
IF 0.9 4区 医学
American Surgeon Pub Date : 2025-10-01 Epub Date: 2025-07-10 DOI: 10.1177/00031348251359121
Lorena Garcia, Hye Kwang E Kim, Amy H Kaji, Jessica A Keeley, Alexander C Schwed
{"title":"Prehospital CPR for Traumatic Arrest: Can Prehospital Variables Help Identify Futile Transport?","authors":"Lorena Garcia, Hye Kwang E Kim, Amy H Kaji, Jessica A Keeley, Alexander C Schwed","doi":"10.1177/00031348251359121","DOIUrl":"10.1177/00031348251359121","url":null,"abstract":"<p><p>Resuscitative efforts (RE) for patients suffering cardiac arrest following trauma require significant prehospital (PH) and hospital resources. Patients who are transported and undergo immediate termination of resuscitative efforts (ITRE) and declared dead on arrival (DOA) may represent a population for whom improved triage can conserve hospital resources. <b>Methods:</b> We sought to identify PH variables associated with DOA/ITRE. 405 trauma patients who had PHCPR from 2014 to 2023 at a Level 1 trauma center were included. Clinical variables analyzed included demographics, mechanism of injury (MOI), PHRE, and hospital RE. The primary outcome of interest was DOA/ITRE. <b>Results:</b> Most patients were male (80.5%), with median age 35, (IQR [25-50]), suffered a penetrating MOI (56.5%), and were severely injured (ISS 34, IQR [25-75]). 102 (25.2%) patients had DOA/ITRE; they tended to be older (41.5 [29-53] vs. 32 [24-47], <i>P</i> = 0.01), were more likely to have a blunt MOIs (52/176 patients (29.6%) vs 50/229 patients (21.8%), <i>P</i> = 0.007), and less likely to have PH interventions (30.3% vs. 69.7%, <i>P</i> = 0.004). When stratified by MOI, patients with penetrating injuries spent a significantly shorter amount of time in the ED (6.3 vs 12.4 min, <i>P</i> <0.001), while in those with blunt injuries did not (10.6 vs 12.5 min, <i>P</i> = 0.3). <b>Discussion:</b> More than 25% of transported patients following traumatic arrest undergo DOA/ITRE. These patients were more likely to have a blunt MOI, older age, and fewer PH interventions. Improved triage of patients in the field may help conserve PH and hospital resources for patients more likely to benefit from transport.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1792-1797"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607198","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
Prehospital versus Emergency Department Glasgow Coma Scale in Blunt Traumatic Brain Injury: A Retrospective Review of the National Trauma Data Bank. 钝性创伤性脑损伤院前与急诊科格拉斯哥昏迷评分:对国家创伤数据库的回顾性回顾
IF 0.9 4区 医学
American Surgeon Pub Date : 2025-10-01 Epub Date: 2025-07-08 DOI: 10.1177/00031348251359122
Taylor E Messick-Ngo, Bhani K Chawla-Kondal, Gabriel L Scally, Brittany R Sadoma, Nicholas W Sheets, David S Plurad, Emily D Dubina
{"title":"Prehospital versus Emergency Department Glasgow Coma Scale in Blunt Traumatic Brain Injury: A Retrospective Review of the National Trauma Data Bank.","authors":"Taylor E Messick-Ngo, Bhani K Chawla-Kondal, Gabriel L Scally, Brittany R Sadoma, Nicholas W Sheets, David S Plurad, Emily D Dubina","doi":"10.1177/00031348251359122","DOIUrl":"10.1177/00031348251359122","url":null,"abstract":"<p><p>IntroductionPrevious studies have demonstrated variability between prehospital (PH) and Emergency Department (ED) Glasgow Coma Scale (GCS) for patients suffering traumatic brain injuries (TBIs). Understanding the relationship between PH and ED GCS, as well as the factors that may contribute to any observed differences, is crucial for optimizing trauma triage protocols and resource allocation.MethodsThe National Trauma Data Bank (NTDB) was surveyed for adults aged ≥18 years following blunt TBI. PH and ED GCS scores were compared, including subgroup analysis of different TBI severities, Injury Severity Score (ISS), transport time, trauma verification level, intoxication, ICP monitor use, and mortality.Results419 145 patients were included. Overall, there was no difference in median PH and ED GCS (15 vs 15, z = 0.00, <i>P =</i> 1.00), with substantial agreement (κ<sub>w</sub> = 0.759, <i>P</i> < .001). For mild TBI, there was fair agreement between PH and ED GCS (κ<sub>w</sub> = 0.409, <i>P</i> < .001); for moderate TBI, there was moderate agreement (κ<sub>w</sub> = 0.569, <i>P</i> < .001); and for severe TBI, there was substantial agreement (κ<sub>w</sub> = 0.665, <i>P</i> < .001). Alcohol and drug intoxication, mortality, need for ICP monitor, and transport times were associated with differences in PH vs ED GCS, while ISS was not.DiscussionPH and ED providers overall score patients similarly for GCS. While some minor differences were seen for certain subgroups (mild and severe TBI, mortality, alcohol or drug intoxication, transport times), these differences are likely not clinically significant.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1778-1785"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590288","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
Discovering a Never Event: What to Disclose, When, to Whom, and Why. 发现一个从未发生过的事件:什么时候,向谁披露,以及为什么。
IF 0.9 4区 医学
American Surgeon Pub Date : 2025-09-30 DOI: 10.1177/00031348251383481
John J Newland, Eric M Krause, Mark D Kligman, Stephen M Kavic
{"title":"Discovering a Never Event: What to Disclose, When, to Whom, and Why.","authors":"John J Newland, Eric M Krause, Mark D Kligman, Stephen M Kavic","doi":"10.1177/00031348251383481","DOIUrl":"https://doi.org/10.1177/00031348251383481","url":null,"abstract":"<p><p>In 2008, the Centers for Medicare and Medicaid Services formally described \"Never Events\" as hospital-acquired conditions for which a hospital would not be reimbursed under the inpatient prospective payment system. While provisions have been created to prevent never events at hospitals, periodically, a never event is discovered incidentally. In the case of an incidentally discovered never event, the steps by which those discovered events are reported and disclosed are not clearly defined. In this discussion, we review methods by which one should discuss incidentally discovered never events and the steps to take in order to prevent future events from occurring.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348251383481"},"PeriodicalIF":0.9,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190601","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
Diagnostic Accuracy of Scalene and Pectoralis Minor Muscle Blocks for Thoracic Outlet Syndrome: A Systematic Review and Meta-Analysis. 斜角肌和胸小肌阻滞对胸廓出口综合征的诊断准确性:系统回顾和荟萃分析。
IF 0.9 4区 医学
American Surgeon Pub Date : 2025-09-30 DOI: 10.1177/00031348251339530
Khanjan H Nagarsheth, Christina Schweitzer
{"title":"Diagnostic Accuracy of Scalene and Pectoralis Minor Muscle Blocks for Thoracic Outlet Syndrome: A Systematic Review and Meta-Analysis.","authors":"Khanjan H Nagarsheth, Christina Schweitzer","doi":"10.1177/00031348251339530","DOIUrl":"https://doi.org/10.1177/00031348251339530","url":null,"abstract":"<p><p>BackgroundThoracic outlet syndrome (TOS) is a complex neurovascular condition that remains challenging to diagnose, particularly neurogenic TOS (nTOS), which comprises most cases. While vascular TOS has clear diagnostic criteria, nTOS diagnosis relies on clinical assessments, imaging, and electrophysiologic studies. Scalene and pectoralis minor muscle blocks have been proposed as diagnostic tools, but their accuracy remains uncertain.ObjectiveThis systematic review and meta-analysis assesses the pooled sensitivity, specificity, and diagnostic accuracy of scalene and pectoralis minor blocks for TOS.MethodsA systematic literature search was performed across PubMed, Embase, Scopus, Cochrane Library, Web of Science, and Google Scholar following PRISMA guidelines. Studies evaluating the diagnostic accuracy of these blocks for TOS were included. The QUADAS-2 and Newcastle-Ottawa Scale were used for quality assessment. A meta-analysis using RevMan and STATA assessed pooled sensitivity, specificity, and diagnostic odds ratios (DORs).ResultsOf the 180 reports yielded by the search, 12 studies met inclusion criteria (950 patients). Pooled sensitivity for scalene and pectoralis minor blocks was 87% (95% CI: 83%-90%), while specificity was 34% (95% CI: 26%-43%). The diagnostic odds ratio was 3.98 (95% CI: 2.50-6.34). Substantial heterogeneity was observed (I<sup>2</sup> = 68%, <i>P</i> < 0.001), attributed to variations in injection protocols, outcome definitions, and patient selection.ConclusionScalene and pectoralis minor blocks have high sensitivity but low specificity for TOS diagnosis. Their use as stand-alone diagnostic tools is limited. However, they may be valuable within a multimodal diagnostic framework integrating clinical evaluation, imaging, and electrophysiologic testing.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348251339530"},"PeriodicalIF":0.9,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197892","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
Artificial Intelligence for Postoperative Wound Monitoring: An Integrative Review of Digital Innovation and Clinical Feasibility. 人工智能用于术后伤口监测:数字创新和临床可行性的综合综述。
IF 0.9 4区 医学
American Surgeon Pub Date : 2025-09-30 DOI: 10.1177/00031348251385104
Joel Grunhut, Khanjan Nagarsheth
{"title":"Artificial Intelligence for Postoperative Wound Monitoring: An Integrative Review of Digital Innovation and Clinical Feasibility.","authors":"Joel Grunhut, Khanjan Nagarsheth","doi":"10.1177/00031348251385104","DOIUrl":"https://doi.org/10.1177/00031348251385104","url":null,"abstract":"<p><p>Artificial intelligence (AI) has transformative potential in postoperative wound care through precise, automated, and timely wound assessment, yet specific applications to surgical wounds remain relatively unexplored compared to chronic wound care. This integrative review critically assesses the state-of-the-art in AI-driven postoperative wound monitoring, highlighting significant advancements, existing limitations, and opportunities for future development. Following an extensive literature search of PubMed, Google Scholar, and Medline, we identified 118 relevant articles meeting stringent inclusion criteria. Our analysis underscores the critical need for large-scale, standardized datasets, explainable AI frameworks, and robust clinical validation studies. By evaluating AI technologies-such as deep learning, wearable biosensors, mobile applications, and natural language processing-we propose a roadmap for integrating advanced AI methods into surgical practice, aiming ultimately to enhance clinical outcomes and patient care.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348251385104"},"PeriodicalIF":0.9,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197952","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
Development of a Nomogram for Predicting Postoperative Prolonged Ileus in Gastric Cancer Patients: A Retrospective and Prospective Cohort Study. 预测胃癌患者术后延长肠梗阻的Nomogram:一项回顾性和前瞻性队列研究。
IF 0.9 4区 医学
American Surgeon Pub Date : 2025-09-29 DOI: 10.1177/00031348251383475
Xiao-Chun Zhang, Dan-Li Shen, Jia-Ling Shi, Guan-Wen Gong, Gang Wang, Zhi-Wei Jiang, Hei-Ying Jin, Zheng-Ming Deng
{"title":"Development of a Nomogram for Predicting Postoperative Prolonged Ileus in Gastric Cancer Patients: A Retrospective and Prospective Cohort Study.","authors":"Xiao-Chun Zhang, Dan-Li Shen, Jia-Ling Shi, Guan-Wen Gong, Gang Wang, Zhi-Wei Jiang, Hei-Ying Jin, Zheng-Ming Deng","doi":"10.1177/00031348251383475","DOIUrl":"https://doi.org/10.1177/00031348251383475","url":null,"abstract":"<p><p>ObjectiveTo develop and validate a nomogram for predicting the risk of postoperative prolonged ileus (PPOI) in patients undergoing gastric cancer (GC) surgery, providing a personalized risk assessment tool for early identification and optimized postoperative management.MethodsA retrospective cohort (January 2019-December 2023) was used to develop and internally test the nomogram, while a prospective cohort (January-December 2024) was used for external validation. Univariate and multivariate logistic regression with backward stepwise selection identified independent predictors. Model performance was assessed through receiver operating characteristic (ROC) curves, calibration curves, decision-curve analysis (DCA), and clinical impact curve analysis (CICA). Patients were stratified into low, medium, and high-risk groups based on nomogram scores for further analysis.ResultsA total of 780 patients in the training cohort and 294 in the validation cohort were included, with postoperative prolonged ileus rates of 11.54% and 16.33%, respectively (χ<sup>2</sup> = 4.371, <i>P</i> =.037). Independent predictors included electroacupuncture, pain self-efficacy questionnaire (PSEQ) score, preoperative serum albumin (Alb), body fat, postoperative day 1 Visual Analog Scale (Pod1 VAS), and intensive care unit (ICU) admission. The nomogram demonstrated strong discriminatory ability and calibration, with clinical utility confirmed through DCA and CICA. Higher nomogram scores correlated with increased PPOI incidence.ConclusionsThe developed nomogram is a valuable tool for early identification of PPOI in GC patients, supporting clinicians and nurses in implementing personalized preventive strategies.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348251383475"},"PeriodicalIF":0.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190661","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
Bromelain-Based Enzymatic Debridement of a Third-Degree Burn to Skin-Grafted Bowel. 菠萝蛋白酶酶清创治疗皮肤移植肠三度烧伤。
IF 0.9 4区 医学
American Surgeon Pub Date : 2025-09-29 DOI: 10.1177/00031348251378908
Shengqing Wang, Janie Faris, Kareem Abdelfattah, Samuel Mandell, M Victoria P Miles
{"title":"Bromelain-Based Enzymatic Debridement of a Third-Degree Burn to Skin-Grafted Bowel.","authors":"Shengqing Wang, Janie Faris, Kareem Abdelfattah, Samuel Mandell, M Victoria P Miles","doi":"10.1177/00031348251378908","DOIUrl":"https://doi.org/10.1177/00031348251378908","url":null,"abstract":"<p><p>Burn injuries over previously grafted tissue present a formidable challenge for excision and debridement, particularly when there are critical underlying structures such as bowel. Enzymatic debridement with the recently approved anacaulase-bcdb, a bromelain-based enzymatic debridement gel (Nexobrid<sup>®</sup>), presents an additional method of burn excision that may be useful in such a situation. This brief report presents the management of a complex third-degree burn over a remotely skin-grafted bowel mass using anacaulase-bcdb gel. This report is written with documented patient consent and approval by the Human Research Protection Program office in compliance with institutional policy. A 52-year-old man presented to our level I burn center with a third-degree 3% total body surface area contact burn to a remotely skin-grafted bowel mass. The patient was admitted with the decision to proceed with anacaulase-bcdb debridement of his wound to minimize the risk of compromising his underlying bowel. The patient underwent the debridement without any sign of succus emanating from the wound. Post-debridement, he was transitioned to a negative pressure wound dressing and discharged home. He continued receiving wound care at clinic follow-ups and eventually underwent complex open ventral hernia repair. This brief report provides a safe alternative to operative excision of wounds with underlying critical structures.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348251378908"},"PeriodicalIF":0.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190671","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
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信