A mortality prediction model was developed for patients with intra-abdominal hypertension (IAH) utilizing abdominal perfusion pressure (APP) and advanced AI techniques. The study analyzed 1,354 patients, revealing that APP < 60 mmHg was linked to higher mortality rates within 7 to 90 days. The machine learning model demonstrated an AUC of 0.80, outperforming traditional clinical […]
Author: STITCHES Newsletter
Skeletal muscle quality changes predict prognosis in gastric cancer
Changes in skeletal muscle quality (δmimac) post-gastrectomy were associated with prognosis in early gastric cancer (EGC) patients, contrary to body weight (δbw) changes. Statistical analyses demonstrated that δmimac was significantly correlated with survival outcomes (p = 0.037), while δbw was not (p = 0.243). The severely decreased mimac group exhibited poorer prognosis (p = 0.030), […]
High social vulnerability increases risks in colon cancer surgery.
Findings revealed that among Medicare patients undergoing colectomy for colon cancer, those in the highest social vulnerability quintile faced a greater likelihood of unplanned surgeries (35.6% vs. 28.9%) and higher 30-day (3.4% vs. 2.9%) and 1-year mortality rates (10.8% vs. 8.6%). The adjusted odds ratios indicated significant risks associated with higher social vulnerability (AOR 1.36, […]
Circumferential margin involvement shapes outcomes in rectal cancer
A study of 3,020 stage III rectal cancer patients identified that 12.4% had a positive circumferential resection margin (CRM). Notably, CRM involvement predominantly occurred through primary tumor invasion (63.2%). Local recurrence and distant metastasis rates varied, being lowest with lymph node metastasis and highest with multiple factors. Multivariate analysis revealed that primary tumor invasion, tumor […]
Higher surgical volume centers reduce postoperative mortality
Among 143,582 patients undergoing digestive cancer surgery, those treated at high-volume centers experienced significantly lower 90-day mortality rates compared to low-volume centers. Univariate analysis revealed mortality rates of 5.06% at high-volume centers vs. 7.23% at low-volume centers for gastric surgeries and similar trends across other subspecialties. Multivariate analysis indicated a substantial reduction in mortality for […]
Standardized protocol reduces complications in pancreatic surgery
An observational cohort study evaluated a standardized perioperative protocol for pancreatic oncological surgery from 2015 to 2022, finding significant reductions in postoperative complications. The rate of grade B and C pancreatic fistulas was 4.2%, while postoperative hemorrhage and delayed gastric emptying occurred in 2.5% and 9.2% of patients, respectively. These results demonstrate that implementing a […]
Women are more likely to undergo cancer surgery than men.
In a comprehensive study of 367,887 patients, findings reveal that women are 44% more likely than men to receive cancer surgery. However, the likelihood decreases for both sexes with age and increasing co-morbid conditions, particularly among women. Men display higher rates of 90-day reoperations (21.2%) and mortality (1.2%) compared to women (18.8% and 0.9%, respectively), […]
Social-environmental injustice affects surgical outcomes for patients.
Social-environmental inequalities significantly impact surgical outcomes, as revealed by the analysis of 1,052,040 Medicare beneficiaries. Patients from areas marked by greater environmental injustice showed reduced chances of achieving textbook surgical outcomes (odds ratio 0.95) and lower likelihood of safe discharge (odds ratio 0.97). Both outcomes highlight the critical role of socio-environmental factors in healthcare, indicating […]
Nomogram predicts postoperative complications in rectal cancer surgery
A nomogram was developed to predict postoperative complications in 207 patients with middle and low rectal cancer undergoing transanal total mesorectal excision (TATME). Findings indicated that 27.5% of patients experienced complications. Key predictors included operation time, smoking history, anastomotic technique, and ASA score, each significantly influencing risk. The model’s accuracy was validated through multiple statistical […]
Indocyanine green fluorescence reduces anastomotic leak rates.
A systematic review and meta-analysis of six randomized trials, including 1949 patients, demonstrated that indocyanine green (ICG) fluorescence significantly reduces anastomotic leak rates in left-sided colorectal resections. The pooled odds ratio showed a 4.7% absolute reduction in leak rates (OR: 0.586, 95% CI: 0.434-0.792), indicating moderate confidence in its efficacy. ICG may serve as a […]