A novel machine learning model has been developed to predict gangrenous cholecystitis, utilizing clinical data from 1006 patients. Employing the XGBoost algorithm and SHAP for interpretability, key clinical features were identified, including white blood cell count and d-dimer levels. This explainable model aims to assist clinicians in making timely surgical decisions, thereby potentially improving patient […]
Category: Appendix, Gallbladder and Surgical Emergencies
Perioperative pathway significantly reduces complications in emergency laparotomy patients
The implementation of the Emergency Laparotomy Audit (EMLA) perioperative care bundle resulted in notable improvements in patient outcomes for emergency laparotomy procedures. Surgical complications decreased from 34.8% to 20.6%. The study encompassed a cohort of 429 patients, divided into pre- and post-intervention groups, assessing length of stay, hospitalization costs, and adherence to protocols. The findings […]
New guidelines recommend optimal surgical management for diverticulitis
Evidence-informed guidelines indicate that patients with complicated diverticulitis without sepsis should prefer primary resection and anastomosis (pra) over Hartmann’s resection (hr) or laparoscopic lavage (lpl), contingent on surgical expertise. Conversely, hr is advised for septic or frail patients. Key outcomes highlighted a greater probability of avoiding stoma formation at one year with pra. The guidelines […]
Comorbidities significantly impact gallstone recurrence risk.
A comprehensive analysis of 16,763 patients revealed that gallstone recurrence is influenced by stone size and specific comorbidities, including venous thrombosis, respiratory diseases, and cirrhosis. The study found that while gallbladder stones were predominant, they exhibited low recurrence rates. Variations in stone types affected complications and demographic factors such as gender and age. Understanding these […]
Machine learning models effectively predict appendicitis in emergencies
This proof-of-concept study reveals that machine learning models can predict appendicitis in patients with acute abdominal pain more accurately than traditional methods. With AUROCs of 0.919 and 0.923 when including laboratory test results, the models outperformed the Alvarado scoring system (AUROC of 0.824) and matched or exceeded the performance of emergency department physicians. These findings […]
Minimally invasive surgery lowers risk in frail colon surgery patients
In a study involving 11,976 frail patients undergoing emergency colon resections, minimally invasive surgery demonstrated significant benefits compared to open surgery. The approach was linked to lower rates of death (4.6% reduction), severe complications (6.9%), and overall complications (8.8%) within 30 days post-operation. Patients underwent either method based on various conditions, with minimally invasive surgery […]
Balanced Solutions Enhance Outcomes in Severe Acute Pancreatitis
Among patients with predicted severe acute pancreatitis, the use of balanced multielectrolyte solutions (bmes) led to significantly lower serum chloride levels compared to normal saline (ns) on trial day 3. Additionally, patients receiving bmes experienced reduced systemic inflammatory response syndrome rates, increased organ failure-free days, and longer durations of survival outside the intensive care unit […]
Acute care surgery system improves outcomes in South Korea
The implementation of the acute care surgery (ACS) system in South Korea significantly improved clinical outcomes for patients requiring emergency general surgery. In a study involving 2,146 patients, the time from emergency room admission to operating room transfer decreased from 522.1 to 452.2 minutes post-ACS. Additionally, complication rates fell from 38.3% to 31.3%. These findings […]
Mesh Bridging Improves Outcomes in Burst Abdomen Repairs
Findings indicate that using mesh bridging for temporary closure of burst abdomen significantly reduces hospital stays and severe complications compared to negative pressure wound therapy (NPWT). Among 119 patients studied, those receiving mesh bridging had a remarkable average stay of 29 days, opposed to 93 days with NPWT. Furthermore, mesh bridging led to fewer severe […]
Decision tree algorithm enhances treatment choices for acute cholecystitis
An innovative decision tree algorithm was developed to classify patients with acute cholecystitis based solely on laboratory parameters. Analyzing 1,352 cases, the algorithm showed an impressive 82.17% accuracy in predicting the need for surgery and 73.86% accuracy for identifying gangrenous cholecystitis. Key parameters included the platelet-to-lymphocyte ratio, C-reactive protein levels, and patient age, enabling efficient […]