A retrospective cohort study analyzing 1,317 emergency hiatal hernia repairs revealed that fundoplication significantly reduced 30-day complication (odds ratio [OR] 0.53, p < 0.001) and mortality rates (OR 0.55, p = 0.033) compared to gastric fixation. No significant differences were found regarding 30-day readmission (OR 0.86, p = 0.449) or reoperation rates (OR 0.66, p […]
Category: Appendix, Gallbladder and Surgical Emergencies
Increase in trauma-related injuries noted post-earthquake
A retrospective study analyzed 2,155 patients admitted after the February 2023 Kahramanmaraş earthquake. Falls accounted for 57.2% of injuries, with significant occurrences of rhabdomyolysis (20.6%) and fractures (11.1% upper, 21.3% lower extremities). The orthopedics department performed the most surgical interventions, revealing a critical need for healthcare professionals to manage increased workloads. Mortality reached 2.87%. Effective […]
Combined use of diagnostic criteria significantly enhances appendicitis detection
Diagnostic accuracy for appendicitis improves beyond 90% when utilizing Alvarado criteria, ultrasound, and CRP together. Individual sensitivities showed Alvarado at 75.2% compared to ultrasound and CRP, which were higher. Analyses demonstrated that combinations, particularly Alvarado with CRP, outperformed others, indicating a need for a more integrated approach to diagnosing acute appendicitis. The study emphasizes the […]
Causal relationships exist between biliary disorders and GERD.
Significant causal effects of genetically predicted cholelithiasis, cholecystitis, and cholecystectomy on gastroesophageal reflux disease (GERD) were identified, with odds ratios of 1.04, 1.06, and 2.56, respectively. Additionally, the study confirmed a bidirectional relationship, where GERD also influences the likelihood of developing cholelithiasis and cholecystitis. Mediation analyses showed that both biliary disorders and GERD partially mediate […]
Investigational 4F-PCC Shows Noninferiority for VKA Reversal
Findings from this randomized clinical trial demonstrated that the investigational 4-factor prothrombin complex concentrate (4F-PCC) is statistically noninferior to the control 4F-PCC for rapid reversal of vitamin K antagonists (VKAs) in patients at substantial risk for bleeding during urgent surgeries. Effective hemostasis was achieved in 94.3% of patients receiving the investigational 4F-PCC compared to 94.2% […]
Laparoscopic surgery reduces complications for octogenarians with cholecystitis
In a study involving 212 octogenarians with acute cholecystitis, the laparoscopic approach demonstrated significant advantages over the open approach. Post-surgery, patients who underwent laparoscopic cholecystectomy experienced reduced hospital stays (5 days vs. 8 days), lower 30-day morbidity (26.5% vs. 48.5%), and decreased 30-day mortality rates (1.5% vs. 13.2%). Additionally, septicemia occurrences were absent in the […]
CHAMPS Score Outperforms Existing Tools in Predicting Mortality
The CHAMPS score proved highly effective in predicting mortality in patients with non-variceal upper gastrointestinal bleeding, showing an area under the receiver operating characteristic curve (AUROC) of 0.89. It significantly outperformed the Glasgow-Blatchford score (0.72) and AIM65 score (0.71). In low-risk categories, mortality and rebleeding rates were zero; however, 58.8% of patients in the low-risk […]
Global burden of appendicitis shows steady decline but regional disparities persist
Between 1990 and 2021, the global burden of appendicitis displayed a significant decline in mortality and disability-adjusted life-years (DALYs), yet regional disparities in incidence and mortality persist. In 2021, global age-standardized mortality was 0.358 per 100,000, with the highest incidence rates in high-income Asia Pacific. While overall trends indicate improvement, nearly half of the regions […]
Implementation of the ACS model enhances acute appendicitis outcomes
The acute care surgery (ACS) model significantly improved patient management for acute appendicitis over a five-year study at a Seoul tertiary hospital. Key findings included reduced time intervals for surgical decision-making, decreased perforation rates, and higher discharge rates within 24 or 48 hours post-surgery. Comparisons between 447 pre-ACS and 453 post-ACS patients revealed statistically significant […]
Machine learning model surpasses clinical risk scores for GI bleeding
In a comparative analysis of an electronic health record-based machine learning model and established clinical risk scores for gastrointestinal bleeding, researchers found the model significantly outperformed the Glasgow-Blatchford Score and Oakland Score. With an area under the receiver-operating-characteristic curve (AUC) of 0.92 versus 0.89 (p