Acute care surgery is essential for effective trauma and emergency care but faces sustainability challenges. Current staffing models vary—traditional vs. time delineated—affecting workload and academic involvement. Compensation often relies on work relative value units, which don’t reflect the full scope of ACS responsibilities. Sustainable staffing and fair compensation are crucial for maintaining quality care and […]
Category: Appendix, Gallbladder and Surgical Emergencies
Improving Readiness in Deployed Field Hospitals
Surgeons need to know that clinical readiness among personnel in deployed field hospitals shows significant gaps, particularly affecting surgical outcomes. Only 8% of enlisted personnel held full-time clinical roles, impacting their preparedness for patient care. 69% of respondents felt more pre-deployment training could have prevented clinical errors. Surgeons should advocate for enhanced training and clinical […]
Vascular Injuries in Homicide Victims: A Call for Action
Most homicide victims with isolated extremity injuries face a high risk of fatal vascular damage, emphasizing the need for bystander intervention training. Among 5,765 homicide autopsies, 84% had gunshot wounds; extremity injuries occurred in 47% of these cases. Isolated gunshot extremity wounds were linked to a 10-fold increase in major vascular injuries compared to nonisolated […]
Hispanic/Latinx Injury Survivors Face Language-Related Outcomes Gap
Hispanic/Latinx patients with limited English proficiency show worse post-discharge outcomes after traumatic injury. Spanish-speaking Hispanic/Latinx survivors had a lower quality of life score (38.5) than non-Hispanic whites (41.6). They had reduced odds of returning to work (OR 0.47) and lower rates of engaging in non-injury-related care (OR 0.45). Improving access for these patients could help […]
Volume of EMS Clinicians Linked to Lower Trauma Mortality
Increased annual trauma volumes per EMS clinician significantly lower early mortality in severely injured patients. For every 5 additional adult trauma patients annually, 6-hour mortality decreases by 10% (adjusted odds ratio 0.899). A 2.6% reduction in in-hospital mortality is also observed with increased volume (aor 0.974). Consider optimizing EMS staffing and training to improve early […]
Long-Term Outcomes: Laparoscopic vs Open Adhesiolysis
Laparoscopic adhesiolysis for small bowel obstruction (SBO) offers short-term recovery advantages but shows no long-term superiority over open surgery. At five years, recurrence rates were similar: 9.7% for open vs. 12.5% for laparoscopic (p>.99). Incisional hernia rates were also comparable at 6.1% for open vs. 6.3% for laparoscopic (p>.99). Quality of life scores, based on […]
Elective Surgery Waitlists Linked to High Emergency Admissions
Patients awaiting elective procedures are facing significant emergency hospital admissions, highlighting a need for timely surgical interventions. Over 33 million waiting days led to 69,322 emergency admissions, using 535,806 bed days. Highest emergency admission rates were for urinary stent procedures (0.71) and endoscopic retrograde cholangiopancreatography (0.63). Surgeons should prioritize timely treatment to reduce patient risks […]
Chronic Immunosuppression Elevates Risks in Emergency Surgery
Patients on chronic immunosuppression face higher mortality after emergency surgery, especially with complex procedures. 5.1% of over 30,000 patients studied were on chronic immunosuppression, showing a 2.3% higher mortality risk (p<0.001). Increased complications, infections, and readmission rates were also observed for this group. Surgeons should be cautious with emergency exploratory laparotomy in these patients while […]
New strategies for managing cancer-related intestinal obstruction
Cancer-related incomplete intestinal obstruction complicates treatment in advanced malignancy patients. Recent techniques such as endoscopic stenting and laparoscopic surgery show improved outcomes and lower complication rates. Integration of systemic therapies like immunotherapy reduces tumor burden and alleviates obstruction. Multidisciplinary approaches remain vital for individualizing patient care and optimizing recovery. Nutritional support and fluid management are […]
Laparoscopic choledocholithotripsy lower recurrence, costs than ERCP
A meta-analysis of 1,576 patients shows outcomes for managing common bile duct stones. Preoperative endoscopic sphincterotomy (est) has a higher CBD clearance rate (OR 1.72). Laparoscopic choledocholithotripsy (lcbde) shows lower stone recurrence (OR 0.27) and reduced costs ($2,059 savings). Both methods have similar safety profiles; tailor treatment based on expertise and patient factors. Hospital stays […]