A comprehensive analysis revealed that opioid reduction strategies initially aimed at pancreatectomy markedly influenced posthepatectomy prescribing. With a cohort of 2,005 patients, researchers documented over a 50% reduction in intraoperative and total inpatient opioid use, coupled with a 73% decline in discharge opioids. Importantly, patient pain scores remained stable, and the percentage of opioid-free discharges […]
Category: General Surgery
Disease etiology significantly influences postoperative outcomes after colectomy.
A study analyzing over 280,000 colectomy patients reveals that those treated for inflammatory bowel disease (IBD) face notably higher postoperative risks compared to those with colon cancer or infections. Unadjusted data indicated the highest mortality and morbidity in patients with infectious causes. However, after adjusting for covariates, IBD patients exhibited a 30% higher likelihood of […]
Preoperative opioid use significantly decreased among surgical patients
The opioid stewardship program in Pennsylvania and New Jersey successfully reduced preoperative opioid use among surgical patients, dropping from 17% to 10% from 2019 to 2023. Additionally, the adoption of intraoperative blocks rose from 21% to 27%. Despite ongoing challenges from the COVID-19 pandemic, opioid avoidance strategies were effectively sustained, with 68% to 70% of […]
Home IV fluid protocol significantly improves outcomes in ileostomy patients
Implementation of a novel protocol involving home intravenous fluids and structured daily follow-ups markedly reduced hospital stay, readmission rates, complication rates, and overall care costs for ileostomy patients across two academic centers. In a cohort study of 600 patients, post-protocol outcomes included a decrease in length of stay from 8 to 3 days and readmission […]
EUS-PD shows high success rates and manageable adverse events
A systematic review and meta-analysis of endoscopic ultrasound-guided pancreatic duct drainage (EUS-PD) revealed significant effectiveness, with technical success at 89% and clinical success at 88%. Examining 27 trials involving 902 patients, the study also noted a 17% rate of adverse events, primarily post-EUS-PD acute pancreatitis at 3%. Other complications like bleeding, perforation, pancreatic leak, and […]
Liver transplant with sleeve gastrectomy sustains weight loss and reduces obesity-related complications
The study demonstrates that simultaneous liver transplant and sleeve gastrectomy leads to significant long-term weight loss, improved diabetes and hypertension outcomes, and lower rates of allograft steatosis compared to liver transplant alone. Over a follow-up period, ltsg patients, starting with a higher average BMI, showed remarkable post-operative results, including a decrease in diabetes prevalence and […]
Hospital frailty risk score predicts surgical outcomes most effectively
Multi-frailty instrument analysis involving 1,385,505 emergency general surgery patients revealed that the hospital frailty risk score significantly outperformed other indices in predicting in-hospital mortality and complications. Notably, patients characterized as frail by this score bore the highest risk of mortality (adjusted odds ratio 7.8) and complications (adjusted odds ratio 8.4). These findings underscore the importance […]
Incident food insecurity affects post-surgical trauma patients significantly.
A multicenter study found that 21% of previously food-secure surgical trauma patients experienced new food insecurity within six months post-operation. Key risk factors included prolonged hospital stays, ICU admissions, and reliance on daily wage employment. Conversely, higher household income correlated with greater food security. The findings stress the importance of assessing food insecurity after discharge […]
New model predicts post-hospital care for injured adults
A sophisticated stacked ensemble model has been developed to predict discharge outcomes for injured adults aged 35-70 within 24 hours of hospital admission. Utilizing data from over 2.3 million patients, the model evaluates factors such as demographics and early resource utilization. Its performance metrics, with AUCs ranging from 0.73 to 0.97, indicate strong generalizability, enhancing […]
Controlled hyperventilation alleviates shoulder pain after surgery
In a controlled trial involving 150 patients, intraoperative controlled hyperventilation significantly reduced the incidence of shoulder pain after laparoscopic cholecystectomy, with pain rates dropping from 60% to 36%. The group experienced shorter pain duration and intensity, along with improved surgical conditions, reflected by reduced operation time and lower pneumoperitoneum pressure. Patient satisfaction also increased from […]