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Frailty significantly impacts mortality and morbidity following emergency laparotomy.

A meta-analysis of 12 articles involving 5,704 patients revealed that frailty, assessed via the Clinical Frailty Scale, significantly correlates with both short- (30-day mortality odds ratio 3.84) and long-term (1-year mortality odds ratio 3.03) mortality after emergency laparotomy. Frailty prevalence was found to be 25% overall and 32% in patients aged 55 and older. Additionally, frail patients exhibited higher rates of major complications and increased care needs post-surgery, highlighting the necessity for tailored care strategies.

Systematic Review by Park B, Alani Z (…) MacCormick AD et 5 al. in BJS Open

© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd.

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Higher Fresh Frozen Plasma Ratio Linked to Improved Survival

A multicenter cohort study analyzed 1,954 adults with severe blunt trauma, revealing that a high fresh frozen plasma (FFP) to red blood cell (RBC) ratio (greater than 1) was associated with lower in-hospital mortality (OR 0.73). This suggests that patients receiving a higher FFP ratio benefitted from improved survival compared to those with a lower ratio. Nonlinear trends indicated a potential ceiling effect, emphasizing the need for updated transfusion protocols in trauma care.

Journal Article by Fujiwara G, Okada Y (…) Ohtsuru S et 3 al. in JAMA Surg

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Surgeons express willingness to adopt sustainable practices despite knowledge gaps.

A survey involving 1,024 surgeons revealed that 63% are motivated to improve surgical sustainability; however, less than 10% can estimate the carbon footprint of their practices. Most respondents are unconcerned about negative impacts from sustainability efforts, indicating a readiness to implement proposed changes. Preferred educational formats include online webinars and modules. Notably, a subgroup appears keen to adopt sustainable practices despite lacking environmental impact knowledge. The survey highlights a critical issue with operating room waste.

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Journal Article by Sathe TS, Alseidi A (…) Sylla P et 27 al. in Surg Endosc

© 2024. The Author(s).

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Circulating tumor DNA methylation predicts outcomes in colorectal cancer

The study demonstrated that circulating tumor DNA (ctDNA) methylation analysis is a valuable prognostic tool for long-term outcomes in stage IV colorectal cancer. Patients with high levels of CHFR-rmv experienced significantly worse recurrence-free survival compared to those with low levels (p = 0.001), establishing CHFR-rmv as an independent prognostic factor (hazard ratio = 2.63). Likewise, high SOX11-rmv levels indicated poorer outcomes post-surgery (p = 0.004). These findings advocate for future investigations in this area.

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Journal Article by Momose H, Sugimoto K (…) Sakamoto K et 6 al. in J Surg Oncol

© 2024 Wiley Periodicals LLC.

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Accredited hospitals improve treatment and survival for Black patients

Findings indicate that non-Hispanic Black patients with colon cancer treated at Commission on Cancer (CoC)-accredited hospitals received significantly more guideline-concordant care than those treated at non-accredited facilities. Specifically, the odds of undergoing necessary lymphadenectomy and chemotherapy were higher (adjusted odds ratios of 1.89 and 2.31, respectively). Moreover, patients at accredited hospitals demonstrated lower cancer-specific mortality, with adjusted hazard ratios of 0.87 for surgical patients and 0.75 for chemotherapy-eligible patients.

Journal Article by Chan K, Palis BE (…) Ko CY et 4 al. in JAMA Netw Open

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Abdominal perfusion pressure predicts mortality in intra-abdominal hypertension.

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 scoring systems. These findings emphasize the critical role of APP in predicting short-term mortality in IAH patients.

Journal Article by Xu L, Zhao W (…) Qiu Y et 7 al. in Int J Surg

Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

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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), highlighting a clearer predictive value for δmimac over δbw (AUC 0.697 vs. 0.542).

Journal Article by Kobayashi S, Kamiya K (…) Hiki N et 8 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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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, p<0.001; AOR 1.20 for 30-day mortality, p<0.001; AOR 1.30 for 1-year mortality, p<0.001).

Journal Article by Isenberg EE, Kunnath N (…) Harbaugh CM et 3 al. in J Gastrointest Surg

Copyright © 2024 Society for Surgery of the Alimentary Tract. Published by Elsevier Inc. All rights reserved.

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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 deposits, and multiple factors correlated with poor overall survival, emphasizing the need for precise reporting of CRM involvement in treatment strategies.

Journal Article by Hugen N, Voorham QJM (…) Nagtegaal ID et 3 al. in Eur J Surg Oncol

Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

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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 high-volume centers (OR=0.78, CI 0.71-0.87, p<0.001). Regulatory thresholds appear justified and beneficial.

Journal Article by Jaquet R, Challine A (…) Lazzati A et 4 al. in Eur J Surg Oncol

Copyright © 2024 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

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