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40
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Text
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<a href="http://doi.org/10.1016/j.jss.2019.08.030" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.jss.2019.08.030</a>
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ISSN
1095-8673
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The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Emergency General Surgery Volume and Its Impact on Outcomes in Military Treatment Facilities
Publisher
An entity responsible for making the resource available
The Journal Of Surgical Research
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-11-04
Subject
The topic of the resource
Emergency general surgery; Military health system; Volume-based outcomes
Creator
An entity primarily responsible for making the resource
Chaudhary Muhammad Ali; Learn Peter A; Sturgeon Daniel J; Havens Joaquim M; Goralnick Eric; Koehlmoos Tracey; Haider Adil H; Schoenfeld Andrew J
Description
An account of the resource
BACKGROUND: Low hospital volume for emergency general surgery (EGS) procedures is associated with worse patient outcomes within the civilian health care system. The military maintains treatment facilities (MTFs) in remote locations to provide access to service members and their families. We sought to determine if patients treated at low-volume MTFs for EGS conditions experience worse outcomes compared with high-volume centers. MATERIALS AND METHODS: We analyzed TRICARE data from 2006 to 2014. Patients were identified using an established coding algorithm for EGS admission. MTFs were divided into quartiles based on annual EGS volume. Outcomes included 30-d mortality, complications, and readmissions. Logistic regression models adjusting for clinical and sociodemographic differences in case-mix including EGS condition, surgical intervention, and comorbidities were used to determine the influence of hospital volume on outcomes. RESULTS: We identified 106,915 patients treated for an EGS condition at 79 MTFs. The overall mortality rate was 0.21%, with complications occurring in 8.55% and readmissions in 4.45%. After risk adjustment, lowest-volume MTFs did not demonstrate significantly higher odds of mortality (OR: 2.02, CI: 0.45-9.06) or readmissions (OR: 0.77, CI: 0.54-1.11) compared with the highest-volume centers. Lowest-volume facilities exhibited a lower likelihood of complications (OR: 0.76, CI: 0.59-0.98). CONCLUSIONS: EGS patients treated at low-volume MTFs did not experience worse clinical outcomes when compared with high-volume centers. Remote MTFs appear to provide care for EGS conditions comparable with that of high-volume facilities. Our findings speak against the need to reduce services at small, critical access facilities within the military health care system.
Identifier
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<a href="http://doi.org/10.1016/j.jss.2019.08.030" target="_blank" rel="noreferrer noopener">10.1016/j.jss.2019.08.030</a>
PMID: 31699538
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Journal Article
2019
Chaudhary Muhammad Ali
Emergency general surgery
Goralnick Eric
Haider Adil H
Havens Joaquim M
Journal Article
Koehlmoos Tracey
Learn Peter A
Military health system
NEOMED Alumnus
NEOMED College of Medicine
November 2019 Update
Schoenfeld Andrew J
Sturgeon Daniel J
The Journal of surgical research
Volume-based outcomes
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1016/j.jss.2013.04.084" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.jss.2013.04.084</a>
Pages
193–199
Issue
1
Volume
184
Dublin Core
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Title
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Selective lateral compartment neck dissection for thyroid cancer.
Publisher
An entity responsible for making the resource available
The Journal of surgical research
Date
A point or period of time associated with an event in the lifecycle of the resource
2013
2013-09
Subject
The topic of the resource
80 and over; Adenocarcinoma; Adult; Aged; Carcinoma; Female; Follicular/mortality/secondary/surgery; Follow-Up Studies; Humans; Local/mortality/pathology/surgery; Lymph Node Excision/*methods; Lymph Nodes/anatomy & histology/surgery; Lymphatic Metastasis; Male; Medullary/mortality/secondary/*surgery; Middle Aged; Morbidity; Neck Dissection/*methods; Neck Muscles/anatomy & histology/surgery; Neoplasm Recurrence; Papillary/mortality/secondary/surgery; Retrospective Studies; Selective lateral compartment neck dissection; Thyroid cancer; Thyroid Neoplasms/mortality/pathology/*surgery; Thyroidectomy/*methods; Young Adult
Creator
An entity primarily responsible for making the resource
Welch Kellen; McHenry Christopher R
Description
An account of the resource
BACKGROUND: Compartment-oriented lymph node dissection in patients with thyroid cancer and macroscopic lymph node metastases reduces recurrence and improves survival. However, the extent of lymph node dissection remains controversial. The purpose of this study was to examine the results of selective lateral compartment neck dissection (LCND) for thyroid cancer. METHODS: We completed a retrospective review of patients with thyroid cancer who underwent selective LCND from
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.jss.2013.04.084" target="_blank" rel="noreferrer noopener">10.1016/j.jss.2013.04.084</a>
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Information about rights held in and over the resource
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
2013
80 and over
Adenocarcinoma
Adult
Aged
Carcinoma
Female
Follicular/mortality/secondary/surgery
Follow-Up Studies
Humans
Local/mortality/pathology/surgery
Lymph Node Excision/*methods
Lymph Nodes/anatomy & histology/surgery
Lymphatic Metastasis
Male
McHenry Christopher R
Medullary/mortality/secondary/*surgery
Middle Aged
Morbidity
Neck Dissection/*methods
Neck Muscles/anatomy & histology/surgery
Neoplasm Recurrence
Papillary/mortality/secondary/surgery
Retrospective Studies
Selective lateral compartment neck dissection
The Journal of surgical research
Thyroid cancer
Thyroid Neoplasms/mortality/pathology/*surgery
Thyroidectomy/*methods
Welch Kellen
Young Adult
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1016/j.jss.2011.03.054" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.jss.2011.03.054</a>
Pages
96–99
Issue
1
Volume
170
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Total thyroidectomy: is morbidity higher for Graves' disease than nontoxic goiter?
Publisher
An entity responsible for making the resource available
The Journal of surgical research
Date
A point or period of time associated with an event in the lifecycle of the resource
2011
2011-09
Subject
The topic of the resource
Adult; Aged; Female; Goiter; Graves Disease/pathology/*surgery; Humans; Hypocalcemia/epidemiology; Male; Middle Aged; Morbidity; Nodular/pathology/*surgery; Postoperative Complications/epidemiology; Retrospective Studies; Thyroidectomy/*adverse effects
Creator
An entity primarily responsible for making the resource
Welch Kellen C; McHenry Christopher R
Description
An account of the resource
BACKGROUND: Total thyroidectomy for treatment of Graves' disease is controversial and much of the debate centers on the concern for complications. The purpose of this study was to evaluate the morbidity of total thyroidectomy for Graves' disease and determine if it is different than for patients with nontoxic nodular goiter. METHODS: The rates of life threatening neck hematoma, recurrent laryngeal nerve (RLN) injury, transient hypocalcemia, and hypoparathyroidism were determined for consecutive patients with Graves' disease treated with total thyroidectomy from 1996 to 2010. Results were compared with patients who underwent total thyroidectomy for nontoxic nodular goiter during the same period, matched for the weight of the excised thyroid gland. RESULTS: Total thyroidectomy was performed in 111 patients with Graves' disease (group I) and 283 patients with nontoxic nodular goiter (group II). Parathyroid autotransplantation was performed in 31(28%) patients in group I and 98 (35%) patients in group II (P = NS). Comparative analysis of morbidity revealed no significant difference in neck hematoma, 0(0%) (I) versus 3(1%) (II); permanent RLN injury, 0(0%) (I) versus 2(1%) (II); and permanent hypoparathyroidism in 1(1%) (I) versus 1 (0.4%) (II) (P = NS). Transient hypocalcemia was more common in patients with Graves' disease, 80(72%) (I) versus 170 (60%) (II) (P \textless 0.05), but not when matched for thyroid weight. CONCLUSIONS: Total thyroidectomy can be performed with low morbidity in patients with Graves' disease; only transient hypocalcemia occurred more often than in patients with nodular goiter. Total thyroidectomy should be presented as a therapeutic option for all patients with Graves' disease.
Identifier
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<a href="http://doi.org/10.1016/j.jss.2011.03.054" target="_blank" rel="noreferrer noopener">10.1016/j.jss.2011.03.054</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
2011
Adult
Aged
Female
Goiter
Graves Disease/pathology/*surgery
Humans
Hypocalcemia/epidemiology
Male
McHenry Christopher R
Middle Aged
Morbidity
Nodular/pathology/*surgery
Postoperative Complications/epidemiology
Retrospective Studies
The Journal of surgical research
Thyroidectomy/*adverse effects
Welch Kellen C