Introduction Advances in neoadjuvant therapy and surgical techniques have led to more total pancreatectomies (TP) with vascular resection for pancreatic cancer. This study assesses contemporary outc...

Postoperative pain may be significant following mastectomy and immediate autologous breast reconstruction, and pain management regimens must be balanc…

AbstractContext. Hip fractures incur high morbidity and mortality. Data on secular trends in mortality from hip fractures and risk predictive models are sc

The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) has recognized UCSF Health for achieving meritorious outcomes for surgical patient care in 2024.

Background: Infection Preventionists use National Healthcare Safety Network (NHSN) definitions to report required healthcare-acquired infection (HAI) measures. These measures can be publicly reported, and influence pay for performance metrics. The National Surgical Quality Improvement Program (NSQIP) also uses definitions to identify HAIs but is a quality program designed to drive outcome improvements. While both use definitions to define an HAI, those definitions, denominators, and metrics are very different.

STUDY DESIGN: We conducted a multicenter retrospective cohort study using the American College of Surgeons NSQIP database from 2012 to 2020. We analyzed patient outcomes before (2012 to 2014) and af...

Purpose Pre-existing comorbidities may negatively impact surgical outcomes, yet risk profiles based on combinations of comorbidities are underutilized. We aimed to identify comorbidity clusters associated with adverse surgical outcomes after inguinal or ventral hernia repair. Methods We performed a retrospective cohort study using the ACS-NSQIP database (2016–2023). Adults undergoing elective inguinal or ventral hernia repair were identified using CPT and ICD-10 codes. Latent class analysis (LCA) identified subgroups of patients who shared similar patterns of comorbidities. Outcomes included postoperative complications, hospital length of stay, and 30-day mortality. Results Among 224,522 patients, LCA identified six profiles: no comorbidities, smoking, bleeding disorder or congestive heart failure (CHF), obesity with diabetes or smoking, obesity without diabetes or smoking, and hypertension. Compared with no comorbidities, risk of complications was higher in the smoking (OR 1.32, 95% CI 1.18–1.49), bleeding disorder or CHF (OR 1.68, 95% CI 1.23–2.29), obesity with diabetes or smoking (OR 1.41, 95% CI 1.25–1.58), obesity without diabetes or smoking (OR 1.17, 95% CI 1.06–1.29), and hypertension (OR 1.16, 95% CI 1.05–1.28) clusters. These clusters also had longer hospital stays compared to patients with no comorbidities. 30-day mortality was significantly increased in the “bleeding disorder or CHF” (OR 3.22, 95% CI 1.52–6.84) and hypertension (OR 1.66, 95% CI 1.09–2.54) clusters. Conclusion Distinct comorbidity clusters predict complications, prolonged hospitalization, and mortality following hernia repair. Incorporating comorbidity profiles into preoperative risk stratification may enhance surgical decision-making, allow targeted interventions, and improve outcomes in high-risk patients.

Frailty is an independent risk factor for prolonged postoperative LOS among older surgical patients, even after adjustment for patient and procedure covariates. Other independent risk factors for incr...

Patients with end-stage renal disease (ESRD) are at increased risk for bleeding complications following surgery. However, the approach to the preoperative risk assessment and risk reduction, if feasible, in ESRD patients undergoing nonelective abdominal surgery has not been comprehensively studied. We aim to determine the prevalence and risk factors for perioperative bleeding in patients on dialysis undergoing nonelective abdominal surgery.

Objective Deep brain stimulation (DBS) is an established surgical therapy for movement disorders, epilepsy, and psychiatric conditions, yet remains underutilized due to perceived risks. We therefore...

NSHA release: Aberdeen Hospital has been named one of 76 hospitals in North America to achieve meritorious outcomes for surgical patient care in 2024, through the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). The hospital was recognized on the “All Cases” Meritorious list, which honours hospitals that demonstrate outstanding composite quality […] More

Using targeted NSQIP vascular data from 2011 to 2021, which comprised 6601 patients who received endovascular revascularization for AIOD, we built ML algorithms that pre-operatively predict 30-day MALE or death with excellent performance (AUROC 0.94). Our models also predicted 30-day...