Editor's Note Using machine learning on electronic health record (EHR) postoperative data linked to the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) outcomes data, researchers developed a model with 163 predictors of postoperative complications at the University of Colorado Hospital. Of 6,840 patients analyzed with the…

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Editor's Note The Centers for Medicare & Medicaid Services (CMS) on October 9 announced proposed changes to how it enforces the Physician Self-Referral Law (ie, Stark Law), which penalizes physicians and other healthcare providers for referring patients to outside services they could stand to benefit from financially. The proposed rule…

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Editor's Note This survey of Harvard Medical School students’ perceptions of barriers to a career in surgery found high rates of verbal discouragement and concerns about family aspirations. Of 729 medical students surveyed, 261 completed the questionnaire (58.6% women, 41% men, 0.4% transgender). Results showed: no significant gender difference in…

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Editor's Note This national survey of surgical residents found that needlesticks occur frequently, many events are not reported, and numerous reporting barriers exist. Of 7,395 respondents from all 260 general surgery residency programs, 27.7% noted experiencing a needlestick in the last 6 months. Most events occurred in the OR (77.5%)…

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Enhanced Recovery After Surgery (ERAS®) is a comprehensive, multifaceted, and multidisciplinary approach to the care of the surgical patient. ERAS bundles evidence-based elements to facilitate a faster recovery with fewer complications.1 Spanning the continuum of perioperative care, ERAS elements include: • patient engagement and education • preoperative optimization of nutrition…

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Editor's Note Though recent guidelines mandating additional barrier attire for all scrubbed and unscrubbed OR personnel from the Agency for Healthcare Research and Quality (AHRQ) and Joint Commission, which include bouffant caps covering all hair and long-sleeved surgical attire covering all exposed skin, this study finds that this mandate does…

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Editor's Note Overlapping, nonconcurrent surgery was not associated with an increase in serious unanticipated events in this study. Of 61,525 surgical procedures performed over 1 year at a large academic medical center, a total of 8,391 patients had any overlap (beginning or end) and were matched on 11 variables. Compared…

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Editor's Note This study found a very large variability in the use of postoperative opioids in different countries. The study sample included 129,379 opioid-naïve patients in the US, 84,653 in Canada, and 9,802 in Sweden. More than 70% of surgical patients in the US (76.2%) and Canada (78.6%) filled opioid prescriptions…

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Editor's Note In this study, robotic cholecystectomy was associated with lesser lengths of stay and readmission rates than laparoscopic cholecystectomy. The robotic procedure also had greater operative duration and hospital costs. Of 3,255 patients who had cholecystectomy during the study period, the researchers matched 106 robotic and 1,060 laparoscopic cases.…

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Editor's Note Senior surgical residents can safely supervise junior residents performing appendectomies, and training programs should encourage faculty to let senior residents manage operative appendicitis as independently as possible as well as supervise junior residents intraoperatively, this study finds. In this review of 928 appendectomies performed at the University of…

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