Editor's Note This study found that implementation of a clinical practice guideline for management of pediatric complicated appendicitis standardized practice patterns among surgeons and was associated with reduced resource use and improved patient outcomes. Compared with the pre-guideline group, patients in the post-guideline group were less likely to: receive a…

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Editor's Note In this study, patient factors, hospital case volume, and practice patterns were found to be associated with in-hospital mortality after elective abdominal aortic aneurysm (AAA) repair. Of 166, 443 AAA repairs performed at 1,207 hospitals, in-hospital mortality was 0.7% for endovascular AAA repair and 3.8% for open AAA…

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Editor's Note In this study, researchers concluded that risk-adjusted postoperative 30-day mortality is useful as a surrogate for long-term outcomes in patients at Veterans Health Administration (VHA) hospitals. Though the VHA has used 30-day mortality as a measure of surgical quality for more than 20 years, the measure has been…

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Editor's Note The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Surgical Risk Calculator accurately estimates the risk of postoperative complications, and the calculator’s performance would improve with recalibration, this study finds. The statistical analysis for this study was based on 2.7 million surgical records collected between…

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Editor's Note Arthroscopic surgery may not be the best option for patients over 60 years of age with hip arthritis, this study finds. Though most patients prefer minimally invasive hip arthroscopy rather than total hip replacement, researchers from the Hospital for Special Surgery, New York City, found that more than…

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Editor's Note In this study, Medicare patients having common surgical procedures at critical access hospitals had no significant difference in 30-day mortality than those at noncritical access hospitals (5.4% vs 5.6%), and they had lower rates of serious complications (6% vs 14%) and lower expenditures ($14,450 vs $15, 845). The…

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Editor's Note A new measure for assessing the body’s response to painful stimuli during surgery may allow for better anesthesia management, less pain when regaining consciousness, and better postoperative outcomes, this study finds. The measure, called the nociception (pain) level index, uses an algorithm to process multiple hormonal and neurological…

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Editor's Note Autonomous robotic surgery performed by the Smart Tissue Autonomous Robot (STAR) may help healthcare providers improve outcomes and efficiency, while reducing errors, finds this study. STAR integrates a robotic arm, suturing device, and imaging capabilities. Surgeons tested STAR against manual, laparoscopic, and robot-assisted surgery for porcine intestinal anastomoses…

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Editor's Note In a new study, military surgeons are proposing a new education and training paradigm that will benefit them and their patients in both military and civilian practice environments, the American College of Surgeons reports. Military surgeons face a unique challenge in that they serve as a “jack-of-all trades”…

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Editor's Note A simple arm test that uses a wearable technology can rapidly and accurately identify physiological frailty in older adults facing surgery, finds this study. Researchers developed a 20-second upper arm extension test (ie, upper extremity frailty [UEF] system) to assess biomarkers of frailty, such as slowness of motion,…

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