H. Soltani, M. Latif, M. Hadadzadeh, Azadeh Shahidzadeh, A. Shahidzadeh
Introduction: Clopidogrel improves intravascular stent patency reduces ischemic events but there are little data on its effect fallowing OPCAB. This study was designed to Material and Method: In this randomized clinical trial, 413 patients undergoing OPCAB were randomized to receive aspirin 80 mg plus Clopidogrel 75 mg (n=214, intervention group) or aspirin 80 mg (n=199, control group) for three days after surgery and then were treated in accordance with the common guidelines. Patients with coagulation disorders and those who rejected taking drugs were excluded. The data were then analyzed by using Student t-test and Chi-square test through SPSS ver. 20. Result: Mean age of patients was 61.081 ± 10.84 years. There was no significant difference between in two groups in pre and perioperation data. Mean of bleeding in the mean of bleeding during three days between two groups (p: 0.013). Conclusion: According to our findings patients treated with Clopidogrel plus aspirin had significantly less bleeding compared with the group treated with aspirin alone during three days. It seems that the effect of Clopidogrel on outcomes of operation is considerable and Clopidogrel can be introduced as a qualified supplement therapy for aspirin although the side effect of recombinant antiplatelet therapy is also controversial.
{"title":"Evaluation of Efficacy of Clopidogrel Plus Aspirin vs. Aspirin Alone of Early Clinical Outcomes Following Off Pump Coronary Artery Bypass Graft Surgery","authors":"H. Soltani, M. Latif, M. Hadadzadeh, Azadeh Shahidzadeh, A. Shahidzadeh","doi":"10.37421/JOS.2020.16.8","DOIUrl":"https://doi.org/10.37421/JOS.2020.16.8","url":null,"abstract":"Introduction: Clopidogrel improves intravascular stent patency reduces ischemic events but there are little data on its effect fallowing OPCAB. This study was designed to Material and Method: In this randomized clinical trial, 413 patients undergoing OPCAB were randomized to receive aspirin 80 mg plus Clopidogrel 75 mg (n=214, intervention group) or aspirin 80 mg (n=199, control group) for three days after surgery and then were treated in accordance with the common guidelines. Patients with coagulation disorders and those who rejected taking drugs were excluded. The data were then analyzed by using Student t-test and Chi-square test through SPSS ver. 20. Result: Mean age of patients was 61.081 ± 10.84 years. There was no significant difference between in two groups in pre and perioperation data. Mean of bleeding in the mean of bleeding during three days between two groups (p: 0.013). Conclusion: According to our findings patients treated with Clopidogrel plus aspirin had significantly less bleeding compared with the group treated with aspirin alone during three days. It seems that the effect of Clopidogrel on outcomes of operation is considerable and Clopidogrel can be introduced as a qualified supplement therapy for aspirin although the side effect of recombinant antiplatelet therapy is also controversial.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"67 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83593842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Accidental ingestion of foreign bodies in children is uncommon, regardless whether in the developed or underdeveloped countries. Reports in the United States show that the most common object is coin. Majority of the patients are asymptomatic. As the patients are asymptomatic, most of the patients were treated conservatively as the foreign bodies pass out spontaneously. In certain cases, an endoscopy is needed to retrieve the objects. This study illustrates the experience in managing the condition in the developing country. Methods: This is a retrospective study looking into the management of accidental foreign body ingestion in the local hospital. A computer search was made into the hospital database searching for diagnosis of foreign body ingestion between April 2017 to May 2018. The parameters of the patients were retrieved from the computer database. Patients with incomplete data were excluded Result: 14 patients were identified with the diagnosis of ingested foreign bodies. One was excluded due to incomplete data. The patients age ranges from 1 to 10 year old with 6/13 (46%) are 3 years or below. The most common objects ingested is coin (46%) followed by coin cell battery (23%). Only in one patient, the ingested material was radiolucent (stone) which was not seen on radiolograph. Majority (76.9%) of the ingested material passed out spontaneously except in 3/13 (23%), endoscopic retrieval of the material needed to be performed. There was no patient needed exploratory laparotomy. Conclusion: Accidental ingestion of coin is still the most common objects in children. Coin cell battery which is commonly used in electronic device is getting more common. Majority of the objects can be visualized by radiograph and in majority of cases, the material passed out spontaneously without any intervention.
{"title":"Accidental Ingestion of Foreign Bodies in Children: Experience from Developing Countries","authors":"M. Rohaizak, RA Mukhlis, Nfha Dalek","doi":"10.37421/JOS.2020.16.7","DOIUrl":"https://doi.org/10.37421/JOS.2020.16.7","url":null,"abstract":"Introduction: Accidental ingestion of foreign bodies in children is uncommon, regardless whether in the developed or underdeveloped countries. Reports in the United States show that the most common object is coin. Majority of the patients are asymptomatic. As the patients are asymptomatic, most of the patients were treated conservatively as the foreign bodies pass out spontaneously. In certain cases, an endoscopy is needed to retrieve the objects. This study illustrates the experience in managing the condition in the developing country. Methods: This is a retrospective study looking into the management of accidental foreign body ingestion in the local hospital. A computer search was made into the hospital database searching for diagnosis of foreign body ingestion between April 2017 to May 2018. The parameters of the patients were retrieved from the computer database. Patients with incomplete data were excluded Result: 14 patients were identified with the diagnosis of ingested foreign bodies. One was excluded due to incomplete data. The patients age ranges from 1 to 10 year old with 6/13 (46%) are 3 years or below. The most common objects ingested is coin (46%) followed by coin cell battery (23%). Only in one patient, the ingested material was radiolucent (stone) which was not seen on radiolograph. Majority (76.9%) of the ingested material passed out spontaneously except in 3/13 (23%), endoscopic retrieval of the material needed to be performed. There was no patient needed exploratory laparotomy. Conclusion: Accidental ingestion of coin is still the most common objects in children. Coin cell battery which is commonly used in electronic device is getting more common. Majority of the objects can be visualized by radiograph and in majority of cases, the material passed out spontaneously without any intervention.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"56 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88872130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Craniofacial Surgery Conference brings together individuals who have an interest in different fields of surgery like renowned scientists, Physicians, Surgeons, Professors, Instrumentalists, Medical and Industrial professions, young researchers, students and Business delegates under a single roof providing an opportunity to share the knowledge and scientific progress in the field of Craniofacial Surgery shaping the future research.
{"title":"Accelerating Innovations and fostering advances in Craniofacial Surgery","authors":"V. Veer","doi":"10.37421/JOS.2020.16.10","DOIUrl":"https://doi.org/10.37421/JOS.2020.16.10","url":null,"abstract":"Craniofacial Surgery Conference brings together individuals who have an interest in different fields of surgery like renowned scientists, Physicians, Surgeons, Professors, Instrumentalists, Medical and Industrial professions, young researchers, students and Business delegates under a single roof providing an opportunity to share the knowledge and scientific progress in the field of Craniofacial Surgery shaping the future research.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"123 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73440098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Surgery Asia Pacific 2020 invites research scholars & young scientists, to submit the nominations for Young Scientist Awards: Surgery Asia Pacific 2020.This Surgery Asia Pacific 2020 Young Scientist Awards will be announced at the upcoming “12th International Conference on Surgery and Anesthesia” at Tokyo, Japan this May 2020.
{"title":"Young Research Forum-Young Scientist Awards: Surgery Asia Pacific 2020, Tokyo,Japan, May 20-21, 2020","authors":"Marina Temelkovska Stevanovska","doi":"10.37421/JOS.2020.16.12","DOIUrl":"https://doi.org/10.37421/JOS.2020.16.12","url":null,"abstract":"Surgery Asia Pacific 2020 invites research scholars & young scientists, to submit the nominations for Young Scientist Awards: Surgery Asia Pacific 2020.This Surgery Asia Pacific 2020 Young Scientist Awards will be announced at the upcoming “12th International Conference on Surgery and Anesthesia” at Tokyo, Japan this May 2020.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"74 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89627225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The hemorrhoids are normal vascular components in the anal canal. About 5% of the general population is affected by symptoms related to the hemorrhoidal disease. They will become a disease when inflamed or enlarged, termed "hemorrhoid" that is frequently applied for indicating to a disease. Hemorrhoids are commonly diagnosed by the physical examination. The internal hemorrhoids were originated above the dentate (pectinate) line meanwhile; external hemorrhoids were originated below it. During 1985, the internal hemorrhoids were categorized into 4 grades based on the degree of prolapse. The aim of the present investigation is to determine and estimate the efficacy of hemorrhoidectomy performed by the harmonic US and LigaSure scalpels in terms of minimizing postoperative pain, and lowering the complexities versus conventional hemorrhoidectomy. Between October 2015 and October 2019, this investigation included 60 patients complaining from III or IV-degree internal hemorrhoids, classified into 3 groups; 20 patients for each, group A, in which hemorrhoidectomy done with harmonic US scalpel, group B, hemorrhidectomy done with LigaSure and group C, hemorrhidectomy done with conventional scalpel and monopolar electrocautery. Harmonic scalpel and LigaSure, are more safe and effective procedures for surgical treatment of Grade III and Grade IV hemorrhoidal disease. Less postoperative pain, time consuming, bloodless and lower postoperative complications compared with conventional hemorrhidectomy and earlier wound healing. However, the unique disadvantage of Harmonic scalpel and LigaSure is a moderately expensive than the conventional protocol.
{"title":"Efficacy of Harmonic US and LigaSure in Surgical Treatment of 3rd and 4th Degree Internal Hemorrhoids versus Conventional Hemorrhoidectomy","authors":"M. Elhorbity, M. Mansour, N. Mahmoud","doi":"10.37421/jos.2020.16.1","DOIUrl":"https://doi.org/10.37421/jos.2020.16.1","url":null,"abstract":"The hemorrhoids are normal vascular components in the anal canal. About 5% of the general population is affected by symptoms related to the hemorrhoidal disease. They will become a disease when inflamed or enlarged, termed \"hemorrhoid\" that is frequently applied for indicating to a disease. Hemorrhoids are commonly diagnosed by the physical examination. The internal hemorrhoids were originated above the dentate (pectinate) line meanwhile; external hemorrhoids were originated below it. During 1985, the internal hemorrhoids were categorized into 4 grades based on the degree of prolapse. The aim of the present investigation is to determine and estimate the efficacy of hemorrhoidectomy performed by the harmonic US and LigaSure scalpels in terms of minimizing postoperative pain, and lowering the complexities versus conventional hemorrhoidectomy. Between October 2015 and October 2019, this investigation included 60 patients complaining from III or IV-degree internal hemorrhoids, classified into 3 groups; 20 patients for each, group A, in which hemorrhoidectomy done with harmonic US scalpel, group B, hemorrhidectomy done with LigaSure and group C, hemorrhidectomy done with conventional scalpel and monopolar electrocautery. Harmonic scalpel and LigaSure, are more safe and effective procedures for surgical treatment of Grade III and Grade IV hemorrhoidal disease. Less postoperative pain, time consuming, bloodless and lower postoperative complications compared with conventional hemorrhidectomy and earlier wound healing. However, the unique disadvantage of Harmonic scalpel and LigaSure is a moderately expensive than the conventional protocol.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"248 6","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91435204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.29011/2575-9760.001297
Ahmed Alsehily Mohamed Kamal-Eldin Elhadary and Mohamed HamdyShaban
{"title":"Evaluation the Effectiveness of Pre-Operative Prediction Scoring System for Difficult Laparoscopic Cholecystectomy","authors":"Ahmed Alsehily Mohamed Kamal-Eldin Elhadary and Mohamed HamdyShaban","doi":"10.29011/2575-9760.001297","DOIUrl":"https://doi.org/10.29011/2575-9760.001297","url":null,"abstract":"","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"106 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83690651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.29011/2575-9760.001294
Gomez Gonzalez Mr, D. HellínMeseguer, J. ManuelMondéjar, Mosito Sm
Objective: This study gives details of a rare case of cervical mass. We want to emphasize the importance of a good differential diagnosis in a cervical mass in an adult patient. Method: This study presents a case report and review of the literature. Results: We report the case of a 57-year-old male with a cervical mass of months of evolution, suspicious malignancy that after a difficult diagnostic process, turned out to be a reaction to a foreign body (toothpick) that had migrated and fistulized from the mandibular cortex to the skin of the neck. Conclusion: This study presents a rare case of cervical mass and the difficulty sometimes involved in its management. After reviewing the medical literature, we have not found any similar cases described.
{"title":"The Importance of a Good Differential Diagnosis of a Neck Mass. Neck Mass by Migration of a Toothpick from Mandubular Cortex","authors":"Gomez Gonzalez Mr, D. HellínMeseguer, J. ManuelMondéjar, Mosito Sm","doi":"10.29011/2575-9760.001294","DOIUrl":"https://doi.org/10.29011/2575-9760.001294","url":null,"abstract":"Objective: This study gives details of a rare case of cervical mass. We want to emphasize the importance of a good differential diagnosis in a cervical mass in an adult patient. Method: This study presents a case report and review of the literature. Results: We report the case of a 57-year-old male with a cervical mass of months of evolution, suspicious malignancy that after a difficult diagnostic process, turned out to be a reaction to a foreign body (toothpick) that had migrated and fistulized from the mandibular cortex to the skin of the neck. Conclusion: This study presents a rare case of cervical mass and the difficulty sometimes involved in its management. After reviewing the medical literature, we have not found any similar cases described.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"159 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86731908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Perforation peritonitis is a common serious condition encountered in day to day surgical practice in any hospital. One of the reasons for high mortality in these conditions is lack of risk stratifications resulting in delay in providing adequate management, although a number of scoring systems are available to stratify these patients according to severity, but most of these cannot be used in developing countries like India due to their dependency on sophisticated investigation which are usually lacking in most parts of these countries. So a simple prognostic scoring system which could be easily reproduced without sophisticated investigations and also provide a reliable objective assessment of severity and operative risk is required.
{"title":"Perforation peritonitis is a common serious condition encountered in day to day surgical practice inany hospital","authors":"Nirbhaibir Singh","doi":"10.37421/JOS.2020.16.13","DOIUrl":"https://doi.org/10.37421/JOS.2020.16.13","url":null,"abstract":"Perforation peritonitis is a common serious condition encountered in day to day surgical practice in any hospital. One of the reasons for high mortality in these conditions is lack of risk stratifications resulting in delay in providing adequate management, although a number of scoring systems are available to stratify these patients according to severity, but most of these cannot be used in developing countries like India due to their dependency on sophisticated investigation which are usually lacking in most parts of these countries. So a simple prognostic scoring system which could be easily reproduced without sophisticated investigations and also provide a reliable objective assessment of severity and operative risk is required.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"22 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80751664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Saad Slaiki, H. E. Bouhaddouti, A. Ousadden, K. A. Taleb, E. Benjelloun
A spontaneous splenic rupture is a rare entity. The classic treatment remains splenectomy but several recent works has highlighted the value of conservative treatment. We report the case of a young man who had a spontaneous spleen rupture in association with idiopathic thrombocytopenia purpura and who benefited from a conservative treatment.
{"title":"Spontaneous Splenic Rupture Case Report","authors":"Saad Slaiki, H. E. Bouhaddouti, A. Ousadden, K. A. Taleb, E. Benjelloun","doi":"10.37421/JOS.2020.16.2","DOIUrl":"https://doi.org/10.37421/JOS.2020.16.2","url":null,"abstract":"A spontaneous splenic rupture is a rare entity. The classic treatment remains splenectomy but several recent works has highlighted the value of conservative treatment. We report the case of a young man who had a spontaneous spleen rupture in association with idiopathic thrombocytopenia purpura and who benefited from a conservative treatment.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"57 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79756208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.29011/2575-9760.001303
J. Ferrell, D. Bowden, Cindy Tong, K. Etter, R. Bruce
Introduction: Hip fractures are common and costly in the elderly population, often contributing to loss of function and independence. Prompt surgical care may improve clinical and economic outcomes. Materials and Methods: We implemented a protocol-driven care program focused on minimizing time spent immobilized awaiting surgery and streamlining the care pathway for hip fracture. The Hip Fracture Care Program (HFCP) was implemented in a single facility in the Willis Knighton Health System. Time to surgery, length of stay, and cost of length of stay were compared before and after the intervention, utilizing an interrupted time series analysis to account for background trends. Results: One-hundred and sixty patients received HFCP care for acute femur fracture requiring surgical fixation. Compared to 379 patients serving as the pre-implementation comparison group, patients receiving the HFCP intervention were more likely to have minor disease severity and mortality risk. Bivariate analysis demonstrated HFCP was associated with a reduced mean length of stay (from 5.99 to 5.33, p=0.016). Interrupted time series analysis adjusting for disease severity showed no statistically significant difference in length of stay or time to surgery after implementation of the intervention. Mean overall cost based on length of stay was reduced in the post-intervention period, but results were not statistically significant. Discussion: Early cost savings are promising, and program refinement may translate to additional utilization improvements and implications for value-based health care delivery. Conclusions: A standardized care program can be successfully implemented in a community hospital. The program led to nonsignificant reductions in overall LOS and estimated cost savings attributable to LOS reductions. Further efforts to evaluate the effect on complications and other patient-centered outcomes are needed.
{"title":"Implementation of a Comprehensive Hip Fracture Care Program in a Community Hospital Setting","authors":"J. Ferrell, D. Bowden, Cindy Tong, K. Etter, R. Bruce","doi":"10.29011/2575-9760.001303","DOIUrl":"https://doi.org/10.29011/2575-9760.001303","url":null,"abstract":"Introduction: Hip fractures are common and costly in the elderly population, often contributing to loss of function and independence. Prompt surgical care may improve clinical and economic outcomes. Materials and Methods: We implemented a protocol-driven care program focused on minimizing time spent immobilized awaiting surgery and streamlining the care pathway for hip fracture. The Hip Fracture Care Program (HFCP) was implemented in a single facility in the Willis Knighton Health System. Time to surgery, length of stay, and cost of length of stay were compared before and after the intervention, utilizing an interrupted time series analysis to account for background trends. Results: One-hundred and sixty patients received HFCP care for acute femur fracture requiring surgical fixation. Compared to 379 patients serving as the pre-implementation comparison group, patients receiving the HFCP intervention were more likely to have minor disease severity and mortality risk. Bivariate analysis demonstrated HFCP was associated with a reduced mean length of stay (from 5.99 to 5.33, p=0.016). Interrupted time series analysis adjusting for disease severity showed no statistically significant difference in length of stay or time to surgery after implementation of the intervention. Mean overall cost based on length of stay was reduced in the post-intervention period, but results were not statistically significant. Discussion: Early cost savings are promising, and program refinement may translate to additional utilization improvements and implications for value-based health care delivery. Conclusions: A standardized care program can be successfully implemented in a community hospital. The program led to nonsignificant reductions in overall LOS and estimated cost savings attributable to LOS reductions. Further efforts to evaluate the effect on complications and other patient-centered outcomes are needed.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83073406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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