دورية أكاديمية
Validation of the American Association for the Surgery of Trauma Emergency General Surgery Grading System for Colorectal Resection: An EAST Multicenter Study.
| العنوان: | Validation of the American Association for the Surgery of Trauma Emergency General Surgery Grading System for Colorectal Resection: An EAST Multicenter Study. |
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| المؤلفون: | Aicher, Brittany O.1 baicher@som.umaryland.edu, Betancourt-Ramirez, Alejandro2, Grossman, Michael D.2, Heise, Holly3, Schroeppel, Thomas J.3, Hernandez, Matthew C.4, Zielinski, Martin D.4, Kongkaewpaisan, Napaporn5, Kaafarani, Haytham M. A.5, Wagner, Afton6, Grabo, Daniel6, Scott, Michael7, Peck, Gregory7, Chang, Gloria8, Matsushima, Kazuhide8, Cullinane, Daniel C.9, Cullinane, Laura M.9, Stocker, Benjamin10, Posluszny, Joseph10, Simonoski, Ursula J.11 |
| المصدر: | American Surgeon. May2022, Vol. 88 Issue 5, p953-958. 6p. |
| مصطلحات موضوعية: | *LENGTH of stay in hospitals, *RESEARCH, *OPERATIVE surgery, *RESEARCH methodology, *RETROSPECTIVE studies, *EVALUATION research, *COLORECTAL cancer, *SEVERITY of illness index, *TREATMENT effectiveness, *COMPARATIVE studies, *LAPAROSCOPY |
| مصطلحات جغرافية: | UNITED States |
| مستخلص: | |
| قاعدة البيانات: | Academic Search Index |
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asx Academic Search Index 156290311 1335 6 Academic Journal academicJournal 1335.13513183594 |
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https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&scope=site&db=asx&AN=156290311&custid=s6537998&authtype=sso |
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Array ( [Name] => Author [Label] => Authors [Group] => Au [Data] => <searchLink fieldCode="AR" term="%22Aicher%2C+Brittany+O%2E%22">Aicher, Brittany O.</searchLink><relatesTo>1</relatesTo><i> baicher@som.umaryland.edu</i><br /><searchLink fieldCode="AR" term="%22Betancourt-Ramirez%2C+Alejandro%22">Betancourt-Ramirez, Alejandro</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Grossman%2C+Michael+D%2E%22">Grossman, Michael D.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Heise%2C+Holly%22">Heise, Holly</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Schroeppel%2C+Thomas+J%2E%22">Schroeppel, Thomas J.</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Hernandez%2C+Matthew+C%2E%22">Hernandez, Matthew C.</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Zielinski%2C+Martin+D%2E%22">Zielinski, Martin D.</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Kongkaewpaisan%2C+Napaporn%22">Kongkaewpaisan, Napaporn</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Kaafarani%2C+Haytham+M%2E+A%2E%22">Kaafarani, Haytham M. A.</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Wagner%2C+Afton%22">Wagner, Afton</searchLink><relatesTo>6</relatesTo><br /><searchLink fieldCode="AR" term="%22Grabo%2C+Daniel%22">Grabo, Daniel</searchLink><relatesTo>6</relatesTo><br /><searchLink fieldCode="AR" term="%22Scott%2C+Michael%22">Scott, Michael</searchLink><relatesTo>7</relatesTo><br /><searchLink fieldCode="AR" term="%22Peck%2C+Gregory%22">Peck, Gregory</searchLink><relatesTo>7</relatesTo><br /><searchLink fieldCode="AR" term="%22Chang%2C+Gloria%22">Chang, Gloria</searchLink><relatesTo>8</relatesTo><br /><searchLink fieldCode="AR" term="%22Matsushima%2C+Kazuhide%22">Matsushima, Kazuhide</searchLink><relatesTo>8</relatesTo><br /><searchLink fieldCode="AR" term="%22Cullinane%2C+Daniel+C%2E%22">Cullinane, Daniel C.</searchLink><relatesTo>9</relatesTo><br /><searchLink fieldCode="AR" term="%22Cullinane%2C+Laura+M%2E%22">Cullinane, Laura M.</searchLink><relatesTo>9</relatesTo><br /><searchLink fieldCode="AR" term="%22Stocker%2C+Benjamin%22">Stocker, Benjamin</searchLink><relatesTo>10</relatesTo><br /><searchLink fieldCode="AR" term="%22Posluszny%2C+Joseph%22">Posluszny, Joseph</searchLink><relatesTo>10</relatesTo><br /><searchLink fieldCode="AR" term="%22Simonoski%2C+Ursula+J%2E%22">Simonoski, Ursula J.</searchLink><relatesTo>11</relatesTo> ) Array ( [Name] => TitleSource [Label] => Source [Group] => Src [Data] => <searchLink fieldCode="JN" term="%22American+Surgeon%22">American Surgeon</searchLink>. May2022, Vol. 88 Issue 5, p953-958. 6p. ) Array ( [Name] => Subject [Label] => Subject Terms [Group] => Su [Data] => *<searchLink fieldCode="DE" term="%22LENGTH+of+stay+in+hospitals%22">LENGTH of stay in hospitals</searchLink><br />*<searchLink fieldCode="DE" term="%22RESEARCH%22">RESEARCH</searchLink><br />*<searchLink fieldCode="DE" term="%22OPERATIVE+surgery%22">OPERATIVE surgery</searchLink><br />*<searchLink fieldCode="DE" term="%22RESEARCH+methodology%22">RESEARCH methodology</searchLink><br />*<searchLink fieldCode="DE" term="%22RETROSPECTIVE+studies%22">RETROSPECTIVE studies</searchLink><br />*<searchLink fieldCode="DE" term="%22EVALUATION+research%22">EVALUATION research</searchLink><br />*<searchLink fieldCode="DE" term="%22COLORECTAL+cancer%22">COLORECTAL cancer</searchLink><br />*<searchLink fieldCode="DE" term="%22SEVERITY+of+illness+index%22">SEVERITY of illness index</searchLink><br />*<searchLink fieldCode="DE" term="%22TREATMENT+effectiveness%22">TREATMENT effectiveness</searchLink><br />*<searchLink fieldCode="DE" term="%22COMPARATIVE+studies%22">COMPARATIVE studies</searchLink><br />*<searchLink fieldCode="DE" term="%22LAPAROSCOPY%22">LAPAROSCOPY</searchLink> ) Array ( [Name] => SubjectGeographic [Label] => Geographic Terms [Group] => Su [Data] => <searchLink fieldCode="DE" term="%22UNITED+States%22">UNITED States</searchLink> ) Array ( [Name] => Abstract [Label] => Abstract [Group] => Ab [Data] => <bold>Background: </bold>The American Association for the Surgery of Trauma (AAST) has developed a grading system for emergency general surgery (EGS) conditions. We sought to validate the AAST EGS grades for patients undergoing urgent/emergent colorectal resection.<bold>Methods: </bold>Patients enrolled in the "Eastern Association for the Surgery of Trauma Multicenter Colorectal Resection in EGS-to anastomose or not to anastomose" study undergoing urgent/emergent surgery for obstruction, ischemia, or diverticulitis were included. Baseline demographics, comorbidity severity as defined by Charlson comorbidity index (CCI), procedure type, and AAST grade were prospectively collected. Outcomes included length of stay (LOS) in-hospital mortality, and surgical complications (superficial/deep/organ-space surgical site infection, anastomotic leak, stoma complication, fascial dehiscence, and need for further intervention). Multivariable logistic regression models were used to describe outcomes and risk factors for surgical complication or mortality.<bold>Results: </bold>There were 367 patients, with a mean (± SD) age of 62 ± 15 years. 39% were women. The median interquartile range (IQR) CCI was 4 (2-6). Overall, the pathologies encompassed the following AAST EGS grades: I (17, 5%), II (54, 15%), III (115, 31%), IV (95, 26%), and V (86, 23%). Management included laparoscopic (24, 7%), open (319, 87%), and laparoscopy converted to laparotomy (24, 6%). Higher AAST grade was associated with laparotomy (P = .01). The median LOS was 13 days (8-22). At least 1 surgical complication occurred in 33% of patients and the mortality rate was 14%. Development of at least 1 surgical complication, need for unplanned intervention, mortality, and increased LOS were associated with increasing AAST severity grade. On multivariable analysis, factors predictive of in-hospital mortality included AAST organ grade, CCI, and preoperative vasopressor use (odds ratio (OR) 1.9, 1.6, 3.1, respectively). The American Association for the Surgery of Trauma emergency general surgery grade was also associated with the development of at least 1 surgical complication (OR 2.5), while CCI, preoperative vasopressor use, respiratory failure, and pneumoperitoneum were not.<bold>Conclusion: </bold>The American Association for the Surgery of Trauma emergency general surgery grading systems display construct validity for mortality and surgical complications after urgent/emergent colorectal resection. These results support incorporation of AAST EGS grades for quality benchmarking and surgical outcomes research. [ABSTRACT FROM AUTHOR] ) |
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