New Surgical Research in April: Preoperative Weight Loss, Opioid Stewardship, Motion Tracking for Surgical Education, and More

CHICAGO — The April issue of the Journal of the American College of Surgeons (JACS), which includes research presented at the Southern Surgical Association 136th Annual Meeting, features new findings including the impact of academic medical centers on other nearby hospitals, whether liver injury affects rates of venous thromboembolism in trauma patients, and the role of a hospital’s massive transfusion protocol in reducing “door-to-cooler” times, among others.

Read highlights from the issue below. The full issue is available on the JACS website.

Examining Geographic Disparity: Variation in Cancer Outcomes within Appalachia

Fewer people are being diagnosed with and dying from cancer in Appalachia. But, compared to elsewhere in the United States, cancer incidence and death rates remain substantially higher, especially in certain areas of Central Appalachia. These findings reflect the most up-to-date cancer data from the Appalachian region and include in-depth analyses within Appalachia by county.

Read the press release

Impact of Academic Medical Centers on Surgical Outcomes of Neighboring Non-Academic Medical Centers Study

Researchers assessed geographic variation in Academic Medical Centers (AMCs) across the United States and evaluated their impact on postoperative complications, readmission rates, and mortality following major surgical procedures performed at nearby non-AMCs.  Key findings include:

• A high presence of AMCs was associated with lower morbidity and mortality rates at nearby non-AMCs.
• The influence of AMCs on clinical outcomes likely extends beyond direct patient care, indicating spillover effects on outcomes for patients in neighboring non-AMCs.
• DOI: 10.1097/XCS.0000000000001272

Limited or Lasting: Is Preoperative Weight Loss as Part of Prehabilitation Maintained after Open Ventral Hernia Repair? Long-term Preoperative Weight Loss Study

Researchers examined the use of prehabilitation and non-medicated ways of maintaining weight loss for people undergoing hernia operations. The results support the sustainability and long-term successful maintenance of preoperative weight loss in overweight abdominal wall reconstruction patients. This represents the largest study that quantifies preoperative weight loss, according to the authors.

DOI: 10.1097/XCS.0000000000001348

Surgical Opioid Stewardship: From the Epidemic Through the Pandemic and Beyond Analysis

The Pennsylvania New Jersey – Surgical Opioid Stewardship (PENNJ-SOS) program reduced perioperative opioid overuse from September 2019 through August 2023, remaining effective throughout the COVID-19 pandemic. Data from 15 National Surgical Quality Improvement Program (NSQIP) hospitals in two states on 12 operations among seven surgical specialties, including 18,325 patients with nine opioid-specific variables monitored.

DOI: 10.1097/XCS.0000000000001274

Novel Use of Objective Sensor Technology: Creation of Individualized Education Plans to Develop Operative Mastery Study

Researchers tested how performance goals could be defined for surgeons’ skill development in a new way. Ninety-four volunteer surgeons and surgeons in training wore motion-tracking sensors while performing two laparoscopic skill simulations and a simulated laparoscopic cholecystectomy. Two groups, practice-ready and not practice-ready, were formulated. The differences between the groups were then used to develop novel sensor-based motion metric benchmarks which, when used as criteria, enabled the successful creation of individualized learners report cards.

DOI: 10.1097/XCS.0000000000001286

Liver Injury is Independently Associated with Pulmonary Embolism in Severely Injured Patients Study

Trauma patients’ liver injury (LI) is not typically included in traditional venous thromboembolism (VTE) risk assessment models, which also include deep vein thrombosis (DVT) and pulmonary embolism (PE). Researchers evaluated the relationship between LI and VTE rates and tested whether LI is associated with increased rates of VTE in severely injured patients. They also analyzed American College of Surgeons Trauma Quality Improvement Project data, revealing that liver injury is an independent factor in developing PE, but not DVT.

DOI: 10.1097/XCS.0000000000001293

The Impact of Massive Transfusion Activations on Time to Delivery of the First Cooler and Patient Survival: A Study of 4,313 Consecutive Activations

Researchers evaluated the effectiveness of their hospital’s massive transfusion protocols (MTP). From 52,328 trauma patient admissions and 4,313 MTP trauma activations, they assessed the impact and sustainability of the hospital’s quality improvement interventions on time to MTP cooler delivery (“door-to-cooler" time) and their association with trauma patient survival. Findings resulted in a 35% decrease in a patients’ odds of dying by reducing “door-to-cooler” times.

DOI: 10.1097/XCS.0000000000001282

Journalists should contact pressinquiry@facs.org to receive a full copy of any of these studies or to set up an interview with a researcher.

About the American College of Surgeons

The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has approximately 90,000 members and is the largest organization of surgeons in the world. "FACS" designates that a surgeon is a Fellow of the American College of Surgeons.

Contact

• Dan Hamilton | 312-202-5328
• Sheila Evans | 312-202-5386 
• Email: pressinquiry@facs.org