Benefits of an Enhanced Recovery Pathway for Lower Extremity Amputation Patients.

Background: Enhanced recovery programs (ERPs) may improve lower extremity amputation (LEA) care through interdisciplinary collaboration, patient education, multimodal pain control, and early mobilization. We sought to determine the ERP impact on outcomes for patients undergoing major LEA.

Methods: Patients receiving ERP care (02/01/2022-07/31/2023) were compared to a historic pre-ERP cohort (01/01/2020-01/31/2022).

Standardized electronic order sets decreases inpatient opioid use in emergency general surgery.

Background: Effective pain management while limiting opioids optimizes surgical care. Emergency general surgery (EGS) patients are a vulnerable population and are excluded from enhanced recovery pathways. We examined the effect of standardized pain control order sets for EGS.

Sex Differences in Textbook Outcomes among Adults Undergoing Elective Abdominal Aortic Aneurysm Repair.

Background: Female patients with abdominal aortic aneurysms (AAAs) undergoing repair have worse outcomes than men. Textbook outcomes (TOs) have been described as a metric to direct quality improvement efforts and assess institutional performance. We investigated sex differences among patients achieving a TO after open (OAR) and endovascular aortic aneurysm repair (EVAR).

Textbook outcomes as a novel patient-centric metric to inform carotid revascularization.

Objective: The recent National Coverage Determination surrounding carotid stenting and shared decision-making has ushered in an era of patient-centric carotid care. However, historical carotid intervention endpoints have lacked patient-centered nuances to inform clinical decisions. Accordingly, we aimed to create a comprehensive novel, patient-centric textbook outcome (TO) to inform treatment paradigms.

Evolving practices of spinal drain use for branch/fenestrated endovascular aortic repair patients in the United States Aortic Research Consortium.

Objective: The use of cerebrospinal fluid drains (CSFDs) for the prevention or mitigation of spinal cord ischemia (SCI) is a subject of debate for patients undergoing branch/fenestrated endovascular aortic repair. We sought to evaluate the practices surrounding CSFD use concurrently with rates of SCI occurrence, recovery, and CSFD complications in the US Aortic Research Consortium.

Methods: We conducted a retrospective analysis of the US Aortic Research Consortium registry consisting of patients undergoing branch/fenestrated endovascular aortic repair under individual physician-sponsored investigational device exemptions from January 2011 to April 2024.

Diminishing Returns: An Analysis of Surgeon Compensation in the Setting of Ever-Increasing Student Debt.

Background: The knowledge required to manage surgical patients has expanded considerably during the past 40 years. Simultaneously, the cost of medical education has increased substantially. Surgical trainees are at a particular disadvantage due to the time demands of training.

A prevention protocol reduces spinal cord ischemia in patients undergoing branched/fenestrated endovascular aortic repair.

Objective: Spinal cord ischemia (SCI) is a devastating complication that is associated with thoracoabdominal aortic repair, with higher risk associated with increased aortic coverage length, making patients undergoing branched/fenestrated endovascular repair (B/FEVAR) particularly vulnerable. A bundled SCI prevention protocol was previously reported to reduce SCI rates when compared to a historic cohort in a single-center study. Therefore, this analysis aims to further validate and update outcomes associated with the protocol given the routine implementation of this strategy at two institutions (University of Florida and the University of Alabama at Birmingham) since inception.

Combined Heart-Liver and Domino Liver Transplantation in Familial Amyloidosis.

Background: Combined heart-liver transplantation (CHLT) is the only curative option for patients with concomitant pathology affecting the heart and liver. In some cases, the native livers of familial amyloidosis (FA) patients may be suitable for domino transplantation into other recipients.

Methods: Retrospective analysis (2013 to 2019) of all CHLT at our center was performed.