The Operative Word

• E36: Association of Discharge Against Medical Advice with Surgical Outcomes and Healthcare Cost

  In this episode, Tom Varghese, MD, FACS, is joined by Timothy Pawlik, MD, FACS, from The Ohio State University. They discuss Dr Pawlik’s recent article, “Association of Discharge Against Medical Advice with Surgical Outcomes and Healthcare Cost,” in which the authors found that discharge against medical advice (DAMA) among surgical patients is associated with increased 30-day readmission, complication, fragmented care, and higher healthcare cost. DAMA patients were younger, socioeconomically vulnerable, and often had substance use or psychiatric disorders.     Disclosure Information: Drs Varghese and Pawlik have nothing to disclose.    To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.   Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.    #JACSOperativeWord 

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• E35: Association of State Helmet Laws with Helmet Use and Injury Outcomes in Motorcycle Crashes

  In this episode, Lillian Erdahl, MD, FACS, is joined by Stephanie M Jensen, MD, MPH, and A Britt Christmas, MD, MBA, FACS, from the Carolinas Medical Center, Charlotte, NC. They discuss the recent article by Drs Jensen and Christmas, “Association of State Helmet Laws with Helmet Use and Injury Outcomes in Motorcycle Crashes,” in which the authors analyzed a decade of motorcycle collision data from an American College of Surgeons-verified Level I Trauma Center positioned at the border of 2 states with differing motorcycle helmet laws. The study found that helmeted patients had reduced injury severity, and that state helmet laws significantly influence helmet usage among motorcyclists. Disclosure Information: Drs Erdahl, Jensen, and Christmas, speakers, have nothing to disclose. To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date. Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more. #JACSOperativeWord

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• E34: Evaluating Outcomes of Initial Site Visits Across American College of Surgeons Accreditation Programs

  In this episode, Tom Varghese, MD, FACS, is joined by Brett Johnson, MD, and Clifford Ko, MD, FACS, from the American College of Surgeons (ACS). They discuss the recent article by Drs Johnson and Ko, “Evaluating Outcomes of Initial Site Visits Across American College of Surgeons Accreditation Programs,” in which the authors found that ACS accreditation identifies significant gaps in hospital quality, with only 61% of hospitals passing on their initial attempt. However, most ultimately succeed after remediation. These findings highlight that ACS accreditation both validates hospitals meeting rigorous standards and drives quality improvement in those that initially fall short. Disclosure Information: Drs Varghese, speaker, has no relevant financial conflicts to disclose. Drs Johnson and Ko, speakers, are employees of the American College of Surgeons. Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more. #JACSOperativeWord

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• E33: Limited or Lasting: Is Preoperative Weight Loss as Part of Prehabilitation Maintained after Open Ventral Hernia Repair?

  In this episode, Tom Varghese, MD, FACS, is joined by Todd Heniford, MD, FACS, and Alexis Holland, MD, from the Carolinas Medical Center. They discuss the recent article by Drs Heniford and Holland, “Limited or Lasting: Is Preoperative Weight Loss as Part of Prehabilitation Maintained after Open Ventral Hernia Repair?” This study supports the implementation of preoperative optimization and weight loss before hernia surgery, which remains controversial. Long-term maintenance of preoperative weight loss before abdominal wall reconstruction is achievable and sustainable.   Disclosure Information: Drs Varghese and Holland have nothing to disclose. Dr Heniford is a surgical research grant recipient and receives speaking honoraria from WL Gore.   To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date. Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.   #JACSOperativeWord

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• E32: Validation of Artificial Intelligence-Based POTTER Calculator in Emergency General Surgery Patients Undergoing Laparotomy: Prospective, Bi-Institutional Study

  In this episode, Tom Varghese, MD, FACS, is joined by Haytham Kaafarani, MD, MPH, FACS, and Vahe Panossian, MD, from the Department of Surgery, Massachusetts General Hospital and Harvard Medical School. They discuss the recent article by Drs Kaafarani and Panossian, “Validation of Artificial Intelligence-Based POTTER Calculator in Emergency General Surgery Patients Undergoing Laparotomy: Prospective, Bi-Institutional Study.” This study found that POTTER accurately predicts mortality and postoperative complication, and the superior accuracy, user-friendliness, and interpretability of POTTER make it a useful bedside tool for preoperative counseling.    Disclosure Information: Drs Varghese and Panossian have nothing to disclose. Dr Kaafarani receives honoraria payments from UpToDate. The POTTER calculator is available online for free, and Dr Kaafarani has not been compensated for the development or ongoing use of the calculator.  To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date. Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more. #JACSOperativeWord

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