Surgery News - March 2009 - (Page 1) VOL. 5 • NO. 3 • MARCH 2009 MICHIGAN TRANSPLANT CENTER Early Data Show Percent Body Fat As SSI Predictor Ongoing study of over 400 patients. BY DAMIAN MCNAMARA INSIDE THIS ISSUE 20/20 Trauma VISION THE Training Surgeons get their hands on unusual but difficult injuries in an intensive 1-day course. • 6 BOB GARYPIE/UNIVERSITY OF Practice Trends Else vier Global Medical Ne ws Five crashes related to organ procurement have occurred since 1990, said Dr. Michael Englesbe (R) of the University of Michigan. Organ Procurement Risks Raise Concerns B Y M I C H E L E G. S U L L I VA N Else vier Global Medical Ne ws M ost transplant team members feel unsafe on organ procurement missions, and their fears are not unfounded: 15% of U.S. transplant surgeons have been involved in at least one accident while traveling to procure organs, according to Dr. Michael Englesbe. Since 1990, five plane crashes related to organ procurement have occurred, four of which resulted in 10 deaths. A crash in 2007 cost the lives of two surgeons and two technicians who were part of the University of Michigan’s transplant team. Both pilots also died when the plane crashed into Lake Michigan shortly after taking off from Milwaukee. The cause of the accident remains under investigation. The crash shocked Dr. Englesbe and his colleagues in the university’s transplant department, prompting them to examine the problem in a broader sense, and to seek solutions. A survey they sent last year to all members of the American Society of Transplant Surgeons is the only source of systematically collected data on the dangers of organ procurement travSee Procurement • page 4 M I A M I B E A C H — Preoperative percent body fat is an independent predictor of surgical site infection risk and is a more accurate way to define obesity than is body mass index, according to preliminary results of a prospective, ongoing trial. Surgical site infections (SSIs) develop in an estimated 290,000 of the 27 million procedures performed annually in the United States, data from the Centers for Disease Control and Prevention indicate. Previous research has linked obesity—as well as type of procedure, patient comorbidity, immunosuppression, and cigarette smoking—to an increased risk of such infections (Dis. Colon Rectum. 2007;50: 2223-37; J. Cardiovasc. Surg. 2007;48:641-6). In the initial cohort of 194 patients in this study, Harvard medical student Emily Waisbren and her associates in the departments of anesthesiology and surgery at Brigham and Women’s Hospital in Boston measured percent body fat using bioelectrical impedance analysis and body mass index (BMI) using the standard height and weight formula. Patients ranged in age from 18 years to 64 years (mean age, 49), and 66% were women. The mean BMI was 29.5 kg/m2, while overall mean body fat was 34%. Patients were considered obese if their BMI exceeded 30 kg/m2 and if body fat exceeded 25% (in men) or 31% (in women), based on the definition from the American Council on Exercise. “This has an accuracy of 2% plus or minus compared to water immersion studies, which are the gold standard,” See SSI • page 5 More for Less? A new plan envisions wider health care coverage with reduced spending. • 9 Vascular Stress Test A wall stress measurement gauges AAA rupture risk. • 1 0 News From the College Mentoring An essay contest showcases surgeons as mentors. • 1 3 ONLINE EDITION Visit www.facs.org to access articles available only online. Go to Periodicals, then Surgery News to read the latest on topics such as: •how surgeons feel about their careers •Crohn’s disease •drug-related liability claims Stimulus Bill Pushes EHR Adoption B Y M A RY E L L E N SCHNEIDER Else vier Global Medical Ne ws VITAL SIGNS Annual National Health Expenditure Has Risen Ninefold Since 1980 2,500 2,000 1,500 1,000 ELSEVIER GLOBAL MEDICAL NEWS newly economic law Theofstimulusenactedwill infuse tens billions of dollars into the health care sector, providing incentives for using health information technology and launching initiatives in comparative effectiveness research. The $787 billion American Recovery and Reinvestment Act of 2009 (H.R. 1), signed into law by President Obama on Feb. 17, includes about $17 billion in financial incentives through the Medicare and Medicaid programs to physicians and other health care providers to adopt and use electronic health records (EHRs). Another $2 billion in funding is designated for the Billions of dollars Public funds Office of the National Coordinator for Health Information Technology to encourage health IT adoption, aid in standard setting, and support regional efforts at health information exchange. Under Medicare, providers could receive incentives for EHR use over 5 years starting at a maximum of $18,000 in the first year and dropping to a maximum of $2,000 in year 5. 60 Columbia Rd., Bldg. B, 2nd flr. Morristown, NJ 07960 CHANGE SERVICE REQUESTED SURGERY NEWS However, physicians who do not engage in “meaningful” EHR use by 2015 could see cuts to their Medicare payments starting at 1% in 2015 and rising to 3% in 2017 and subsequent years. Physicians who have a Medicaid patient volume of at least 30% will be eligible to receive incentive payments for EHR See Stimulus • page 5 Presorted Standard U.S. Postage PAID Permit No. 384 Lebanon Jct. KY 500 0 1980 1990 2000 2004 Private funds 2005 2006 2007 Note: Based on data from the Centers for Medicare and Medicaid Services’ Office of the Actuary. Source: Health Affairs 2009;28:246-61 http://www.facs.org
Table of Contents Feed for the Digital Edition of Surgery News - March 2009 Surgery News - March 2009 Contents Trauma Training More for Less? Stress Test Mentoring Surgery News - March 2009 Surgery News - March 2009 - Contents (Page 1) Surgery News - March 2009 - Contents (Page 2) Surgery News - March 2009 - Contents (Page 3) Surgery News - March 2009 - Contents (Page 4) Surgery News - March 2009 - Contents (Page 5) Surgery News - March 2009 - Trauma Training (Page 6) Surgery News - March 2009 - Trauma Training (Page 7) Surgery News - March 2009 - Trauma Training (Page 8) Surgery News - March 2009 - More for Less? (Page 9) Surgery News - March 2009 - Stress Test (Page 10) Surgery News - March 2009 - Stress Test (Page 11) Surgery News - March 2009 - Stress Test (Page 12) Surgery News - March 2009 - Mentoring (Page 13) Surgery News - March 2009 - Mentoring (Page 14) Surgery News - March 2009 - Mentoring (Page 15) Surgery News - March 2009 - Mentoring (Page 16)
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