Journal of the American College of Surgeons
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American College of Surgeons NSQIP Hospital Benchmarking Using Bayesian Variational Inference to Adjust for Many CPT Codes

Aug 7, 2026

The authors aimed to evaluate the effectiveness of Bayesian automatic differentiation variational inference (ADVI) as a method for risk adjustment in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), particularly in comparison to the conventional CatBoost (CATB) approach. They found that while both methods showed similar discrimination for outcomes, ADVI provided superior calibration, significantly reduced computational time, and improved stability for sparse CPT code combinations, suggesting it as a more efficient alternative for hospital benchmarking in surgical outcomes.

Plain Radiograph Use in Pediatric Blunt Trauma Patients with Suspicion for Cervical Spine Injury: A Prospective Observational Analysis of the Western Pediatric Cervical Spine Study

Aug 7, 2026

The authors aimed to evaluate the utilization and diagnostic performance of plain radiography (XR) in pediatric patients with suspected cervical spine injuries, specifically those meeting established criteria for XR-first imaging. Their study found that XR was underutilized, with only 39% of eligible patients receiving it, while demonstrating a high negative predictive value (NPV) of 99.9% for clinically significant injuries in appropriately selected cases. This suggests that implementing XR-first imaging strategies could significantly reduce the reliance on CT scans and associated radiation exposure in children.

Robotic vs Laparoscopic Cholecystectomy: Preoperative and Intraoperative Severity-Adjusted Outcomes with Strasberg-Classified Bile Duct Injury

Aug 7, 2026

This study aimed to determine whether robot-assisted cholecystectomy reduces the incidence of bile duct injury compared to laparoscopic cholecystectomy, while accounting for disease severity and operative complexity. The authors found that robot-assisted procedures were associated with a lower risk of bile duct injury and improved perioperative outcomes, including reduced conversion rates and shorter hospital stays, even when performed on more complex cases of acute cholecystitis.

Coronary Calcium Screening and Incidental Lung Cancer Detection in Patients Ineligible for US Preventive Services Task Force Screening

Aug 7, 2026

The authors investigate whether coronary calcium screening CT can facilitate the early detection of lung cancer in patients who do not meet the current U.S. Preventive Services Task Force screening criteria. Their retrospective study found that actionable pulmonary nodules were identified in a significant portion of patients, leading to early-stage lung cancer diagnoses and high survival rates, suggesting that integrating thoracic assessments from coronary calcium screenings could enhance lung cancer detection in underserved populations.

Impact of Increased Time for Trial of Nonoperative Management in Small Bowel Obstruction: Evidence from the American College of Surgeons NSQIP Emergency General Surgery Targeted Database

Jul 30, 2026

The authors aimed to investigate the optimal duration of nonoperative management (NOM) for small bowel obstruction (SBO) and its impact on clinical outcomes and healthcare utilization. Their study found significant national variation in NOM duration, with longer NOM associated with increased postoperative length of stay but no improvement in short-term morbidity, mortality, or readmission rates. These findings suggest a need for standardization in the management of SBO to optimize healthcare resources.

Incidence and Predictors of Textbook Outcomes after Metabolic and Bariatric Surgery in Adolescents

Jul 29, 2026

The authors aimed to evaluate the incidence and predictors of achieving textbook outcomes (TO) in adolescents undergoing metabolic and bariatric surgery, specifically vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB). They found that 90.8% of patients achieved TO, with higher rates after VSG compared to RYGB, and identified factors such as surgical approach, patient age, and race/ethnicity that influenced the likelihood of achieving TO. The study highlights the importance of procedure type and patient demographics in surgical outcomes for this population.

Hospital Variation in Postoperative Delirium Screening and Outcomes in Older Adult Surgical Patients: A National Analysis of Geriatric and Non-Geriatric Surgery Verification Hospitals

Jun 10, 2026

The authors aimed to investigate the implementation and impact of standardized postoperative delirium screening in older surgical patients across Geriatric Surgery Verification (GSV) and non-GSV hospitals. Their findings revealed that GSV hospitals had significantly higher screening rates but similar delirium detection rates compared to non-GSV hospitals, suggesting that variations in screening practices do not reflect differences in actual delirium incidence. Additionally, GSV hospitals exhibited shorter lengths of stay, indicating that structured geriatric care processes may enhance efficiency and outcomes, regardless of delirium development.

Impact of the Quebec Provincial Enhanced Recovery After Surgery Program on Postoperative Outcomes for Patients Undergoing Colorectal Operation

Jun 9, 2026

The authors aimed to evaluate the impact of the Quebec Provincial Enhanced Recovery After Surgery (ERAS) program on postoperative outcomes for patients undergoing colorectal surgery. Their findings indicate that the implementation of the ERAS program led to improved adherence to perioperative measures and a significant reduction in median length of stay, while maintaining stable complication rates. This study highlights the importance of consistent ERAS adherence across hospitals to enhance surgical outcomes.

Self-Reported Flourishing Among U.S. Surgeons: A National Physician Survey

Jun 4, 2026

The authors aimed to assess the levels of flourishing among U.S. surgeons and identify personal and professional factors associated with it. Through a survey of 1,000 practicing surgeons, they found that while surgeons reported high levels of flourishing, particularly in areas of financial stability and meaning, there were notable deficits in social connectivity. The study suggests that addressing these aspects could enhance well-being and reduce burnout in the surgical profession.