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Surgeon Social Jet Lag and Patient Risk of Major Adverse Events.
Pascal L, Polazzi S, Skinner SC, Lifante JC, Mazza S, Duclos A; TopSurgeons Study Group. Pascal L, et al. Among authors: duclos a. JAMA Surg. 2026 Jun 3:e261796. doi: 10.1001/jamasurg.2026.1796. Online ahead of print. JAMA Surg. 2026. PMID: 42234451 Free PMC article.
DESIGN, SETTING, AND PARTICIPANTS: This multicenter prospective cohort study was conducted from November 1, 2020, to December 31, 2021, across 14 surgical departments in 7 specialties at 4 university hospitals in France. Patients were excluded if they were younger than 18 …
DESIGN, SETTING, AND PARTICIPANTS: This multicenter prospective cohort study was conducted from November 1, 2020, to December 31, 2021, acro …
Surgeons' physiological parameters and surgical performance: a systematic scoping review.
Pascal L, Ducarroz S, Skinner SC, Cordier Q, Lifante JC, Mazza S, Duclos A. Pascal L, et al. Among authors: duclos a. Patient Saf Surg. 2025 Oct 1;19(1):27. doi: 10.1186/s13037-025-00445-z. Patient Saf Surg. 2025. PMID: 41034907 Free PMC article. Review.
BACKGROUND: Wearable sensors enable objective, non-invasive and accurate measurement of surgeons' physiological parameters that potentially impact surgeon performance and patient outcomes. ...Most studies investigated the relationship between physiological parameter …
BACKGROUND: Wearable sensors enable objective, non-invasive and accurate measurement of surgeons' physiological parameters that poten …
Association Between Surgeon Age and Patient Hemodynamic Instability in Pheochromocytoma Surgery: A Multicenter Cohort Study.
Skinner SC, Pascal L, Polazzi S, Fanget F, Brunaud L, Collet D, Dousset B, Ménégaux F, Mirallié E, Sebag F, Zinzindohoue F, Lifante JC, Duclos A. Skinner SC, et al. Among authors: duclos a. J Patient Saf. 2025 Jul 1. doi: 10.1097/PTS.0000000000001387. Online ahead of print. J Patient Saf. 2025. PMID: 40590687
Surgeon experience was quantified using surgeon's age at the time of surgery, and performance was evaluated using IHI occurrence. GEE logistic regression models, adjusted for potential confounders related to the patient and surgical procedure, were use …
Surgeon experience was quantified using surgeon's age at the time of surgery, and performance was evaluated using IHI o …
Surgery scheduling based on large language models.
Wan F, Wang T, Wang K, Si Y, Fondrevelle J, Du S, Duclos A. Wan F, et al. Among authors: duclos a. Artif Intell Med. 2025 Aug;166:103151. doi: 10.1016/j.artmed.2025.103151. Epub 2025 May 7. Artif Intell Med. 2025. PMID: 40349664
This study explores their application in solving multi-objective combinatorial optimization problems-surgery scheduling problem. Traditional multi-objective optimization algorithms, such as the Non-dominated Sorting Genetic Algorithm II (NSGA-II), often require domain expe …
This study explores their application in solving multi-objective combinatorial optimization problems-surgery scheduling problem. Trad …
Influence of the Surgeon's First Operation of the Day on Patient Outcomes.
Dagnino F, Polazzi S, Lifante JC, Dey T, Duclos A; TopSurgeons Study Group. Dagnino F, et al. Among authors: duclos a. Ann Surg. 2026 Jul 1;284(1):43-50. doi: 10.1097/SLA.0000000000006666. Epub 2025 Feb 13. Ann Surg. 2026. PMID: 39945091 Free PMC article.
OBJECTIVE: To investigate whether the cumulative operative time spent by a surgeon operating on patients on the same day before starting a new procedure was associated with surgical outcomes. ...CONCLUSIONS: First patient of the day may experience worse outcomes, pr …
OBJECTIVE: To investigate whether the cumulative operative time spent by a surgeon operating on patients on the same day before start …
Daily physical activity habits influence surgeons' stress in the operating room: a prospective cohort study.
Skinner SC, Awtry JA, Pascal L, Polazzi S, Lifante JC, Duclos A. Skinner SC, et al. Among authors: duclos a. Int J Surg. 2025 Mar 1;111(3):2505-2515. doi: 10.1097/JS9.0000000000002258. Int J Surg. 2025. PMID: 39903564 Free PMC article.
This study aims to evaluate the relationship between surgeons' physical activity habits and their stress, assessed as heart rate variability, at the start of surgery. ...RESULTS: We analyzed 722 surgeries performed by 37 surgeons (median age = 47 (IQR …
This study aims to evaluate the relationship between surgeons' physical activity habits and their stress, assessed as heart rate vari …
The influence of familiarity between the surgeon and their assistant on patient outcomes: a prospective observational cohort study.
Stelzl DR, Polazzi S, Lifante JC, Dey T, Duclos A; TopSurgeons Study Group. Stelzl DR, et al. Among authors: duclos a. Int J Surg. 2025 Mar 1;111(3):2525-2534. doi: 10.1097/JS9.0000000000002269. Int J Surg. 2025. PMID: 39878179 Free PMC article.
Surgical team familiarity was measured as the cumulative number of previous operations performed by the same dyad of attending and assisting surgeons. Composite of adverse events within 30 days of surgery encompassed major surgical complication, unplan …
Surgical team familiarity was measured as the cumulative number of previous operations performed by the same dyad of attending and as …
Association Between Surgeon Stress and Major Surgical Complications.
Awtry J, Skinner S, Polazzi S, Lifante JC, Dey T, Duclos A; TopSurgeons Study Group. Awtry J, et al. Among authors: duclos a. JAMA Surg. 2025 Mar 1;160(3):332-340. doi: 10.1001/jamasurg.2024.6072. JAMA Surg. 2025. PMID: 39813063 Free PMC article.
EXPOSURE: Sympathovagal balance of the attending surgeon in the first 5 minutes of surgery. MAIN OUTCOMES AND MEASURES: Major surgical complications, extended intensive care unit stay, and mortality within 30 days, after adjustment via mixed-effects multivari …
EXPOSURE: Sympathovagal balance of the attending surgeon in the first 5 minutes of surgery. MAIN OUTCOMES AND MEASURES: Major …
The portfolio effect: an opportunity for improving handoffs quality in ICU.
Monard C, Carrere J, Abraham P, Cerro V, Polazzi S, Payet C, Rimmelé T, Duclos A. Monard C, et al. Among authors: duclos a. BMC Health Serv Res. 2024 Dec 4;24(1):1544. doi: 10.1186/s12913-024-12007-7. BMC Health Serv Res. 2024. PMID: 39633382 Free PMC article.
METHODS: Two research assistants observed the morning handoffs in two ICUs (ICU-1, a 20-bed trauma and surgical ICU and ICU-2 a 10-bed medical and surgical ICU) within a university hospital, over a 6-month period. ...
METHODS: Two research assistants observed the morning handoffs in two ICUs (ICU-1, a 20-bed trauma and surgical ICU and ICU-2 a 10-be …
Risk-adjusted observed minus expected cumulative sum (RA O-E CUSUM) chart for visualisation and monitoring of surgical outcomes.
Cordier Q, Prieur H, Duclos A; Top Surgeons Study Group. Cordier Q, et al. Among authors: duclos a. BMJ Qual Saf. 2025 Apr 17;34(5):330-338. doi: 10.1136/bmjqs-2024-017935. BMJ Qual Saf. 2025. PMID: 39586610 Free PMC article.
These tools belong to a broad family, making it challenging to identify the most suitable methodology to monitor surgical outcomes. The selected tools must balance statistical rigour with surgeon usability, enabling both statistical interpretation of trends over tim …
These tools belong to a broad family, making it challenging to identify the most suitable methodology to monitor surgical outcomes. T …
Surgeon ability to predict physical activity and sedentary time: Comparison of self-reported and measured activity.
Soelling S, Polazzi S, Lifante JC, Dey T, Duclos A. Soelling S, et al. Among authors: duclos a. Surgeon. 2024 Dec;22(6):332-337. doi: 10.1016/j.surge.2024.09.008. Epub 2024 Nov 22. Surgeon. 2024. PMID: 39581639 Free PMC article.
RESULTS: Overall, there were 38 surgeons in the cohort and 8810 surgeries performed. Surgeons were 78.9 % male, median age was 46.1, and median BMI was 24.5. ...Increased awareness is needed to improve surgeon wellness....
RESULTS: Overall, there were 38 surgeons in the cohort and 8810 surgeries performed. Surgeons were 78.9 % male, median …
Safety of inpatient care in surgical settings: cohort study.
Duclos A, Frits ML, Iannaccone C, Lipsitz SR, Cooper Z, Weissman JS, Bates DW. Duclos A, et al. BMJ. 2024 Nov 13;387:e080480. doi: 10.1136/bmj-2024-080480. BMJ. 2024. PMID: 39537329 Free PMC article.
The most common adverse events were related to surgical procedures (n=292, 49.3%), followed by adverse drug events (n=158, 26.6%), healthcare associated infections (n=74, 12.4%), patient care events (n=66, 11.2%), and blood transfusion reactions (n=3, 0.5%). ...CONCLUSIONS …
The most common adverse events were related to surgical procedures (n=292, 49.3%), followed by adverse drug events (n=158, 26.6%), he …
Influence of a surgeon's exposure to operating room turnover delays on patient outcomes.
Pasquer A, Cordier Q, Lifante JC, Poncet G, Polazzi S, Duclos A. Pasquer A, et al. Among authors: duclos a. BJS Open. 2024 Sep 3;8(5):zrae117. doi: 10.1093/bjsopen/zrae117. BJS Open. 2024. PMID: 39405502 Free PMC article.
The aim of this study was to investigate the link between a surgeon's exposure to delays in starting scheduled operations and patient outcomes. METHODS: A prospective observational study was conducted from 1 November 2020 to 31 December 2021, across 14 surgical depa …
The aim of this study was to investigate the link between a surgeon's exposure to delays in starting scheduled operations and patient …
A Familiar Working Environment Influences Surgeon's Stress in the Operating Room: A Multi-Specialty Prospective Cohort Study.
Awtry JA, Skinner SC, Pascal L, Polazzi S, Lifante JC, Duclos A; TopSurgeons Study Group. Awtry JA, et al. Among authors: duclos a. Ann Surg. 2026 Apr 1;283(4):620-627. doi: 10.1097/SLA.0000000000006543. Epub 2024 Oct 1. Ann Surg. 2026. PMID: 39352812 Free PMC article.
OBJECTIVE: To determine the influence of operating room familiarity on surgeon stress. BACKGROUND: Regulating surgeon stress may improve patient safety. This study evaluated how assisting surgeons and operating room familiarity influence intraoperative heart …
OBJECTIVE: To determine the influence of operating room familiarity on surgeon stress. BACKGROUND: Regulating surgeon stress m …
The impact of hospital saturation on non-COVID-19 hospital mortality during the pandemic in France: a national population-based cohort study.
Boyer L, Pauly V, Brousse Y, Orleans V, Tran B, Yon DK, Auquier P, Fond G, Duclos A. Boyer L, et al. Among authors: duclos a. BMC Public Health. 2024 Jul 5;24(1):1798. doi: 10.1186/s12889-024-19282-3. BMC Public Health. 2024. PMID: 38970000 Free PMC article.
BACKGROUND: A previous study reported significant excess mortality among non-COVID-19 patients due to disrupted surgical care caused by resource prioritization for COVID-19 cases in France. The primary objective was to investigate if a similar impact occurred for medical c …
BACKGROUND: A previous study reported significant excess mortality among non-COVID-19 patients due to disrupted surgical care caused …
A time-adjusted control chart for monitoring surgical outcome variations.
Cordier Q, Le Thien MA, Polazzi S, Chollet F, Carty MJ, Lifante JC, Duclos A. Cordier Q, et al. Among authors: duclos a. PLoS One. 2024 May 15;19(5):e0303543. doi: 10.1371/journal.pone.0303543. eCollection 2024. PLoS One. 2024. PMID: 38748637 Free PMC article.
We aimed to demonstrate the value of considering time-related variables in addition to patient case-mix for detection of special cause variations when monitoring surgical outcomes with control charts. METHODS: A retrospective analysis from the French nationwide hospital da …
We aimed to demonstrate the value of considering time-related variables in addition to patient case-mix for detection of special cause varia …
Operating room organization and surgical performance: a systematic review.
Pasquer A, Ducarroz S, Lifante JC, Skinner S, Poncet G, Duclos A. Pasquer A, et al. Among authors: duclos a. Patient Saf Surg. 2024 Jan 29;18(1):5. doi: 10.1186/s13037-023-00388-3. Patient Saf Surg. 2024. PMID: 38287316 Free PMC article. Review.
BACKGROUND: Organizational factors may influence surgical outcomes, regardless of extensively studied factors such as patient preoperative risk and surgical complexity. ...Prioritizing further research on these organizational drivers is key to enhancing surgical …
BACKGROUND: Organizational factors may influence surgical outcomes, regardless of extensively studied factors such as patient preoper …
Intrathoracic eosinophilic sclerosing fibroplasia with intralesional bacteria in a cat.
Duclos AA, Wolfe A, Mooney CT. Duclos AA, et al. JFMS Open Rep. 2023 Nov 1;9(2):20551169231199447. doi: 10.1177/20551169231199447. eCollection 2023 Jul-Dec. JFMS Open Rep. 2023. PMID: 37927535 Free PMC article.
Ultrasound-guided fine-needle aspiration and core-needle biopsy were performed, but cytology and histopathology were inconclusive. Surgical debulking was performed. Further histological samples identified severe pyogranulomatous and eosinophilic fibrosing mediastinitis, co …
Ultrasound-guided fine-needle aspiration and core-needle biopsy were performed, but cytology and histopathology were inconclusive. Surgic …
Association of Hospital Bed Turnover With Patient Outcomes in Digestive Surgery.
Pasquer A, Pascal L, Polazzi S, Skinner S, Poncet G, Lifante JC, Duclos A. Pasquer A, et al. Among authors: duclos a. Ann Surg Open. 2022 Dec 7;3(4):e229. doi: 10.1097/AS9.0000000000000229. eCollection 2022 Dec. Ann Surg Open. 2022. PMID: 37600282 Free PMC article.
To determine the influence of hospital bed turnover rate (BTR) on the occurrence of complications following minor or major digestive surgery. BACKGROUND: Performance improvement in surgery aims at increasing productivity while preventing complications. ...Such diffe …
To determine the influence of hospital bed turnover rate (BTR) on the occurrence of complications following minor or major digestive surg …
Economic analysis of surgical outcome monitoring using control charts: the SHEWHART cluster randomised trial.
Skinner S, Pascal L, Polazzi S, Chollet F, Lifante JC, Duclos A; SHEWHART Trial Group. Skinner S, et al. Among authors: duclos a. BMJ Qual Saf. 2024 Apr 24;33(5):284-292. doi: 10.1136/bmjqs-2022-015390. BMJ Qual Saf. 2024. PMID: 37553238 Free PMC article. Clinical Trial.
IMPORTANCE: Surgical complications represent a considerable proportion of hospital expenses. Therefore, interventions that improve surgical outcomes could reduce healthcare costs. OBJECTIVE: Evaluate the effects of implementing surgical outcome monitoring usi …
IMPORTANCE: Surgical complications represent a considerable proportion of hospital expenses. Therefore, interventions that improve …
Continued Performance Improvement-What Practicing Surgeons Can Learn From Athletes.
Skinner S, Duclos A. Skinner S, et al. Among authors: duclos a. JAMA Surg. 2023 May 1;158(5):439-440. doi: 10.1001/jamasurg.2022.7732. JAMA Surg. 2023. PMID: 36857060
This Viewpoint describes how surgeons can optimize performance with methods for continuous performance improvement used by athletes....
This Viewpoint describes how surgeons can optimize performance with methods for continuous performance improvement used by athletes.. …
Excess mortality among non-COVID-19 surgical patients attributable to the exposure of French intensive and intermediate care units to the pandemic.
Duclos A, Cordier Q, Polazzi S, Colin C, Rimmelé T, Lifante JC, Carty MJ, Boyer L. Duclos A, et al. Intensive Care Med. 2023 Mar;49(3):313-323. doi: 10.1007/s00134-023-07000-3. Epub 2023 Feb 25. Intensive Care Med. 2023. PMID: 36840798 Free PMC article.
We estimated excess surgical mortality potentially attributable to ICU/IMCUs overwhelmed by COVID-19, and any hospital learning effects between two successive pandemic waves. ...CONCLUSION: Significant excess mortality essentially occurred outside of the ICU/IMCU, suggesti …
We estimated excess surgical mortality potentially attributable to ICU/IMCUs overwhelmed by COVID-19, and any hospital learning effec …
Control Charts Usage for Monitoring Performance in Surgery: A Systematic Review.
Le Thien MA, Cordier Q, Lifante JC, Carty MJ, Duclos A. Le Thien MA, et al. Among authors: duclos a. J Patient Saf. 2023 Mar 1;19(2):110-116. doi: 10.1097/PTS.0000000000001103. Epub 2023 Jan 6. J Patient Saf. 2023. PMID: 36603595
A clear assessment of control chart utilization and its potential impact in surgery is required to justify recommendations for its dissemination. This review aims to describe how performance monitoring using control charts was used over time in surgery. ...CONCLUSIO …
A clear assessment of control chart utilization and its potential impact in surgery is required to justify recommendations for its di …
Impact of the COVID-19 pandemic on non-COVID-19 hospital mortality in patients with schizophrenia: a nationwide population-based cohort study.
Boyer L, Fond G, Pauly V, Orléans V, Auquier P, Solmi M, Correll CU, Yon DK, Llorca PM, Baumstarck-Barrau K, Duclos A. Boyer L, et al. Among authors: duclos a. Mol Psychiatry. 2022 Dec;27(12):5186-5194. doi: 10.1038/s41380-022-01803-4. Epub 2022 Oct 7. Mol Psychiatry. 2022. PMID: 36207583 Free PMC article.
This increased mortality was found for poisoning and injury (aOR = 1.26; p = 0.033), respiratory diseases (aOR = 1.19; p = 0.008) and for both surgery (aOR = 1.26; p = 0.008) and medical care settings (aOR = 1.16; p = 0.001). Significant changes in the case mix were noted …
This increased mortality was found for poisoning and injury (aOR = 1.26; p = 0.033), respiratory diseases (aOR = 1.19; p = 0.008) and for bo …
Coaching for Surgeons: A Scoping Review of the Quantitative Evidence.
Skinner SC, Mazza S, Carty MJ, Lifante JC, Duclos A. Skinner SC, et al. Among authors: duclos a. Ann Surg Open. 2022 Jul 8;3(3):e179. doi: 10.1097/AS9.0000000000000179. eCollection 2022 Sep. Ann Surg Open. 2022. PMID: 36199481 Free PMC article.
BACKGROUND: Surgical coaching is gaining attention as an approach that could help surgeons optimize performance and improve overall wellbeing. ...Published studies targeted technical or nontechnical skills, included 2-26 surgeons as coachees, and used coaches …
BACKGROUND: Surgical coaching is gaining attention as an approach that could help surgeons optimize performance and improve ov …
Change in Sleep Quality of Residents the Night Before High-Fidelity Simulation: Results From a Prospective 1-Year National Survey.
Calmettes M, Denoyel L, Duclos A, Lejus-Bourdeau C, Blanié A, Forestier C, Ciceron F, Mattatia L, Buleon C, Damm C, Mahoudeau G, Lehot JJ, Rimmelé T, Lilot M. Calmettes M, et al. Among authors: duclos a. Turk J Anaesthesiol Reanim. 2022 Aug;50(4):295-302. doi: 10.5152/TJAR.2022.21235. Turk J Anaesthesiol Reanim. 2022. PMID: 35979977 Free PMC article.
Safety Attitude of Operating Room Personnel Associated With Accurate Completion of a Surgical Checklist: A Cross-sectional Observational Study.
Sens F, Viprey M, Piriou V, Peix JL, Herquelot E, Occelli P, Bourdy S, Gawande AA, Carty Mj MJ, Michel P, Lifante JC, Colin C, Duclos A; IDILIC Study Group. Sens F, et al. Among authors: duclos a. J Patient Saf. 2022 Aug 1;18(5):449-456. doi: 10.1097/PTS.0000000000000954. Epub 2021 Dec 17. J Patient Saf. 2022. PMID: 35948294
Understanding the surgeon's behaviour during robot-assisted surgery: protocol for the qualitative Behav'Robot study.
Cormi C, Parpex G, Julio C, Ecarnot F, Laplanche D, Vannieuwenhuyse G, Duclos A, Sanchez S. Cormi C, et al. Among authors: duclos a. BMJ Open. 2022 Apr 7;12(4):e056002. doi: 10.1136/bmjopen-2021-056002. BMJ Open. 2022. PMID: 35393313 Free PMC article.
This study aims to describe and understand the behaviour of the surgeons during robot-assisted surgery and the change in their behaviour with increasing experience in using the robot. METHODS AND ANALYSIS: This is a qualitative study using semistructured interviews …
This study aims to describe and understand the behaviour of the surgeons during robot-assisted surgery and the change in their …
Management of Patients with Pancreatic Ductal Adenocarcinoma in the Real-Life Setting: Lessons from the French National Hospital Database.
de la Fouchardière C, Adham M, Marion-Audibert AM, Duclos A, Darcha C, Berthelet O, Hervieu V, Artru P, Labrosse H, Fayet Y, Ferroud-Plattet B, Aublet-Cuvellier B, Chambon G, Baconnier M, Rebischung C, Farsi F, Ray-Coquard I, Mastier C, Ternamian PJ, Williet N, Buc E, Walter T, Herr AL. de la Fouchardière C, et al. Among authors: duclos a. Cancers (Basel). 2021 Jul 14;13(14):3515. doi: 10.3390/cancers13143515. Cancers (Basel). 2021. PMID: 34298729 Free PMC article.
Effect of monitoring surgical outcomes using control charts to reduce major adverse events in patients: cluster randomised trial.
Duclos A, Chollet F, Pascal L, Ormando H, Carty MJ, Polazzi S, Lifante JC; SHEWHART Trial Group. Duclos A, et al. BMJ. 2020 Nov 4;371:m3840. doi: 10.1136/bmj.m3840. BMJ. 2020. PMID: 33148601 Free PMC article. Clinical Trial.
SETTING: 40 surgical departments of hospitals across France. PARTICIPANTS: 155 362 adults who underwent digestive tract surgery. 20 of the surgical departments were randomised to prospective monitoring of outcomes using control charts with regular feedback on …
SETTING: 40 surgical departments of hospitals across France. PARTICIPANTS: 155 362 adults who underwent digestive tract surgery …
High-dimensional propensity scores improved the control of indication bias in surgical comparative effectiveness studies.
Payet C, Polazzi S, Obadia JF, Armoiry X, Labarère J, Rabilloud M, Duclos A. Payet C, et al. Among authors: duclos a. J Clin Epidemiol. 2021 Feb;130:78-86. doi: 10.1016/j.jclinepi.2020.10.003. Epub 2020 Oct 14. J Clin Epidemiol. 2021. PMID: 33065165
OBJECTIVES: The objective of the study is to evaluate the performance of high-dimensional propensity scores (hdPSs) for controlling indication bias as compared with propensity scores (PSs) in surgical comparative effectiveness studies. STUDY DESIGN AND SETTING: Patients wh …
OBJECTIVES: The objective of the study is to evaluate the performance of high-dimensional propensity scores (hdPSs) for controlling indicati …
Influence of Care Pathway on Thyroid Nodule Surgery Relevance: A Historical Cohort Study.
Castellnou S, Lifante JC, Polazzi S, Pascal L, Borson-Chazot F, Duclos A. Castellnou S, et al. Among authors: duclos a. J Clin Med. 2020 Jul 17;9(7):2271. doi: 10.3390/jcm9072271. J Clin Med. 2020. PMID: 32708905 Free PMC article.
BACKGROUND: Guidelines recommend using fine-needle aspiration cytology (FNAC) to guide thyroid nodule surgical indication. However, the extent to which these guidelines are followed remains unclear. ...Increasing the year for surgery was associated with optimal care …
BACKGROUND: Guidelines recommend using fine-needle aspiration cytology (FNAC) to guide thyroid nodule surgical indication. However, t …
Reoperation Incidence and Severity Within 6 Months After Bariatric Surgery: a Propensity-Matched Study from Nationwide Data.
Brunaud L, Payet C, Polazzi S, Bihain F, Quilliot D, Lifante JC, Duclos A. Brunaud L, et al. Among authors: duclos a. Obes Surg. 2020 Sep;30(9):3378-3386. doi: 10.1007/s11695-020-04570-9. Obes Surg. 2020. PMID: 32367174
BACKGROUND: Data about incidence and severity of reoperations up to 6 months after bariatric surgery are currently limited. The aim of this cohort study was to evaluate the incidence and severity of reoperations after initial bariatric surgical procedures and to com …
BACKGROUND: Data about incidence and severity of reoperations up to 6 months after bariatric surgery are currently limited. The aim o …
Influence of trends in hospital volume over time on patient outcomes for high-risk surgery.
Payet C, Polazzi S, Lifante JC, Cotte E, Grinberg D, Carty MJ, Sanchez S, Rabilloud M, Duclos A. Payet C, et al. Among authors: duclos a. BMC Health Serv Res. 2020 Apr 1;20(1):274. doi: 10.1186/s12913-020-05126-4. BMC Health Serv Res. 2020. PMID: 32238160 Free PMC article.
We aimed to study this concept by investigating whether patient outcomes improve in hospitals with a significantly increased volume of high-risk surgery over time and whether a learning effect existed at the individual hospital level. ...
We aimed to study this concept by investigating whether patient outcomes improve in hospitals with a significantly increased volume of high- …
Influence of Daily Variations in Individual Surgeon's Operative Time on Patient Outcomes.
Meunier E, Payet C, Peix JL, Kraimps JL, Menegaux F, Pattou F, Sebag F, Lifante JC, Duclos A; CATHY study group. Meunier E, et al. Among authors: duclos a. World J Surg. 2019 Nov;43(11):2720-2727. doi: 10.1007/s00268-019-05081-0. World J Surg. 2019. PMID: 31312949
BACKGROUND: Evidence is lacking regarding the potential association between daily variation in individual surgeon's operative time, procedure after procedure, and risk of patient complication. ...CONCLUSION: Patients had a greater risk of complication when the surgeon …
BACKGROUND: Evidence is lacking regarding the potential association between daily variation in individual surgeon's operative time, p …
Impact of Enhanced Recovery Program after Surgery in Patients Undergoing Pancreatectomy on Postoperative Outcomes: A Controlled before and after Study.
Perinel J, Duclos A, Payet C, Bouffard Y, Lifante JC, Adham M. Perinel J, et al. Among authors: duclos a. Dig Surg. 2020;37(1):47-55. doi: 10.1159/000496510. Epub 2019 Feb 22. Dig Surg. 2020. PMID: 30799401 Clinical Trial.
BACKGROUND: Implementation of enhanced recovery after surgery (ERAS) program after pancreatic surgery was associated with decreased length of stay (LOS). ...
BACKGROUND: Implementation of enhanced recovery after surgery (ERAS) program after pancreatic surgery was associated with decr …
Hospital Length of Stay Reduction Over Time and Patient Readmission for Severe Adverse Events Following Surgery.
Pascal L, Polazzi S, Piriou V, Cotte E, Wegrzyn J, Carty MJ, Chollet F, Sanchez S, Lifante JC, Duclos A. Pascal L, et al. Among authors: duclos a. Ann Surg. 2020 Jul;272(1):105-112. doi: 10.1097/SLA.0000000000003206. Ann Surg. 2020. PMID: 30676380
SUMMARY BACKGROUND DATA: Surgical care innovation has encouraged hospitals to shorten LOS under financial pressures with uncertain impact on patient outcomes. ...Development of care bundles to enhance recovery after emergency surgeries may allow better control of LO …
SUMMARY BACKGROUND DATA: Surgical care innovation has encouraged hospitals to shorten LOS under financial pressures with uncertain im …
Unexpected discrepancies in hospital administrative databases can impact the accuracy of monitoring thyroid surgery outcomes in France.
Mercier F, Laplace N, Mitmaker EJ, Colin C, Kraimps JL, Sebag F, Bourdy S, Duclos A, Lifante JC; CATHY Study Group. Mercier F, et al. Among authors: duclos a. PLoS One. 2018 Dec 6;13(12):e0208416. doi: 10.1371/journal.pone.0208416. eCollection 2018. PLoS One. 2018. PMID: 30521574 Free PMC article.
OBJECTIVE: To determine the validity of hospital administrative databases compared to prospective collection of medical data assessing thyroid surgery complications. BACKGROUND: Administrative data are increasingly used to track surgical outcomes. METHODS: All patie …
OBJECTIVE: To determine the validity of hospital administrative databases compared to prospective collection of medical data assessing thyro …
Serum Concentrations of Lidocaine During Bariatric Surgery.
Carabalona JF, Delwarde B, Duclos A, Le Goff MC, Moulsma M, Citterio-Quentin A, Bouffard Y, Rimmelé T. Carabalona JF, et al. Among authors: duclos a. Anesth Analg. 2020 Jan;130(1):e5-e8. doi: 10.1213/ANE.0000000000003905. Anesth Analg. 2020. PMID: 30399021 Clinical Trial.
Lidocaine has been shown to be clinically beneficial during bariatric surgery. However, information about lidocaine serum concentrations in this setting is scarce. This prospective clinical trial included 42 obese patients undergoing laparoscopic bariatric surgery. …
Lidocaine has been shown to be clinically beneficial during bariatric surgery. However, information about lidocaine serum concentrati …
Comparison of transcatheter versus surgical aortic valve implantation in high-risk patients: A nationwide study in France.
Armoiry X, Obadia JF, Pascal L, Polazzi S, Duclos A. Armoiry X, et al. Among authors: duclos a. J Thorac Cardiovasc Surg. 2018 Sep;156(3):1017-1025.e4. doi: 10.1016/j.jtcvs.2018.02.092. Epub 2018 Apr 7. J Thorac Cardiovasc Surg. 2018. PMID: 29764686 Free article.
OBJECTIVE: To compare the clinical outcomes and direct costs at 5 years between transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) using real-world evidence. METHODS: We performed a nationwide longitudinal study using data from the …
OBJECTIVE: To compare the clinical outcomes and direct costs at 5 years between transcatheter aortic valve implantation (TAVI) and surgic …
Health Care Institutions Volume Is Significantly Associated with Postoperative Outcomes in Bariatric Surgery.
Brunaud L, Polazzi S, Lifante JC, Pascal L, Nocca D, Duclos A. Brunaud L, et al. Among authors: duclos a. Obes Surg. 2018 Apr;28(4):923-931. doi: 10.1007/s11695-017-2969-y. Obes Surg. 2018. PMID: 29039053
PURPOSE: The volume of bariatric surgery has significantly increased over the past decade with concomitant postoperative outcomes improvement. The goal of this nationwide study was to estimate the volume-outcome relationship in bariatric surgery at the hospital leve …
PURPOSE: The volume of bariatric surgery has significantly increased over the past decade with concomitant postoperative outcomes imp …
Determinants of operative time in thyroid surgery: A prospective multicenter study of 3454 thyroidectomies.
Patoir A, Payet C, Peix JL, Colin C, Pascal L, Kraimps JL, Menegaux F, Pattou F, Sebag F, Touzet S, Bourdy S, Lifante JC, Duclos A; CATHY Study Group. Patoir A, et al. Among authors: duclos a. PLoS One. 2017 Jul 27;12(7):e0181424. doi: 10.1371/journal.pone.0181424. eCollection 2017. PLoS One. 2017. PMID: 28750022 Free PMC article.
The operative time of 3454 patients who underwent thyroidectomy performed by 28 surgeons in five academic hospitals was monitored. We used multilevel linear regression to model determinants of operative time while accounting for the interplay of characteristics specific to …
The operative time of 3454 patients who underwent thyroidectomy performed by 28 surgeons in five academic hospitals was monitored. We …
Methodological Quality of Surgical Mortality Studies Using Large Hospital Databases: A Systematic Review.
Payet C, Lifante JC, Carty MJ, Rabilloud M, Duclos A. Payet C, et al. Among authors: duclos a. Ann Surg. 2017 Jun;265(6):1113-1118. doi: 10.1097/SLA.0000000000002119. Ann Surg. 2017. PMID: 28027060
OBJECTIVE: To review the methodology employed in surgical mortality studies to control for potential confounders. SUMMARY BACKGROUND DATA: Nationwide hospital data are increasingly used to investigate surgical outcomes. ...RESULTS: Among 89 included studies from 198 …
OBJECTIVE: To review the methodology employed in surgical mortality studies to control for potential confounders. SUMMARY BACKGROUND …
Can we consider immediate complications after thyroidectomy as a quality metric of operation?
Lifante JC, Payet C, Ménégaux F, Sebag F, Kraimps JL, Peix JL, Pattou F, Colin C, Duclos A; CATHY Study Group. Lifante JC, et al. Among authors: duclos a. Surgery. 2017 Jan;161(1):156-165. doi: 10.1016/j.surg.2016.04.049. Epub 2016 Nov 17. Surgery. 2017. PMID: 27866716
Assuming that the rate of immediate complications can predict the permanent complication rate, some authors consider these complications as a valid metric for assessing the performance of individual surgeons. This study aimed to determine the correlation between rates of i …
Assuming that the rate of immediate complications can predict the permanent complication rate, some authors consider these complications as …
The impact of team familiarity and surgical experience on operative efficiency: a retrospective analysis.
Maruthappu M, Duclos A, Zhou CD, Lipsitz SR, Wright J, Orgill D, Carty MJ. Maruthappu M, et al. Among authors: duclos a. J R Soc Med. 2016 Apr;109(4):147-53. doi: 10.1177/0141076816634317. Epub 2016 Apr 6. J R Soc Med. 2016. PMID: 27053357 Free PMC article.
OBJECTIVES: The independent impact of individual surgical experience and team familiarity on surgical performance has been widely studied; however, the interplay of these factors and their relative, quantified, contributions to performance is poorly understood. ...R …
OBJECTIVES: The independent impact of individual surgical experience and team familiarity on surgical performance has been wid …
Elderly patients hospitalized in the ICU in France: a population-based study using secondary data from the national hospital discharge database.
Fassier T, Duclos A, Abbas-Chorfa F, Couray-Targe S, West TE, Argaud L, Colin C. Fassier T, et al. Among authors: duclos a. J Eval Clin Pract. 2016 Jun;22(3):378-86. doi: 10.1111/jep.12497. Epub 2015 Dec 29. J Eval Clin Pract. 2016. PMID: 26711152
The median time spent in the ICU was 3 [interquartile range (IQR), 2-8] days, the median time spent in hospital was 14 (IQR, 8-24) days and 9% of hospitalizations ended by the patient's death involved intensive care. A surgical procedure was included in 43% of hospitalizat …
The median time spent in the ICU was 3 [interquartile range (IQR), 2-8] days, the median time spent in hospital was 14 (IQR, 8-24) days and …
Increased Mortality for Elective Surgery during Summer Vacation: A Longitudinal Analysis of Nationwide Data.
Caillet P, Payet C, Polazzi S, Carty MJ, Lifante JC, Duclos A. Caillet P, et al. Among authors: duclos a. PLoS One. 2015 Sep 25;10(9):e0137754. doi: 10.1371/journal.pone.0137754. eCollection 2015. PLoS One. 2015. PMID: 26407191 Free PMC article.
Surgical safety during vacation periods may be influenced by the interplay of several factors, including workers' leave, hospital activity, climate, and the variety of patient cases. This study aimed to highlight an annually recurring peak of surgical mortality duri …
Surgical safety during vacation periods may be influenced by the interplay of several factors, including workers' leave, hospital act …
Acute Cholecystitis-Optimal Timing for Early Cholecystectomy: a French Nationwide Study.
Polo M, Duclos A, Polazzi S, Payet C, Lifante JC, Cotte E, Barth X, Glehen O, Passot G. Polo M, et al. Among authors: duclos a. J Gastrointest Surg. 2015 Nov;19(11):2003-10. doi: 10.1007/s11605-015-2909-x. Epub 2015 Aug 12. J Gastrointest Surg. 2015. PMID: 26264362
To reduce morbidity and mortality, guidelines recommend early cholecystectomy. However, the optimal timing for surgery on first admission remains controversial. This study aims to determine the best timing for cholecystectomy in patients presenting with acute calculous cho …
To reduce morbidity and mortality, guidelines recommend early cholecystectomy. However, the optimal timing for surgery on first admis …
Surgical risks associated with winter sport tourism.
Sanchez S, Payet C, Lifante JC, Polazzi S, Chollet F, Carty MJ, Duclos A. Sanchez S, et al. Among authors: duclos a. PLoS One. 2015 May 13;10(5):e0124644. doi: 10.1371/journal.pone.0124644. eCollection 2015. PLoS One. 2015. PMID: 25970625 Free PMC article.
After identifying mountain areas with increasing volume of surgical stays during winter, we considered seasonal variations in surgical outcomes using a difference-in-differences study design. We computed multilevel regressions to evaluate whether significant increas …
After identifying mountain areas with increasing volume of surgical stays during winter, we considered seasonal variations in surg …
Qualité en chirurgie thyroidienne: Critères d'évaluation et applications pratiques.
Peix JL, Duclos A, Lifante JC. Peix JL, et al. Among authors: duclos a. Bull Acad Natl Med. 2015 Apr-May;199(4-5):629-38. Bull Acad Natl Med. 2015. PMID: 27509683 French.
We used these 3 types of indicators to assess the quality of thyroid surgery and to evaluate quality indicators. These studies allowed us to demonstrate the importance of a permanent monitoring of the outcomes of the thyroid surgery and the presence of human and org …
We used these 3 types of indicators to assess the quality of thyroid surgery and to evaluate quality indicators. These studies allowe …
Surgical learning curves and operative efficiency: a cross-specialty observational study.
Maruthappu M, Duclos A, Lipsitz SR, Orgill D, Carty MJ. Maruthappu M, et al. Among authors: duclos a. BMJ Open. 2015 Mar 13;5(3):e006679. doi: 10.1136/bmjopen-2014-006679. BMJ Open. 2015. PMID: 25770229 Free PMC article.
Multivariate generalised estimating equation (GEE) regression models were used to adjust for patient risk and clustering of procedures by surgeon. PRIMARY OUTCOME MEASURE: Operative efficiency. RESULTS: A total of 1052 BRMs, 3254 CABGs and 3325 TKRs performed by 30 surg …
Multivariate generalised estimating equation (GEE) regression models were used to adjust for patient risk and clustering of procedures by …
The influence of volume and experience on individual surgical performance: a systematic review.
Maruthappu M, Gilbert BJ, El-Harasis MA, Nagendran M, McCulloch P, Duclos A, Carty MJ. Maruthappu M, et al. Among authors: duclos a. Ann Surg. 2015 Apr;261(4):642-7. doi: 10.1097/SLA.0000000000000852. Ann Surg. 2015. PMID: 25072442
OBJECTIVE: To systematically review studies evaluating the influence of surgical experience on individual performance. BACKGROUND: Experience, measured in case volume or years of practice, is recognized as a key driver of individual surgical performance, giving rise …
OBJECTIVE: To systematically review studies evaluating the influence of surgical experience on individual performance. BACKGROUND: Ex …
Patient- and surgeon-adjusted control charts for monitoring performance.
Maruthappu M, Carty MJ, Lipsitz SR, Wright J, Orgill D, Duclos A. Maruthappu M, et al. Among authors: duclos a. BMJ Open. 2014 Jan 16;4(1):e004046. doi: 10.1136/bmjopen-2013-004046. BMJ Open. 2014. PMID: 24440796 Free PMC article.
Charts were tested by monitoring four other surgeons, performing an average of 389 procedures each. Adjustment for surgeon experience significantly altered the interpretation of operative efficiency (kappa=0.29 (95% CI 0.11 to 0.47)), and enhanced assessment of a …
Charts were tested by monitoring four other surgeons, performing an average of 389 procedures each. Adjustment for surgeon exp …
Temporal variation in surgical mortality within French hospitals.
Duclos A, Polazzi S, Lipsitz SR, Couray-Targe S, Gawande AA, Colin C, Berry W, Ayanian JZ, Carty MJ. Duclos A, et al. Med Care. 2013 Dec;51(12):1085-93. doi: 10.1097/MLR.0b013e3182a97c54. Med Care. 2013. PMID: 24231784
BACKGROUND: Surgical mortality varies widely across hospitals, but the degree of temporal variation within individual hospitals remains unexplored and may reflect unsafe care. ...CONCLUSIONS: Dynamic monitoring of outcomes within every hospital may detect safety issues ear …
BACKGROUND: Surgical mortality varies widely across hospitals, but the degree of temporal variation within individual hospitals remai …
A monitoring tool for performance improvement in plastic surgery at the individual level.
Maruthappu M, Duclos A, Orgill D, Carty MJ. Maruthappu M, et al. Among authors: duclos a. Plast Reconstr Surg. 2013 May;131(5):702e-710e. doi: 10.1097/PRS.0b013e3182865a0c. Plast Reconstr Surg. 2013. PMID: 23629109
BACKGROUND: The assessment of performance in surgery is expanding significantly. Application of relevant frameworks to plastic surgery, however, has been limited. ...The sensitivity and accuracy of these charts were significantly improved by adjustment for case mix …
BACKGROUND: The assessment of performance in surgery is expanding significantly. Application of relevant frameworks to plastic sur …
The teaming curve: a longitudinal study of the influence of surgical team familiarity on operative time.
Xu R, Carty MJ, Orgill DP, Lipsitz SR, Duclos A. Xu R, et al. Among authors: duclos a. Ann Surg. 2013 Dec;258(6):953-7. doi: 10.1097/SLA.0b013e3182864ffe. Ann Surg. 2013. PMID: 23407297
OBJECTIVE: To quantify the association between surgical team familiarity and operative time. BACKGROUND: Team familiarity in the operating room may influence outcomes irrespective of individual surgeons' experience. ...METHODS: We studied 754 bilateral reduction mam …
OBJECTIVE: To quantify the association between surgical team familiarity and operative time. BACKGROUND: Team familiarity in the oper …
Cumulative team experience matters more than individual surgeon experience in cardiac surgery.
Elbardissi AW, Duclos A, Rawn JD, Orgill DP, Carty MJ. Elbardissi AW, et al. Among authors: duclos a. J Thorac Cardiovasc Surg. 2013 Feb;145(2):328-33. doi: 10.1016/j.jtcvs.2012.09.022. Epub 2012 Oct 18. J Thorac Cardiovasc Surg. 2013. PMID: 23083794 Free article.
OBJECTIVES: Individual surgeon experience and the cumulative experience of the surgical team have both been implicated as factors that influence surgical efficiency. ...The influence of attending-fellow pair experience far exceeded the influence of surgica …
OBJECTIVES: Individual surgeon experience and the cumulative experience of the surgical team have both been implicated as fact …
Development of a charting method to monitor the individual performance of surgeons at the beginning of their career.
Duclos A, Carty MJ, Peix JL, Colin C, Lipsitz SR, Kraimps JL, Menegaux F, Pattou F, Sebag F, Voirin N, Touzet S, Bourdy S, Lifante JC; CATHY Study Group. Duclos A, et al. PLoS One. 2012;7(7):e41944. doi: 10.1371/journal.pone.0041944. Epub 2012 Jul 31. PLoS One. 2012. PMID: 22860036 Free PMC article.
To simulate prospective monitoring of individual surgeon outcomes, the testing data were plotted on funnel plots and cumulative sum charts (CUSUM). ...Charts interpretation revealed that a very young surgeon had better outcomes than expected, whereas a more experien …
To simulate prospective monitoring of individual surgeon outcomes, the testing data were plotted on funnel plots and cumulative sum c …
Patient satisfaction and surgeon experience: a follow-up to the reduction mammaplasty learning curve study.
Carty MJ, Duclos A, Gu X, Elele N, Orgill D. Carty MJ, et al. Among authors: duclos a. Eplasty. 2012;12:e22. Epub 2012 May 4. Eplasty. 2012. PMID: 22582119 Free PMC article.
BACKGROUND: While it is known that increasing surgeon experience is correlated with improved efficiency and safety in the reduction mammaplasty procedure, it is unclear whether these improvements lead to an erosion in patient satisfaction. ...CONCLUSIONS: Gains in operativ …
BACKGROUND: While it is known that increasing surgeon experience is correlated with improved efficiency and safety in the reduction m …
Technical refinement and learning curve for attenuating neurapraxia during robotic-assisted radical prostatectomy to improve sexual function.
Alemozaffar M, Duclos A, Hevelone ND, Lipsitz SR, Borza T, Yu HY, Kowalczyk KJ, Hu JC. Alemozaffar M, et al. Among authors: duclos a. Eur Urol. 2012 Jun;61(6):1222-8. doi: 10.1016/j.eururo.2012.02.053. Epub 2012 Mar 8. Eur Urol. 2012. PMID: 22425427
DESIGN, SETTING, AND PARTICIPANTS: We performed a retrospective study of 400 consecutive RARPs, categorized into groups of 50, performed after elimination of continuous surgeon/assistant neurovascular bundle countertraction. SURGICAL PROCEDURE: Our approach to RARP …
DESIGN, SETTING, AND PARTICIPANTS: We performed a retrospective study of 400 consecutive RARPs, categorized into groups of 50, performed aft …
Influence of experience on performance of individual surgeons in thyroid surgery: prospective cross sectional multicentre study.
Duclos A, Peix JL, Colin C, Kraimps JL, Menegaux F, Pattou F, Sebag F, Touzet S, Bourdy S, Voirin N, Lifante JC; CATHY Study Group. Duclos A, et al. BMJ. 2012 Jan 10;344:d8041. doi: 10.1136/bmj.d8041. BMJ. 2012. PMID: 22236412 Free PMC article.
OBJECTIVE: To determine the association between surgeons' experience and postoperative complications in thyroid surgery. DESIGN: Prospective cross sectional multicentre study. ...CONCLUSIONS: Optimum individual performance in thyroid surgery cannot be passive …
OBJECTIVE: To determine the association between surgeons' experience and postoperative complications in thyroid surgery. DESIG …
Impact of a multifaceted program to prevent postoperative delirium in the elderly: the CONFUCIUS stepped wedge protocol.
Mouchoux C, Rippert P, Duclos A, Fassier T, Bonnefoy M, Comte B, Heitz D, Colin C, Krolak-Salmon P. Mouchoux C, et al. Among authors: duclos a. BMC Geriatr. 2011 May 18;11:25. doi: 10.1186/1471-2318-11-25. BMC Geriatr. 2011. PMID: 21592324 Free PMC article. Clinical Trial.
METHOD/DESIGN: Study design is a stepped wedge cluster randomized trial within 3 surgical wards of three French university hospitals. All patients aged 75 and older, and admitted for scheduled surgery will be included. ...The primary outcome is based on postoperativ …
METHOD/DESIGN: Study design is a stepped wedge cluster randomized trial within 3 surgical wards of three French university hospitals. …
Influence of intraoperative neuromonitoring on surgeons' technique during thyroidectomy.
Duclos A, Lifante JC, Ducarroz S, Soardo P, Colin C, Peix JL. Duclos A, et al. World J Surg. 2011 Apr;35(4):773-8. doi: 10.1007/s00268-011-0963-4. World J Surg. 2011. PMID: 21267565
RESULTS: A total of 475 consecutive patients who underwent thyroid surgery with IONM were included. The pattern of learning curves varied among surgeons and ranged from 35 to 304 procedures required for complete IONM acquisition. ...CONCLUSIONS: Intraoperative nerve …
RESULTS: A total of 475 consecutive patients who underwent thyroid surgery with IONM were included. The pattern of learning curves va …
Crude versus case-mix-adjusted control charts for safety monitoring in thyroid surgery.
Duclos A, Voirin N, Touzet S, Soardo P, Schott AM, Colin C, Peix JL, Lifante JC. Duclos A, et al. Qual Saf Health Care. 2010 Dec;19(6):e17. doi: 10.1136/qshc.2008.031799. Epub 2010 Apr 8. Qual Saf Health Care. 2010. PMID: 20378622
This study aimed to compare the detection of indicator variations between crude and case-mix-adjusted control charts using data from thyroid surgeries. METHODS: The study population included each patient who underwent thyroid surgery in a teaching hospital from Janu …
This study aimed to compare the detection of indicator variations between crude and case-mix-adjusted control charts using data from thyroid …