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Copyright of Canadian Journal of Surgery is the property of CMA Impact Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Surgery is the property of CMA Impact Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Examines the epidemiology of acute appendicitis in Ontario. Age and sex of patients; Length of hospital stay; Incidence and seasonal variation of acute appendicitis.

Peripheral artery disease (PAD) refers to atherosclerotic narrowing of the noncardiac, noncranial peripheral arteries. It affects more than 200 million people worldwide and is associated with substantial cardiovascular morbidity, mortality [...], Indigenous Canadians experience a disproportionate burden of chronic atherosclerotic diseases, including peripheral artery disease (PAD). Despite an estimated prevalence of 800 000 patients with PAD in Canada, the burden of the disease among Indigenous Canadians is unclear. Available evidence suggests that this population has a higher prevalence of several major risk factors associated with PAD (diabetes, smoking and kidney disease). Unique socioeconomic, geographic and systemic obstacles affecting Indigenous Canadians' health and health care access may worsen chronic disease outcomes. Little is known about the cardiovascular and limb outcomes of Indigenous peoples with PAD. A novel approach via multidisciplinary vascular health teams engaging Indigenous communities in a culturally competent manner may potentially provide optimal vascular care to this population. Further research into the prevalence and outcomes of PAD among Indigenous Canadians is necessary to define the problem and allow development of more effective initiatives to alleviate the disease burden in this marginalized group. Au Canada, les membres des communautes autochtones sont affectes de maniere disproportionnee par les maladies atherosclereuses chroniques, y compris par l'arterio pa thie peripherique (AP). Malgre une prevalence estimee de 800 000 patients atteints d'AP au Canada, on ignore quel est le fardeau de la maladie chez les membres des communautes autochtones. Selon les donnees accessibles, cette population presente une prevalence plus elevee de plusieurs facteurs de risque majeurs associe a l'AP (diabete, tabagisme et maladie renale). Certains obstacles socioeconomiques, geographiques et systemiques particuliers nuisent aussi a leur sante et leur com pliquent l'acces aux soins de sante, ce qui pourrait aggraver les repercussions des maladies chroniques. On en sait peu sur l'issue des problemes cardiovasculaires et circulatoires peripheriques chez les membres des communautes autochtones touches par l'AP. Une approche nouvelle, impliquant les communautes concernees et offerte de maniere culturellement competente par des equipes de sante vasculaire multidisciplinaires, serait propice a la prestation de soins vasculaires optimaux. Il faudra approfondir la recherche sur la prevalence et l'issue de l'AP chez les membres des communautes autochtones pour cerner le probleme et permettre la mise en place d'initiatives plus efficaces afin d'alleger le fardeau de la maladie dans ce groupe marginalise.

Hospital readmission following major surgery is common and expensive and can serve as a marker for quality of care provided. In 2004, nearly 1 in 5 Medicare beneficiaries were readmitted [...], Background: Rates of hospital readmission following surgery can serve as a marker for quality of care. The aim of this study was to establish the rates and causes of readmission and emergency department visits after vascular surgery and to understand how these patients are managed. Methods: We conducted a prospective observational cohort study including all in patients who underwent major vascular surgery between September 2015 and June 2016 at a tertiary vascular care centre in Toronto. Patients were followed at 30 days after discharge via telephone interview. Results: We enrolled 133 patients (94 men [70.7%] and 39 women [29.3%] with a mean age of 65.3 years). The most common index admission diagnosis was peripheral artery disease (67 patients [50.4%]). At 30 days, 19 patients (14.8%) had been readmitted or had visited the emergency department, most commonly after lower extremity revascularization (19.4%). Ten patients were readmitted a mean of 16.8 days following discharge; surgical site infection was the most common cause for readmission (3 patients). The most common treatment was antimicrobial therapy (4 patients). The mean hospital length of stay was 14.4 days. Nine patients presented to the emergency department a mean of 10.6 days after discharge; 6 reported a wound issue, and most (6 of 9) were managed with oral antibiotic treatment. Conclusion: Early readmission/emergency department visits after lower extremity revascularization surgery in patients with peripheral artery disease are common and are often due to surgical site infection or wound-related issues. Follow-up within 7-10 days and a specialized wound care team may help reduce the occurrence of these events. Contexte : Les taux de readmission a l'hopital apres une chirurgie peuvent servir d'indicateur de la qualite des soins. L'etude visait a determiner les taux et les causes de readmissions et de visites a l'urgence chez les patients ayant subi une chirurgie vasculaire et a etudier la facon dont ces patients etaient pris en charge. Methodes : Nous avons mene une etude de cohorte observationnelle prospective portant sur tous les patients qui ont ete hospitalises pour une importante chirurgie vasculaire entre septembre 2015 et juin 2016 dans un centre de soins tertiaires vasculaires a Toronto. Nous avons fait un suivi telephonique aupres de ces patients 30 jours apres leur conge. Resultats : Nous avons recrute 133 patients (94 hommes [70,7 %] et 39 femmes [29,3 %] dont l'age moyen etait de 65,3 ans). Le diagnostic le plus courant a l'admission initiale etait la maladie arterielle peripherique (67 patients [50,4 %]). A 30 jours, 19 patients (14,8 %) avaient ete rehospitalises ou s'etaient presentes a l'urgence; la plupart avaient initialement subi une revascularisation des membres inferieurs (19,4 %). Dix patients ont ete rehospitalises en moyenne 16,8 jours apres leur conge; l'infection du site operatoire etait la cause la plus courante de readmission (3 patients). Le traitement le plus courant chez les patients rehospitalises etait le traite ment antimicrobien (4 patients). La duree mediane des sejours a l'hopital etait de 14,4 jours. Neuf patients se sont presentes a l'urgence en moyenne 10,6 jours apres leur conge; 6 ont signale un probleme avec leur plaie, et la majorite (6 des 9 patients) ont recu une antibiotherapie orale. Conclusion : Les readmissions ou les visites a l'urgence de patients atteints d'une maladie arterielle peripherique peu apres une chirurgie de revascularisation des membres inferieurs sont courantes et souvent attribuables a une infection du site operatoire ou a des problemes associes a la plaie. Un suivi apres 7 a 10 jours ainsi que les services d'une equipe specialisee en soin des plaies pourraient contribuer a reduire la frequence de ce type d'evenement.