American journal of surgery Impact Factor & Information

Publisher: Elsevier

Journal description

Current impact factor: 2.41

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 2.406
2012 Impact Factor 2.516
2011 Impact Factor 2.776
2010 Impact Factor 2.68
2009 Impact Factor 2.363
2008 Impact Factor 2.605
2007 Impact Factor 2.337
2006 Impact Factor 2.101
2005 Impact Factor 1.924
2004 Impact Factor 2.349
2003 Impact Factor 2.183
2002 Impact Factor 1.758
2001 Impact Factor 2.131
2000 Impact Factor 2.116
1999 Impact Factor 1.721
1998 Impact Factor 1.874
1997 Impact Factor 2.174
1996 Impact Factor 2.302
1995 Impact Factor 1.954
1994 Impact Factor 1.927
1993 Impact Factor 2.23
1992 Impact Factor 2.168

Impact factor over time

Impact factor

Additional details

5-year impact 0.00
Cited half-life 0.00
Immediacy index 0.46
Eigenfactor 0.03
Article influence 0.83
ISSN 1879-1883

Publisher details


  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Pre-print allowed on any website or open access repository
    • Voluntary deposit by author of authors post-print allowed on authors' personal website, or institutions open scholarly website including Institutional Repository, without embargo, where there is not a policy or mandate
    • Deposit due to Funding Body, Institutional and Governmental policy or mandate only allowed where separate agreement between repository and the publisher exists.
    • Permitted deposit due to Funding Body, Institutional and Governmental policy or mandate, may be required to comply with embargo periods of 12 months to 48 months .
    • Set statement to accompany deposit
    • Published source must be acknowledged
    • Must link to journal home page or articles' DOI
    • Publisher's version/PDF cannot be used
    • Articles in some journals can be made Open Access on payment of additional charge
    • NIH Authors articles will be submitted to PubMed Central after 12 months
    • Publisher last contacted on 18/10/2013
  • Classification
    ​ green

Publications in this journal

  • American journal of surgery 05/2015; 210(1). DOI:10.1016/j.amjsurg.2015.05.001
  • American journal of surgery 05/2015; DOI:10.1016/j.amjsurg.2015.01.030
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    ABSTRACT: Patients presenting with ventral hernia-related obstruction are commonly managed with emergent ventral hernia repair (VHR). Selected patients with resolution of obstruction may be managed in a delayed manner. This study sought to assess the effect of delay on VHR outcomes. The American College of Surgeons' National Surgical Quality Improvement Program database from 2005 to 2011 was queried using diagnosis codes for ventral hernia with obstruction. Those who underwent repair over 24 hours after admission were classified as delayed repair. Preoperative comorbid conditions, American Society of Anesthesiology (ASA) scores, and 30-day outcomes were evaluated. We identified 16,881 patients with a mean age of 58 ± 15 years and body mass index of 36 ± 10. Delayed repair occurred in 27.7% of the patients. After controlling for comorbidities and ASA score, delayed VHR was independently associated with mortality (odds ratio [OR] 1.9, 95% confidence interval [CI] 1.41 to 2.48, P < .001), morbidity (OR 1.4, 95% CI 1.24 to 1.50, P < .001), surgical site infection (OR 1.2, 95% CI 1.03 to 1.35, P = .016), and concurrent bowel resection (OR 1.2, 95% CI 1.03 to 1.34, P = .016). VHR for obstructed patients is frequently performed over 24 hours after admission. After adjusting for comorbid conditions and ASA score, delayed VHR is independently associated with worse outcomes. Prompt repair after appropriate resuscitation should be the management of choice. Copyright © 2015 Elsevier Inc. All rights reserved.
    American journal of surgery 05/2015; DOI:10.1016/j.amjsurg.2015.03.015
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    ABSTRACT: To date, the incidence and clinical relevance of arterial stenosis at clamp sites after femoropopliteal bypass surgery is unknown. Ninety-four patients underwent a femoropopliteal bypass in which the arterial inflow and outflow clamp sites were controlled by the Fogarty-Soft-Inlay clamp and marked with an hemoclip. The number of pre-existing atherosclerotic segments, clamp force, and clamp time were recorded and the occurrence of a stenosis at the clamp site was determined. After a mean follow-up of 83 months, a significant stenosis was confirmed at 23 of the 178 clamp sites (12.9%; 95% confidence interval 8.4 to 18.8). The mean number of pre-existing atherosclerotic segments (P = .28) and the mean clamp force (P = .55) was similar between the groups with and without a stenosis. There was a significant difference regarding clamp time between the group with and without a stenosis (38 minutes and 26 minutes, P = .001). Arterial clamping, even with the Fogarty-Soft-Inlay clamp, can lead to clamp stenosis and seems to be related to the duration of clamping, but not to pre-existent atherosclerotic burden. Copyright © 2015 Elsevier Inc. All rights reserved.
    American journal of surgery 05/2015; DOI:10.1016/j.amjsurg.2015.03.003
  • American journal of surgery 05/2015; DOI:10.1016/j.amjsurg.2014.11.020
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    ABSTRACT: Local pancreatic head resection (LPHR) for chronic pancreatitis has had limited adoption in the United States perhaps because of sparse outcomes and quality of life data. Forty-four patients underwent LPHR and retrospective evaluation of patient outcomes and quality of life assessment was performed. The mean age was 49 ± 11 years (50% men) with chronic alcohol use as the etiology in 79% of patients. One patient (2%) died within 90 days. The intensive care unit stay was 1.8 ± 3.1 days and postoperative length of stay was 12.6 ± 9.4 days with 96% of patients discharged home. Ten (22%) patients had major perioperative complications. Biliary stricture was the most common late complication (14%). Quality of life assessment results showed that global status (47/100) and physical (66/100), cognitive (68/100), and social (52/100) functions were acceptable. Prevalent postoperative symptoms were pain (52/100), insomnia (56/100), and digestive disturbance (60/100). LPHR is safe and effective for a substantial proportion of patients with chronic pancreatitis. Further refinement in the selection of patients most likely to benefit from this operation is warranted. Copyright © 2015 Elsevier Inc. All rights reserved.
    American journal of surgery 05/2015; DOI:10.1016/j.amjsurg.2014.12.049
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    ABSTRACT: Work-related injuries (WRIs) represent a significant economic and logistical burden to healthcare systems. All patients with severe WRIs (Injury Severity Score [ISS] ≥ 12) (1995 to 2013) were compared with patients with non-WRIs using standard methodology (P < .05). A total of 1,270 (8.5%) trauma admissions were for severe WRIs (mean age = 45 years, male:female ratio = 2.8:1, mean ISS = 22.7). Compared with patients with non-WRIs, WRI patients were younger, male, and had fewer comorbidities. Despite equivalent ISS, WRIs had a longer intensive care unit length of stay, length of mechanical ventilation, and number of surgical/operative procedures. Fewer patients with WRIs died in hospital and more were discharged home without support services. The acute care economic burden of WRIs was higher (because of intensive care unit and operating theatre, and physician compensation) (all analyses, P < .05). Patients with WRIs were younger, less comorbid, male, and had significantly higher utilization of acute care resources despite a similar ISS. Copyright © 2015 Elsevier Inc. All rights reserved.
    American journal of surgery 05/2015; DOI:10.1016/j.amjsurg.2015.01.023
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    ABSTRACT: Large size is a predictor of failure of percutaneous drainage (PD) for pyogenic liver abscess (PLA). This article serves to establish the safety and sufficiency of PD in giant PLA (GPLA). A retrospective review of all GPLA patients treated at a tertiary care academic hospital from 2001 to 2011 was performed. A GPLA is defined as an abscess greater than or equal to 10 cm size based on imaging. Forty patients (24 men, 60%) were treated for GPLA. All but 1 patient (98%) was managed with PD and the mean duration of drainage was 9 days (range 1 to 23 days). One patient underwent operative drainage. Three patients (7.7%) needed secondary procedures after the initial PD. One patient (2.6%) failed PD and subsequently underwent operative drainage. Among the patients who underwent PD, the overall morbidity was 25%; the median length of hospital stay was 13 days (range 5 to 31 days) and 1 (2.6%) mortality. Large size itself is not a contraindication for PD. PD is safe and sufficient even in GPLA patients. Copyright © 2015 Elsevier Inc. All rights reserved.
    American journal of surgery 05/2015; DOI:10.1016/j.amjsurg.2015.03.002
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    ABSTRACT: The effect of the number of lymph nodes harvested on the long-term survival of gastric cancer according to Tumor, Node, and Metastasis (TNM) stage and tumor location remains unclear. Patients who underwent gastrectomy for gastric cancer (1998 to 2009) were evaluated retrospectively (1,637 patients). The patients' clinicopathological variables, overall survival (OS), and progression-free survival (PFS) were recorded. The effect of the number of lymph nodes harvested on survival was analyzed according to TNM stage and tumor location. Harvest of greater than 30 lymph nodes was associated with significantly better OS and PFS than less than or equal to 14 lymph nodes, but no significant difference was observed between less than or equal to 14 and 15 to 29 lymph nodes harvested. The number of lymph nodes harvested was significantly associated with the OS or/and PFS of late stage cancer (N+, T3 to T4, and stage III to IV), harvest of greater than 30 lymph nodes brought significantly better survival compared with the other 2 groups. A higher number of harvested lymph nodes was associated with significantly better PFS for gastric cancer of the body of stomach, but not for proximal, distal, and whole stomach cancer. When the tumor was located in the body of the stomach, the PFS was better with 15 to 29 lymph nodes than less than 14 lymph nodes; however, the OS and PFS were not significantly different between greater than 30 lymph nodes and 15 to 29 lymph nodes. TNM stage and number of lymph nodes harvested were the independent risk factors affecting the survival. Tailored lymphadenectomy according to TNM stage and tumor location might be considered for gastric cancer patients. Copyright © 2015 Elsevier Inc. All rights reserved.
    American journal of surgery 05/2015; 118. DOI:10.1016/j.amjsurg.2015.01.029
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    ABSTRACT: Laparoscopic adrenalectomy (LA) is normally used to treat small-sized (<6 cm) pheochromocytoma (PCC). This study evaluated the effectiveness and safety of LA for treating large (≥6 cm) PCC. Fifty-one patients with resectable, large-sized (≥6 cm) PCC were prospectively enrolled for elective LA (n = 23) or open adrenalectomy (n = 28). LA was converted into open adrenalectomy in 2 patients (2/23, 8.7%); LA was associated with relatively longer operative time (P = .033) but less intraoperative bleeding (P < .001), faster resumption of ambulatory status (P < .001), and shorter duration of postoperative hospitalization (P < .001). Frequency of PCC recurrence was similar between the 2 groups (P = 1.000). LA is a feasible, effective, and safe treatment modality for large-sized (≥6 cm) PCC. LA is associated with minimal invasiveness and faster postoperative recovery. Copyright © 2015 Elsevier Inc. All rights reserved.
    American journal of surgery 04/2015; DOI:10.1016/j.amjsurg.2014.11.012
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    ABSTRACT: Lack of continuity of care for patients managed by general surgery residents is a commonly recognized problem but objective data evaluating its incidence are limited. The goal of this pilot study was to determine the extent to which senior residents at a large American urban academic center participate in the full course of care for patients on whom they operate. Two hundred twenty-eight total cases performed between January 1, 2012 and December 31, 2012 were reviewed and the operative senior resident was noted: laparoscopic cholecystectomy (n = 50), breast lumpectomy (n = 33), thyroidectomy (n = 50), laparoscopic appendectomy (n = 50), and open partial colectomy (n = 45). Frequency of operative resident involvement in the initial preoperative clinic visit, initial postoperative visit, or both (the entire course of care) was recorded. Overall rate of operative resident involvement was 9.2% for the initial preoperative consultation, 9.0% for the initial follow-up visit, and 0% for the entire course of a patient's care. Residents were on service for greater than 40 days, whereas the average total duration of care for an individual patient was 26 days. The results of this pilot study suggest that continuity of care among general surgery residents is lacking and cannot be entirely accounted for by rotation-specific time constraints. Further research is needed to identify and validate effective curricular strategies for improving opportunities to participate in this essential experience. Copyright © 2015 Elsevier Inc. All rights reserved.
    American journal of surgery 04/2015; 210(1). DOI:10.1016/j.amjsurg.2014.11.016
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    ABSTRACT: Diverticulitis in admitted inpatients is well reported. This study examined colonic diverticulitis treated in the emergency department (ED). The 2010 Nationwide Emergency Department Sample was used to examine relationships among patient age and inpatient admission, surgical intervention, and in-hospital mortality among ED patients with a primary diagnosis of diverticulitis. Of 310,983 ED visits for primary diverticulitis, 53% resulted in hospitalization and 6% in surgical intervention. Most patients 65+ years old were female (69%), and most were hospitalized (63%). Seven percent of ED patients aged 65+ underwent surgery and .96% died in hospital. Patients aged less than 40 years (13% of all admissions) were mostly male (63%), 42% were hospitalized, 4% underwent surgery, and less than .01% died. Compared with patients aged less than 40 years, those 65+ demonstrated greater odds of admission (odds ratio 1.53, 95% confidence interval 1.43 to 1.64) and surgical intervention (odds ratio 1.45, 95% confidence interval 1.27 to 1.65). Half of ED patients were hospitalized and 6% of ED visits resulted in colectomy. Fully 13% of ED patients were less than 40 years old. Future studies examining outpatient services may further illuminate the epidemiology of diverticulitis. Copyright © 2015 Elsevier Inc. All rights reserved.
    American journal of surgery 04/2015; DOI:10.1016/j.amjsurg.2014.12.050
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    ABSTRACT: Information regarding postoperative thromboembolism in curatively resected pancreatic cancer is limited. This study aimed to assess the incidence and significance of postoperative thromboembolism. We retrospectively reviewed the medical records of 121 curatively resected pancreatic cancer patients. Early and late thromboembolisms were defined as events that occurred within 1 year and after 1 year, respectively. Twenty-two patients (18%) experienced thromboembolism. Seven thromboembolic events occurred within 1 month (7, 6%), and the incidence rate decreased over time. Ten (63%) of the 16 patients with early thromboembolism experienced thromboembolism before or at the same time as recurrence; however, 5 (83%) of the 6 patients with late thromboembolism experienced recurrence before thromboembolism (P = .005). A significant difference in recurrence-free survival (P = .016) and borderline difference in overall survival (P = .050) were observed between patients with early thromboembolism and others. Thromboembolic events after curative surgery are prevalent in pancreatic cancer, especially within 1 month. Thromboembolic events within 1 year of surgery should be cautiously monitored. Copyright © 2015 Elsevier Inc. All rights reserved.
    American journal of surgery 04/2015; DOI:10.1016/j.amjsurg.2014.12.051
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    ABSTRACT: Pancreaticoduodenectomy represents the major treatment for pancreatic and periampullary neoplasms. Complications related to pancreaticojejunostomy are still the leading cause of morbidity and mortality. A solution proposed by some surgeons is the occlusion of main pancreatic duct by acrylic glue, avoiding pancreaticojejunostomy. Nevertheless, the consequences of this procedure on glucose metabolism are not well-defined. We retrospectively analyzed a cohort of 50 patients who underwent pancreaticoduodenectomy and had metabolic assessments available. The metabolic evaluation included the following: body composition and clinical evaluation, an oral glucose tolerance test, and an hyperinsulinemic euglycemic clamp procedure. Twenty-three patients underwent pancreatic duct occlusion and were compared with 27 patients, well-matched controls, who underwent pancreaticojejunostomy. Pancreatic duct occlusion leads to a greater impairment in insulin secretion compared with classic pancreaticojeunostomy. Pancreatic duct occlusion is associated with a greater reduction in insulin secretion but does not lead to meaningful differences in the management of patients with diabetes. Copyright © 2015 Elsevier Inc. All rights reserved.
    American journal of surgery 04/2015; DOI:10.1016/j.amjsurg.2014.12.052
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    ABSTRACT: Prior studies suggest that positive blood alcohol concentration (BAC) is associated with lower mortality after motor vehicle collisions (MVCs). We investigated the relationship between increasing BAC and mortality after MVC. A retrospective review of the Los Angeles County trauma database from January 2003 to December 2008 was performed. MVC patients greater than or equal to 16 years of age with admission BAC were considered. Patients were stratified by BAC as follows: BAC0 (<.01), BAC1 (.01 to .08), BAC2 (.09 to .16), BAC3 (.17 to .24), BAC4 (.25 to .32), and BAC5 (>.32). Logistic regression was used to determine predictors of mortality. A total of 12,540 patients were included. Overall mortality rate was 2.2%. Mortality was lowest in BAC3 (1.6%) and BAC4 (1.3%), although the difference among all groups was not statistically significant (P = .07). Decreased rates of Injury Severity Score greater than or equal to 16 were noted with increasing BAC, which was largely because of reduced chest and abdomen/pelvis Abbreviated Injury Scale. Adjusted mortality was lower in BAC3 and BAC4 (both adjusted odds ratio .4, P < .001). A protective effect of alcohol after MVC may be related to decreased truncal injury burden rather than protection after head injury. Copyright © 2015 Elsevier Inc. All rights reserved.
    American journal of surgery 03/2015; 210(1). DOI:10.1016/j.amjsurg.2014.11.015
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    ABSTRACT: During the last decade, interventions to reduce the number of medical errors have been largely ineffective. Although it is widely assumed that medical errors follow a Gaussian distribution, they may actually follow a Power Rule distribution. This article presents the evidence in favor of a Power Rule distribution for medical errors and then examines the consequences of such a distribution for medical errors. As the distribution of medical errors has real-world implications, further research is needed to determine whether medical errors follow a Gaussian or Power Rule distribution. Copyright © 2015 Elsevier Inc. All rights reserved.
    American journal of surgery 03/2015; 210(1). DOI:10.1016/j.amjsurg.2014.10.032
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    ABSTRACT: Variation in cost of surgical care across state lines is poorly understood. We sought to examine state-level variation in wage-adjusted total cost (WATC) of a common surgical procedure. We performed a retrospective cohort study of patients undergoing total thyroidectomy in the Nationwide Inpatient Sample (2007 to 2008). WATC was calculated from charges and adjusted for the area wage index. Hierarchical linear modeling was used to investigate the variation in WATC explained by variables at the patient, hospital, and state levels. We identified 11,058 eligible patients from 35 states. The overall mean WATC was $8,132; 37% of the WATC variance was because of differences across hospitals, whereas 28% was explained by patient-level factors and 8% because of differences across states. More than a quarter of the variation in cost of total thyroidectomy was not explained by patient-, hospital-, or state-level factors. Further research is needed to understand the unexplained residual variation. Copyright © 2015 Elsevier Inc. All rights reserved.
    American journal of surgery 03/2015; DOI:10.1016/j.amjsurg.2014.12.039
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    ABSTRACT: The amount of time medical students (MS) spend in the operating room (OR) during their general surgery core clerkship has not been previously studied as a predictor for choosing a career in surgery. We hypothesize that MS choosing a career in surgery spend more time in the OR. Operative records for surgery cases at our institution from 2009 to 2013 were linked to the schedules of MS from classes of 2010 to 2014. Total number of minutes, cases, and average number of minutes in the OR were calculated and compared with the match lists. Univariate analysis was conducted to assess for associations (P < .05). A total of 117 students and 1,524 procedures were included. Twenty-two MS chose a surgical career (19%). An average of 2,018.5 minutes per rotation was spent in the OR (81.2 min/d), but neither the amount of time nor the number of cases was associated with choosing a career in surgery. Quality of the educational experience trumps quantity regarding what most influences MS career decision. Copyright © 2015 Elsevier Inc. All rights reserved.
    American journal of surgery 03/2015; 210(1). DOI:10.1016/j.amjsurg.2014.10.031
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    ABSTRACT: Some risk factors for anastomotic leak have been identified, but the effect of smoking is unknown. This study aimed to evaluate the effect of smoking on clinical leak after left-sided anastomoses. Adult patients who underwent elective left colectomy between January 1, 2008 and December 31, 2012 were included. Those with stomas and inflammatory bowel diseases were excluded. Primary outcome was anastomotic leak requiring percutaneous drainage or operative intervention within 30 days. There were 246 patients included; 56% were female. Most had a diagnosis of diverticular disease (53%) or cancer (37%). Anastomotic leak rate was 6.5% (n = 16). The rate in smokers was 17% versus 5% in nonsmokers (P = .01). Smokers had over 4 times greater chance of leak (odds ratio 4.2, 95% confidence interval 1.3 to 13.5, P = .02). Smoking is a risk factor for leak after left colectomy. Consideration should be given to delaying elective left colectomy until smoking cessation is achieved. Copyright © 2015 Elsevier Inc. All rights reserved.
    American journal of surgery 03/2015; 210(1). DOI:10.1016/j.amjsurg.2014.10.033