Study concept and design: Salminen, Paajanen, Rautio, Aarnio, Rantanen, Tuominen, Hurme, Mecklin, Jartti, Grönroos.
Acquisition, analysis, or interpretation of data: Salminen, Paajanen, Rautio, Nordström, Rantanen, Tuominen, Hurme, Virtanen, Sand, Jartti, Rinta-Kiikka, Grönroos.
Drafting of the manuscript: Salminen, Paajanen, Rautio, Aarnio, Tuominen, Hurme, Virtanen, Grönroos.
Critical revision of the manuscript for important intellectual content: Salminen, Rautio, Nordström, Rantanen, Tuominen, Hurme, Virtanen, Mecklin, Sand, Jartti, Rinta-Kiikka, Grönroos.
Statistical analysis: Salminen, Tuominen, Hurme, Grönroos.
Obtained funding: Salminen.
Administrative, technical, or material support: Salminen, Rautio, Aarnio, Rantanen, Virtanen, Mecklin, Sand, Rinta-Kiikka, Grönroos.
Study supervision: Salminen, Paajanen, Nordström, Tuominen, Sand, Jartti, Grönroos.
Conflict of Interest Disclosures: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Salminen reported receiving personal fees for lectures from Merck and Roche. No other disclosures were reported.
Funding/Support: The APPAC trial was supported by a government research grant (EVO Foundation) awarded to Turku University Hospital.
Role of the Sponsors: The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication.
Additional Contributions: We thank all the surgeons on call taking part in the enrollment of APPAC trial patients. We also thank Heikki Ahtola, MD (North Carelia Central Hospital, Finland), for his contribution in the study protocol. Dr Ahtola received no compensation for his contribution.