2020
Thirty- and 90-day Readmissions After Spinal Surgery for Spine Metastases
Elsamadicy AA, Koo AB, David WB, Zogg CK, Kundishora AJ, Hong CS, Kuzmik GA, Gorrepati R, Coutinho PO, Kolb L, Laurans M, Abbed K. Thirty- and 90-day Readmissions After Spinal Surgery for Spine Metastases. Spine 2020, 46: 828-835. PMID: 33394977, PMCID: PMC8278805, DOI: 10.1097/brs.0000000000003907.Peer-Reviewed Original ResearchMeSH KeywordsHumansNeurosurgical ProceduresPatient ReadmissionPostoperative ComplicationsRetrospective StudiesSpineConceptsSpine metastasesGenitourinary complicationsPostoperative infectionSpine surgeryRheumatoid arthritis/collagen vascular diseasesAcute post-hemorrhagic anemiaCollagen vascular diseaseRetrospective cohort studyUnplanned hospital readmissionNationwide Readmissions DatabasePatient-level factorsVulnerable patient groupSurgical treatment interventionMultivariate regression analysisFusion spine surgeryInpatient complicationsFrequent readmissionsUnplanned readmissionCohort studyRenal failureClinical factorsHospital readmissionSurgery typePatient groupVascular diseaseQuantifying the Impact of Care Fragmentation on Outcomes After Transcatheter Aortic Valve Implantation
Hirji SA, Zogg CK, Vaduganathan M, Kiehm S, Percy ED, Yazdchi F, Pelletier M, Shah PB, Bhatt DL, O'Gara P, Kaneko T. Quantifying the Impact of Care Fragmentation on Outcomes After Transcatheter Aortic Valve Implantation. The American Journal Of Cardiology 2020, 128: 113-119. PMID: 32650903, DOI: 10.1016/j.amjcard.2020.05.005.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCardiac CatheterizationCenters for Medicare and Medicaid Services, U.S.ComorbidityContinuity of Patient CareCoronary AngiographyDiabetes MellitusFemaleHospital CostsHospital MortalityHospitalsHumansHypertensionLength of StayLung DiseasesMaleMultivariate AnalysisPacemaker, ArtificialPatient ReadmissionPericardiocentesisPostoperative ComplicationsProsthesis ImplantationStrokeTranscatheter Aortic Valve ReplacementUnited StatesConceptsNonindex hospitalNonindex readmissionsCare fragmentationTranscatheter aortic valve implantation outcomesTranscatheter aortic valve implantationHigher co-morbidity burdenNational Readmission DatabaseAortic valve implantationCo-morbidity burdenTotal hospital costsMajor cardiac proceduresUS adult patientsFuture health policyValue of careIndex readmissionTAVI patientsCause mortalityIndex hospitalNoncardiac causesAdult patientsPatient characteristicsReadmission ratesValve implantationReadmission lengthCardiac proceduresBenchmarking the value of care: Variability in hospital costs for common operations and its association with procedure volume.
Zogg CK, Bernard AC, Hirji SA, Minei JP, Staudenmayer KL, Davis KA. Benchmarking the value of care: Variability in hospital costs for common operations and its association with procedure volume. Journal Of Trauma And Acute Care Surgery 2020, 88: 619-628. PMID: 32039972, PMCID: PMC7802807, DOI: 10.1097/ta.0000000000002611.Peer-Reviewed Original ResearchConceptsLaparoscopic appendectomyLaparoscopic cholecystectomyHospital costsMeans of USMedian costProcedure volumeEmergency general surgeryTotal hospital costsMedian hospital costsNational Inpatient SampleAdults 18 yearsNational cost savingsAnnual procedure volumeValue of careHospital complicationsIndex hospitalHealth care valuePatient characteristicsAdverse outcomesInpatient SampleInclusion criteriaGeneral surgeryHospitalLevel IIICommon operationThirty- and 90-Day Readmissions After Treatment of Traumatic Subdural Hematoma: National Trend Analysis
Koo AB, Elsamadicy AA, David WB, Zogg CK, Santarosa C, Sujijantarat N, Robert SM, Kundishora AJ, Cord BJ, Hebert R, Bahrassa F, Malhotra A, Matouk CC. Thirty- and 90-Day Readmissions After Treatment of Traumatic Subdural Hematoma: National Trend Analysis. World Neurosurgery 2020, 139: e212-e219. PMID: 32272271, PMCID: PMC7380544, DOI: 10.1016/j.wneu.2020.03.168.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overFemaleHematoma, SubduralHumansMaleMiddle AgedPatient ReadmissionPostoperative ComplicationsRetrospective StudiesRisk FactorsUnited StatesConceptsTraumatic subdural hematomaSubdural hematomaRheumatoid arthritis/collagen vascular diseasesMultivariate logistic regression analysisCollagen vascular diseaseNationwide Readmissions DatabaseCongestive heart failureLikelihood of readmissionPrimary procedure codeTraumatic brain injuryLogistic regression analysisReadmission ratesRenal failureHeart failurePostoperative infectionNinth RevisionSurgical interventionPatient populationVascular diseaseCerebral meningesBrain injuryClinical ModificationPatient managementReadmissionInternational ClassificationUnderweight patients are at just as much risk as super morbidly obese patients when undergoing anterior cervical spine surgery
Ottesen TD, Malpani R, Galivanche AR, Zogg CK, Varthi AG, Grauer JN. Underweight patients are at just as much risk as super morbidly obese patients when undergoing anterior cervical spine surgery. The Spine Journal 2020, 20: 1085-1095. PMID: 32194246, PMCID: PMC7380546, DOI: 10.1016/j.spinee.2020.03.007.Peer-Reviewed Original ResearchConceptsAnterior cervical spine surgeryBody mass indexCervical spine surgeryNational Surgical Quality Improvement Program databaseSuper morbidly obese patientsQuality Improvement Program databaseWorld Health Organization categoriesMorbidly obese patientsImprovement Program databaseObese patientsAdverse eventsAdverse outcomesSpine surgeryUnderweight patientsPostoperative infectionProgram databaseSurgeons National Surgical Quality Improvement Program databaseMultivariate analysisAnterior cervical spine proceduresOverweight/obese categoriesThirty-day adverse eventsHigher body mass indexLower body mass indexAdverse outcome categoriesNormal BMI patientsRisk Factors Portending Extended Length of Stay After Suboccipital Decompression for Adult Chiari I Malformation
Elsamadicy AA, Koo AB, Lee M, David WB, Kundishora AJ, Freedman IG, Zogg CK, Hong CS, DeSpenza T, Sarkozy M, Kahle KT, DiLuna M. Risk Factors Portending Extended Length of Stay After Suboccipital Decompression for Adult Chiari I Malformation. World Neurosurgery 2020, 138: e515-e522. PMID: 32147550, PMCID: PMC7379177, DOI: 10.1016/j.wneu.2020.02.158.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsArnold-Chiari MalformationDecompression, SurgicalDura MaterFemaleHumansLength of StayMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesRisk FactorsConceptsPatient-level factorsMultivariate logistic regressionExtended LOSLOS cohortSurgical decompressionDecompression surgeryOdds ratioGreater overall complication ratesMultiple patient-level factorsLogistic regressionChiari malformation type IAdult Chiari I malformationPatient's baseline comorbidityOverall complication rateRetrospective cohort studyChiari I malformationRisk-adjusted LOSPostoperative complicationsAdult patientsCohort studyComplication ratePatient demographicsSuboccipital decompressionElectrolyte disordersObstructive hydrocephalusHospital Variation in Geriatric Surgical Safety for Emergency Operation
Becher RD, Sukumar N, DeWane MP, Stolar MJ, Gill TM, Schuster KM, Maung AA, Zogg CK, Davis KA. Hospital Variation in Geriatric Surgical Safety for Emergency Operation. Journal Of The American College Of Surgeons 2020, 230: 966-973.e10. PMID: 32032720, PMCID: PMC7409563, DOI: 10.1016/j.jamcollsurg.2019.10.018.Peer-Reviewed Original ResearchConceptsStandardized mortality ratioHospital-level characteristicsGeneral surgery operationsGeriatric patientsEmergency operationHospital variationEmergency general surgery operationsMean standardized mortality ratioCalifornia State Inpatient DatabaseHospital-based mortalitySignificant hospital variationPatients 65 yearsSubstantial excess mortalitySurgery operationsState Inpatient DatabasesMixed effects logistic regression modelsCommon general surgery operationsLow-mortality outliersLogistic regression modelsPostoperative mortalityHospital deathOlder patientsInpatient DatabaseMortality outcomesNonelective operations
2019
Debunking the July Effect in Cardiac Surgery: A National Analysis of More Than 470,000 Procedures
Shah RM, Hirji SA, Kiehm S, Goel S, Yazdchi F, Bellavia A, Zogg CK, Pelletier MP, Shekar P, Kaneko T. Debunking the July Effect in Cardiac Surgery: A National Analysis of More Than 470,000 Procedures. The Annals Of Thoracic Surgery 2019, 108: 929-934. PMID: 31353035, DOI: 10.1016/j.athoracsur.2019.06.015.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAdultAgedCardiac Surgical ProceduresClinical CompetenceCohort StudiesDatabases, FactualEducation, Medical, GraduateFemaleHospital MortalityHospitals, TeachingHumansInpatientsInternship and ResidencyMaleMedical Staff, HospitalMiddle AgedPostoperative ComplicationsQuality of Health CareRisk AdjustmentSeasonsUnited StatesConceptsAortic valve replacementCardiac surgeryJuly effectHospital mortalityPatient outcomesTeaching hospitalMajor cardiac surgery proceduresSurgical aortic valve replacementCoronary artery bypassCardiac surgery proceduresNational Inpatient SampleRisk-adjusted mortalityMitral valve repairCardiac surgery outcomesHospital complicationsArtery bypassMV surgeryNoncardiac surgeryValve replacementAdjusted mortalityValve repairSurgery outcomesInpatient SampleWorse outcomesHospital support systemsTotal hip arthroplasty versus hemiarthroplasty for independently mobile older adults with intracapsular hip fractures
Metcalfe D, Judge A, Perry DC, Gabbe B, Zogg CK, Costa ML. Total hip arthroplasty versus hemiarthroplasty for independently mobile older adults with intracapsular hip fractures. BMC Musculoskeletal Disorders 2019, 20: 226. PMID: 31101041, PMCID: PMC6525472, DOI: 10.1186/s12891-019-2590-4.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overArthroplasty, Replacement, HipFemur HeadFracture DislocationHemiarthroplastyHip FracturesHumansIndependent LivingMiddle AgedPatient SelectionPostoperative ComplicationsQuality of LifeRandomized Controlled Trials as TopicRegistriesReoperationRisk FactorsUnited KingdomConceptsTotal hip arthroplastyNational Hip Fracture DatabaseHospital Episode StatisticsHip fractureIntracapsular hip fracturesMobile older adultsTHA dislocationOlder adultsHip arthroplastyPropensity scoreHealth-related qualityHip Fracture DatabaseClinical registry dataLength of stayMethodsA systematic reviewUrgent further studyDeath registration dataResultsFive RCTsFit patientsSecondary outcomesPrimary outcomeEpisode StatisticsSafety profileSurgical interventionFunctional outcome
2018
Racial/Ethnic Disparities in Longer-term Outcomes Among Emergency General Surgery Patients
Zogg CK, Jiang W, Ottesen TD, Shafi S, Schuster K, Becher R, Davis KA, Haider AH. Racial/Ethnic Disparities in Longer-term Outcomes Among Emergency General Surgery Patients. Annals Of Surgery 2018, 268: 968-979. PMID: 28742704, PMCID: PMC5783796, DOI: 10.1097/sla.0000000000002449.Peer-Reviewed Original ResearchConceptsEmergency general surgery patientsNon-Hispanic whitesGeneral surgery patientsLong-term outcomesNon-Hispanic blacksNon-Hispanic AsiansMinority patientsMajor morbidityUnplanned readmissionSurgery patientsOlder adultsRisk-adjusted Cox proportional hazards modelsEthnic disparitiesCox proportional hazards modelDiagnostic categoriesRacial/Ethnic DisparitiesUS population agesProportional hazards modelNHB patientsNonagenarian patientsNHW patientsBACKGROUND DATAHospital's percentageMortality differencesMedicare dataDialysis is an independent risk factor for perioperative adverse events, readmission, reoperation, and mortality for patients undergoing elective spine surgery
Ottesen TD, McLynn RP, Zogg CK, Shultz BN, Ondeck NT, Bovonratwet P, Bellamkonda KS, Rubin LE, Grauer JN. Dialysis is an independent risk factor for perioperative adverse events, readmission, reoperation, and mortality for patients undergoing elective spine surgery. The Spine Journal 2018, 18: 2033-2042. PMID: 30077772, DOI: 10.1016/j.spinee.2018.04.007.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedElective Surgical ProceduresFemaleHumansMaleMiddle AgedPatient DischargePatient ReadmissionPostoperative ComplicationsRenal DialysisReoperationSpineConceptsElective spine surgeryNon-dialysis patientsDialysis-dependent patientsPerioperative adverse eventsAdverse eventsDialysis patientsSpine surgeryUnplanned readmissionCohort studyPatient demographicsRisk factorsNational Surgical Quality Improvement Program databaseRisk-adjusted multivariate regressionsQuality Improvement Program databaseOperating roomDialysis-independent patientsInstitutional cohort studyMinor adverse eventsRetrospective cohort studyElective spinal surgeryImprovement Program databaseIndependent risk factorMajor adverse eventsPercentage of complicationsAdministrative database studyThe Cost of Complications Following Major Resection of Malignant Neoplasia
Zogg CK, Ottesen TD, Kebaish KJ, Galivanche A, Murthy S, Changoor NR, Zogg DL, Pawlik TM, Haider AH. The Cost of Complications Following Major Resection of Malignant Neoplasia. Journal Of Gastrointestinal Surgery 2018, 22: 1976-1986. PMID: 29946953, PMCID: PMC6224301, DOI: 10.1007/s11605-018-3850-6.Peer-Reviewed Original ResearchConceptsIncremental hospital costsHospital costsMalignant neoplasiaMajor resectionResection typePre-discharge complicationsSystem-based complicationsImpact of complicationsComplex surgical patientsCost of complicationsLong-term treatmentMore complex patientsMajor gastrointestinal resectionsProviders/payersValue of carePulmonary complicationsUrinary complicationsComplication groupInfectious complicationsAdult patientsRectal resectionSurgical patientsGastrointestinal resectionGI diseaseSurgical outcomesDialysis Patients Undergoing Total Knee Arthroplasty Have Significantly Increased Odds of Perioperative Adverse Events Independent of Demographic and Comorbidity Factors
Ottesen TD, Zogg CK, Haynes MS, Malpani R, Bellamkonda KS, Grauer JN. Dialysis Patients Undergoing Total Knee Arthroplasty Have Significantly Increased Odds of Perioperative Adverse Events Independent of Demographic and Comorbidity Factors. The Journal Of Arthroplasty 2018, 33: 2827-2834. PMID: 29754981, DOI: 10.1016/j.arth.2018.04.012.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overArthroplasty, Replacement, KneeComorbidityElective Surgical ProceduresFemaleHumansInpatientsLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPatient DischargePatient ReadmissionPostoperative ComplicationsQuality ImprovementRegression AnalysisRenal DialysisReoperationRetrospective StudiesRisk AssessmentConceptsTotal knee arthroplastyDialysis-dependent patientsAdverse eventsPatient demographicsDialysis patientsAdverse outcomesKnee arthroplastyNational Surgical Quality Improvement Program databaseOverall healthRisk-adjusted logistic regressionElective total knee arthroplastyQuality Improvement Program databaseImprovement Program databaseMinor adverse eventsNational inpatient databaseSevere adverse eventsBone health statusNondialysis cohortNondialysis patientsPerioperative periodTKA patientsAdult patientsPreoperative riskComorbidity factorsInstitutional cohort
2017
The Need to Consider Longer-term Outcomes of Care
Zogg CK, Olufajo OA, Jiang W, Bystricky A, Scott JW, Shafi S, Havens JM, Salim A, Schoenfeld AJ, Haider AH. The Need to Consider Longer-term Outcomes of Care. Annals Of Surgery 2017, 266: 66-75. PMID: 28140382, DOI: 10.1097/sla.0000000000001932.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedBlack or African AmericanCaliforniaEmergency Service, HospitalHealthcare DisparitiesHispanic or LatinoHospital MortalityHumansIncomeInsurance CoverageInsurance, HealthLongitudinal StudiesMiddle AgedOutcome Assessment, Health CarePatient ReadmissionPostoperative ComplicationsProportional Hazards ModelsSurgical Procedures, OperativeSurvival AnalysisWhite PeopleYoung AdultConceptsLong-term outcomesNon-Hispanic blacksUnplanned readmissionMajor morbidityWhite patientsMinority patientsEthnic disparitiesEmergency general surgery patientsCalifornia State Inpatient DatabaseCox proportional hazards modelDiagnostic categoriesOlder adultsGeneral surgery patientsState Inpatient DatabasesProportional hazards modelRisk-adjusted differencesHispanic older adultsEGS patientsEGS volumeReadmission trendsSurgery patientsSurgical patientsHospital proportionInpatient DatabasePostacute phase
2016
Implementation of a Comprehensive Post-Discharge Venous Thromboembolism Prophylaxis Program for Abdominal and Pelvic Surgery Patients
Najjar PA, Madenci AL, Zogg CK, Schneider EB, Dankers CA, Pimentel MT, Chabria AS, Goldberg JE, Sharma G, Piazza G, Bleday R, Orgill DP, Kachalia A. Implementation of a Comprehensive Post-Discharge Venous Thromboembolism Prophylaxis Program for Abdominal and Pelvic Surgery Patients. Journal Of The American College Of Surgeons 2016, 223: 804-813. PMID: 27693288, PMCID: PMC6309555, DOI: 10.1016/j.jamcollsurg.2016.09.010.Peer-Reviewed Original ResearchConceptsPost-intervention cohortPre-intervention cohortInflammatory bowel diseaseVenous thromboembolismProphylaxis programAbdominal surgeryBowel diseasePost-discharge VTE ratesVenous thromboembolism prophylaxis programBedside medication deliveryInpatient venous thromboembolismInstitutional American CollegeSymptomatic venous thromboembolismPrimary end pointMajor abdominal surgeryVTE prevention programSingle-institution retrospectiveSurgeons NSQIP datasetPost-intervention analysisProphylactic anticoagulationVTE prophylaxisVTE ratesVTE eventsNSQIP datasetRisk patientsRethinking Priorities
Zogg CK, Najjar P, Diaz A, Zogg DL, Tsai TC, Rose JA, Scott JW, Gani F, Alshaikh H, Nagarajan N, Canner JK, Schneider EB, Goldberg JE, Haider AH. Rethinking Priorities. Annals Of Surgery 2016, 264: 312-322. PMID: 26501705, DOI: 10.1097/sla.0000000000001511.Peer-Reviewed Original ResearchConceptsElective colectomyPrimary diagnosisNationwide Inpatient Sample dataIncremental costBenign colonic neoplasmsSystem-based complicationsCost of complicationsSurgical quality improvement initiativesIncremental hospital costsLong-term treatmentQuality improvement initiativesExperienced complicationsInfectious complicationsCardiovascular complicationsComplication groupDiverticular diseaseOpen resectionAdult patientsFrequent diagnosisColonic neoplasmsHospital costsOperative techniqueColectomyComplicationsHealthcare costsUse of National Burden to Define Operative Emergency General Surgery
Scott JW, Olufajo OA, Brat GA, Rose JA, Zogg CK, Haider AH, Salim A, Havens JM. Use of National Burden to Define Operative Emergency General Surgery. JAMA Surgery 2016, 151: e160480-e160480. PMID: 27120712, DOI: 10.1001/jamasurg.2016.0480.Peer-Reviewed Original ResearchConceptsEmergency general surgeryEGS proceduresInpatient costsNational burdenGeneral surgeryClinical Modification procedure codesPrimary EGS diagnosesDay of admissionOverall mortality ratePeptic ulcer diseaseSmall bowel resectionNational Inpatient SampleNational quality benchmarksHospital mortalityMost admissionsSurgical admissionsSurgical mortalityComplication burdenComplication rateMajor complicationsPartial colectomyRetrospective reviewUlcer diseaseEGS diagnosesNinth RevisionAre Older Adults With Hip Fractures Disadvantaged in Level 1 Trauma Centers?
Metcalfe D, Olufajo OA, Zogg CK, Gates JD, Weaver MJ, Harris MB, Rios-Diaz AJ, Haider AH, Salim A. Are Older Adults With Hip Fractures Disadvantaged in Level 1 Trauma Centers? Medical Care 2016, 54: 616-622. PMID: 26974676, DOI: 10.1097/mlr.0000000000000535.Peer-Reviewed Original ResearchConceptsLevel 1 trauma centerHigh-level trauma centersTrauma centerNontrauma centersHip fractureOlder adultsVenous thromboembolismPatient groupLevel 2 trauma centerIsolated hip fractureRetrospective cohort studyWorse clinical outcomesLength of stayLarge regional hospitalInhospital mortalityUnderwent surgeryUnplanned readmissionCohort studySurgical treatmentClinical outcomesInterhospital transferInpatient stayRegional hospitalHigher oddsBetter outcomesUnplanned 30-day readmissions in orthopaedic trauma
Metcalfe D, Olufajo OA, Zogg CK, Rios-Diaz A, Harris M, Weaver MJ, Haider AH, Salim A. Unplanned 30-day readmissions in orthopaedic trauma. Injury 2016, 47: 1794-1797. PMID: 27262770, DOI: 10.1016/j.injury.2016.05.007.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedCaliforniaChildChild, PreschoolComorbidityFemaleHumansInfantMaleMiddle AgedOrthopedic ProceduresPatient ReadmissionPostoperative ComplicationsQuality Indicators, Health CareRetrospective StudiesRisk FactorsSocioeconomic FactorsSurgical Wound InfectionTime FactorsWounds and InjuriesYoung AdultConceptsTrauma patientsCharlson Comorbidity IndexOverall readmission rateOrthopaedic trauma patientsPrimary outcome measureHospital quality metricsUnplanned readmission riskTrauma readmissionsComorbidity indexInitial hospitalizationReadmission ratesHospital readmissionPatient factorsProcedural complicationsTrauma admissionsMale sexReadmission riskSpinal fracturesCardiopulmonary diseaseBlack racePrimary diagnosisAcute hospitalsMusculoskeletal problemsObservational studyMedical adviceNever giving up: outcomes and presentation of emergency general surgery in geriatric octogenarian and nonagenarian patients
Shah AA, Zafar SN, Kodadek LM, Zogg CK, Chapital AB, Iqbal A, Greene WR, Cornwell EE, Havens J, Nitzschke S, Cooper Z, Salim A, Haider AH. Never giving up: outcomes and presentation of emergency general surgery in geriatric octogenarian and nonagenarian patients. The American Journal Of Surgery 2016, 212: 211-220.e3. PMID: 27086200, DOI: 10.1016/j.amjsurg.2016.01.021.Peer-Reviewed Original ResearchConceptsLength of stayNonagenarian patientsYoung adultsUtilization Project Nationwide Inpatient SampleLower total hospital costsEmergency general surgery patientsShorter LOSLower risk-adjusted oddsOlder adultsPrimary EGS diagnosesEmergency general surgeryGeneral surgery patientsRisk-adjusted oddsTotal hospital costsHigher mortality riskRisk-adjusted differencesGastrostomy careMajor morbidityOlder patientsSurgery patientsEGS diagnosesInpatient SampleHospital costsHigher oddsGeneral surgery