2019
Risk Factors, Etiologies, and Screening Tools for Sepsis in Pregnant Women
Bauer ME, Housey M, Bauer ST, Behrmann S, Chau A, Clancy C, Clark EAS, Einav S, Langen E, Leffert L, Lin S, Madapu M, Maile MD, McQuaid-Hanson E, Priessnitz K, Sela HY, Shah A, Sobolewski P, Toledo P, Tsen LC, Bateman BT. Risk Factors, Etiologies, and Screening Tools for Sepsis in Pregnant Women. Anesthesia & Analgesia 2019, Publish Ahead of Print: &na;. PMID: 31743182, PMCID: PMC7543988, DOI: 10.1213/ane.0000000000003709.Peer-Reviewed Original ResearchConceptsSystemic inflammatory response syndromeQuick Sequential Organ Failure AssessmentRisk factorsDelivery hospitalizationsMaternal sepsisSepsis casesCommon causeMortality rateMaternal Early Warning CriteriaSequential Organ Failure AssessmentScreening toolHours of diagnosisTiming of antibioticsOrgan Failure AssessmentCohort of patientsInflammatory response syndromePotential risk factorsHalf of casesAcademic medical centerDate of deliveryQSOFA criteriaControl patientsAntibiotic therapyResponse syndromeSignificant morbidity
2018
Timing and Risk Factors of Postpartum Stroke
Too G, Wen T, Boehme AK, Miller EC, Leffert LR, Attenello FJ, Mack WJ, D'Alton M, Friedman AM. Timing and Risk Factors of Postpartum Stroke. Obstetrics And Gynecology 2018, 131: 70-78. PMID: 29215510, PMCID: PMC6402829, DOI: 10.1097/aog.0000000000002372.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultCohort StudiesConfidence IntervalsCost-Benefit AnalysisDatabases, FactualFemaleHumansHypertension, Pregnancy-InducedMaternal AgeOdds RatioPatient DischargePatient ReadmissionPostpartum PeriodPre-EclampsiaPregnancyPregnancy, High-RiskPrognosisRetrospective StudiesRisk AssessmentStrokeTime FactorsYoung AdultConceptsChronic hypertensionDays of dischargeNationwide Readmissions DatabaseHypertensive diseasePostpartum strokeStroke readmissionDelivery hospitalizationsIndex hospitalizationOdds ratioUtilization Project Nationwide Readmissions DatabaseOptimal blood pressure managementDelivery hospitalization dischargeRetrospective cohort studyBlood pressure managementRisk of readmissionCases of strokeMajority of readmissionsCases of readmissionCalendar year 2013Hospitalization dischargeCohort studyHospital dischargeMedian timeReadmission riskRisk factors
2017
Neuraxial Anesthesia in Obstetric Patients Receiving Thromboprophylaxis With Unfractionated or Low-Molecular-Weight Heparin
Leffert LR, Dubois HM, Butwick AJ, Carvalho B, Houle TT, Landau R. Neuraxial Anesthesia in Obstetric Patients Receiving Thromboprophylaxis With Unfractionated or Low-Molecular-Weight Heparin. Anesthesia & Analgesia 2017, 125: 223-231. PMID: 28628578, DOI: 10.1213/ane.0000000000002173.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAnesthesia, ConductionAnesthesia, ObstetricalAnesthesiologyAnestheticsAnticoagulantsCesarean SectionDelivery, ObstetricFemaleHematoma, Epidural, SpinalHeparinHeparin, Low-Molecular-WeightHumansMiddle AgedNerve BlockPregnancyPregnancy Complications, CardiovascularThrombosisYoung AdultConceptsSpinal epidural hematomaCases of SEHNeuraxial anesthesiaObstetric patientsVenous thromboembolismWeight heparinAnesthesia Closed Claims Project databaseSystematic reviewPractice changePostpartum venous thromboembolismVaginal delivery hospitalizationsWeight heparin doseRisk of thromboembolismLarge-scale registriesMajority of womenEnglish-language studiesAnticoagulated womenDelivery hospitalizationsPharmacological thromboprophylaxisAnticoagulant doseCesarean deliveryEpidural hematomaHeparin doseVaginal deliveryGeneral anesthesia
2016
The Validity of Discharge Billing Codes Reflecting Severe Maternal Morbidity
Sigakis MJ, Leffert LR, Mirzakhani H, Sharawi N, Rajala B, Callaghan WM, Kuklina EV, Creanga AA, Mhyre JM, Bateman BT. The Validity of Discharge Billing Codes Reflecting Severe Maternal Morbidity. Anesthesia & Analgesia 2016, 123: 731-738. PMID: 27387839, PMCID: PMC7481827, DOI: 10.1213/ane.0000000000001436.Peer-Reviewed Original ResearchConceptsICD-9-CM codesSevere maternal morbidityPositive predictive valueMaternal morbidityMassachusetts General HospitalMichigan Health SystemGeneral HospitalClinical categoriesHealth systemCorresponding medical chartsConfidence intervalsLower confidence limitAnesthesia complicationsDelivery hospitalizationsObstetric categoryDelivery admissionMedical chartsDischarge diagnosisDiseases codesClinical dataLaboratory valuesBilling codesInternational ClassificationMorbidityBilling records