2024
National Estimates of Short- and Longer-Term Hospital Readmissions After Major Surgery Among Community-Living Older Adults
Wang Y, Leo-Summers L, Vander Wyk B, Davis-Plourde K, Gill T, Becher R. National Estimates of Short- and Longer-Term Hospital Readmissions After Major Surgery Among Community-Living Older Adults. JAMA Network Open 2024, 7: e240028. PMID: 38416499, PMCID: PMC10902728, DOI: 10.1001/jamanetworkopen.2024.0028.Peer-Reviewed Original ResearchConceptsCenters for Medicare & Medicaid ServicesFee-for-serviceMedicare Advantage beneficiariesHospital readmissionUS residentsNational Health and Aging Trends Study dataCommunity-living older adultsProspective longitudinal cohort studyCommunity-living participantsRate of hospital readmissionLikelihood of hospital readmissionPopulation-based estimatesNationally representative estimatesSex-adjusted modelsCommunity-livingData linkageGeriatric conditionsMedicaid ServicesOlder personsOlder adultsMain OutcomesNational estimatesRepresentative estimatesData analysisCohort study
2022
Population-Based Estimates of 1-Year Mortality After Major Surgery Among Community-Living Older US Adults
Gill TM, Vander Wyk B, Leo-Summers L, Murphy TE, Becher RD. Population-Based Estimates of 1-Year Mortality After Major Surgery Among Community-Living Older US Adults. JAMA Surgery 2022, 157: e225155. PMID: 36260323, PMCID: PMC9582971, DOI: 10.1001/jamasurg.2022.5155.Peer-Reviewed Original ResearchConceptsPopulation-based estimatesMajor surgeryMean survival timeOlder US adultsProbable dementiaUS adultsSurvival timeSex-adjusted hazard ratioProspective longitudinal cohort studyCommunity-living older adultsLongitudinal cohort studyPotential prognostic valueService Medicare beneficiariesNon-Hispanic blacksNon-Hispanic whitesAging Trends StudyGeriatric characteristicsCohort studyGeriatric surgeryHazard ratioNonelective surgeryElective surgeryGeriatric conditionsPrognostic valueMean age
2021
The Incidence and Cumulative Risk of Major Surgery in Older Persons in the United States
Becher RD, Vander Wyk B, Leo-Summers L, Desai MM, Gill TM. The Incidence and Cumulative Risk of Major Surgery in Older Persons in the United States. Annals Of Surgery 2021, 277: 87-92. PMID: 34261884, PMCID: PMC8758792, DOI: 10.1097/sla.0000000000005077.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overDementiaHumansIncidenceLongitudinal StudiesMedicareProspective StudiesUnited StatesConceptsMajor surgeryOlder personsCumulative riskNational HealthCommunity-living older personsHigh-quality surgical careNon-frail groupPopulation-based incidenceService Medicare beneficiariesMedicaid Services dataCumulative risk estimatesProspective longitudinal studyUnited States agesAging Trends StudyGeriatric characteristicsRepresentative incidenceFrail groupAdjusted incidenceGeriatric populationProbable dementiaSurgical carePersons 85Medicare beneficiariesSurgeryVulnerable subgroupsNational trends in emergency department closures, mergers, and utilization, 2005-2015
Venkatesh AK, Janke A, Rothenberg C, Chan E, Becher RD. National trends in emergency department closures, mergers, and utilization, 2005-2015. PLOS ONE 2021, 16: e0251729. PMID: 34015007, PMCID: PMC8136839, DOI: 10.1371/journal.pone.0251729.Peer-Reviewed Original ResearchMeSH KeywordsEmergency Service, HospitalHospitalizationHospitalsHumansInpatientsPatient AdmissionUnited StatesConceptsHospital-based EDsEmergency department closureED visitsHospital admissionHospital bedsED closureYearly ED visitsLarge health systemAmerican Hospital Association Annual SurveyInpatient bed capacityPrimary outcomeSecondary outcomesMore patientsEmergency departmentRelative increaseInpatient bedsPatient volumeRural areasHealth systemAdmissionVisitsNational trendsBed capacityEDObservational analysisAnalysis of Hospital Resource Availability and COVID‐19 Mortality Across the United States
Janke AT, Mei H, Rothenberg C, Becher RD, Lin Z, Venkatesh AK. Analysis of Hospital Resource Availability and COVID‐19 Mortality Across the United States. Journal Of Hospital Medicine 2021, 16: 211-214. PMID: 33496664, PMCID: PMC8025594, DOI: 10.12788/jhm.3539.Peer-Reviewed Original ResearchConceptsCOVID-19 casesHospital resourcesIntensive care unit bedsHospital referral regionsCOVID-19 mortalityAmerican Hospital Association dataCOVID-19 deathsHospital resource availabilityDeath countsIncidence rateSurgical bedCare modelReferral regionsUnit bedsCOVID-19MortalityDeathUnited StatesLittle assessmentCOVID-19 dataCountGeographic areasNurses
2020
Functional Effects of Intervening Illnesses and Injuries After Hospitalization for Major Surgery in Community-living Older Persons
Gill TM, Han L, Gahbauer EA, Leo-Summers L, Murphy TE, Becher RD. Functional Effects of Intervening Illnesses and Injuries After Hospitalization for Major Surgery in Community-living Older Persons. Annals Of Surgery 2020, 273: 834-841. PMID: 33074902, PMCID: PMC8370041, DOI: 10.1097/sla.0000000000004438.Peer-Reviewed Original ResearchConceptsMajor surgeryED visitsRestricted activityFunctional statusFunctional declineOlder personsCommunity-living older personsAdjusted hazard ratioAdverse functional outcomesCommunity-living personsEmergency department visitsTraditional risk factorsCorresponding odds ratiosFunctional effectsIllness/injuryHazard ratioDepartment visitsFunctional recoveryFunctional outcomeRisk factorsOdds ratioHospitalizationSurgeryInjuryVisitsFinancial Hardship After Traumatic Injury: Risk Factors and Drivers of Out-of-Pocket Health Expenses
O'Neill KM, Jean RA, Gross CP, Becher RD, Khera R, Elizondo JV, Nasir K. Financial Hardship After Traumatic Injury: Risk Factors and Drivers of Out-of-Pocket Health Expenses. Journal Of Surgical Research 2020, 256: 1-12. PMID: 32663705, DOI: 10.1016/j.jss.2020.05.095.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedChildChild, PreschoolCost of IllnessCross-Sectional StudiesFamilyFemaleFinancial StressHealth ExpendituresHospitalizationHumansInfantInfant, NewbornInsurance, HealthMaleMiddle AgedPrescription DrugsRetrospective StudiesRisk FactorsSocioeconomic FactorsUnited StatesWounds and InjuriesYoung AdultConceptsTraumatic injuryOOP expensesPocket health expensesExcess financial burdenHealth expensesInpatient costsCatastrophic medical expensesFinancial burdenMultivariable logistic regression analysisMedical expensesHealth care factorsCostly medical conditionsCross-sectional studyMedical Expenditure Panel SurveyLogistic regression analysisPrescription drug costsFinancial hardshipHealth care systemFamily membersTrauma-related disordersPrimary outcomeCare factorsEmergency roomRisk factorsDrug costs
2019
Hospital Operative Volume and Quality Indication for General Surgery Operations Performed Emergently in Geriatric Patients
Becher RD, DeWane MP, Sukumar N, Stolar MJ, Gill TM, Becher RM, Maung AA, Schuster KM, Davis KA. Hospital Operative Volume and Quality Indication for General Surgery Operations Performed Emergently in Geriatric Patients. Journal Of The American College Of Surgeons 2019, 228: 910-923. PMID: 31005629, PMCID: PMC6582986, DOI: 10.1016/j.jamcollsurg.2019.02.053.Peer-Reviewed Original ResearchConceptsHospital operative volumeGeneral surgery operationsGeriatric patientsOperative volumeEmergency operationHospital volumeProbability of survivalEmergency general surgery operationsCalifornia State Inpatient DatabaseRetrospective cohort studySurgery operationsState Inpatient DatabasesHigher operative volumesAverage mortality riskOlder patientsCohort studyInpatient DatabaseGeriatric populationSurgical careSurgical qualityAmerican CollegeMortality riskOptimizing outcomesStandardized increasePatients
2017
Ongoing Evolution of Emergency General Surgery as a Surgical Subspecialty
Becher RD, Davis KA, Rotondo MF, Coimbra R. Ongoing Evolution of Emergency General Surgery as a Surgical Subspecialty. Journal Of The American College Of Surgeons 2017, 226: 194-200. PMID: 29111417, DOI: 10.1016/j.jamcollsurg.2017.10.014.Commentaries, Editorials and Letters
2012
Systemic inflammation worsens outcomes in emergency surgical patients
Becher RD, Hoth JJ, Miller PR, Meredith JW, Chang MC. Systemic inflammation worsens outcomes in emergency surgical patients. Journal Of Trauma And Acute Care Surgery 2012, 72: 1140-1149. PMID: 22673238, DOI: 10.1097/ta.0b013e3182516a97.Peer-Reviewed Original ResearchMeSH KeywordsAgedDigestive System Surgical ProceduresDisease ProgressionEmergenciesFollow-Up StudiesHumansMiddle AgedMorbidityOutcome Assessment, Health CarePostoperative ComplicationsRetrospective StudiesRisk FactorsSeverity of Illness IndexSurvival RateSystemic Inflammatory Response SyndromeUnited StatesConceptsSystemic inflammatory response syndromeSevere sepsis/septic shockSepsis/septic shockPreoperative systemic inflammationEmergency surgical patientsSystemic inflammatory responseThirty-day survivalSystemic inflammationInflammatory responsePostoperative outcomesSurgical patientsSeptic shockEmergent colon surgeryEmergency general surgeryInflammatory response syndromeTimely surgical interventionAcute care surgeonsKaplan-Meier methodRisk of morbidityDamage control operationPreoperative inflammationColorectal operationsPostoperative complicationsHazard ratioSepsis patients
2011
Creation and Implementation of an Emergency General Surgery Registry Modeled after the National Trauma Data Bank
Becher RD, Meredith JW, Chang MC, Hoth JJ, Beard HR, Miller PR. Creation and Implementation of an Emergency General Surgery Registry Modeled after the National Trauma Data Bank. Journal Of The American College Of Surgeons 2011, 214: 156-163. PMID: 22153352, DOI: 10.1016/j.jamcollsurg.2011.11.001.Peer-Reviewed Original ResearchConceptsNational Trauma Data BankTrauma Data BankEGS patientsInclusion criteriaEGS serviceICD-9 diagnostic codesICD-9 diagnosis codesEGS patient outcomesAcute care surgeryICD-9 codesEGS admissionsCare surgeryRetrospective reviewProspective populationDiagnosis codesProspective dataDiagnostic codesPatient outcomesPatientsSurgery evolvesPatient identificationMulti-institutional collaborationAdmissionMonthsOutcomesA Critical Assessment of Outcomes in Emergency versus Nonemergency General Surgery Using the American College of Surgeons National Surgical Quality Improvement Program Database
Becher RD, Hoth JJ, Miller PR, Mowery NT, Chang MC, Meredith JW. A Critical Assessment of Outcomes in Emergency versus Nonemergency General Surgery Using the American College of Surgeons National Surgical Quality Improvement Program Database. The American Surgeon 2011, 77: 951-959. PMID: 21944366, DOI: 10.1177/000313481107700738.Peer-Reviewed Original ResearchConceptsEmergent operationPostoperative morbidityAmerican CollegeNonemergent casesSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseGeneral surgery inpatientsGeneral surgery patientsImprovement Program databaseDeep vein thrombosisSpecific outcome dataGeneral surgery operationsGeneral surgery proceduresHigh mortality rateSystems of carePostoperative complicationsRenal failureSurgery patientsVein thrombosisNonemergent patientsHigh morbidityPoor outcomeUnique ClinicalInflammatory response