2020
Increased Healthcare Utilization for Medical Comorbidities Prior to Surgery Improves Postoperative Outcomes
Leeds IL, Canner JK, Gani F, Meyers PM, Haut ER, Efron JE, Johnston FM. Increased Healthcare Utilization for Medical Comorbidities Prior to Surgery Improves Postoperative Outcomes. Annals Of Surgery 2020, Publish Ahead of Print: &na;. PMID: 29864092, PMCID: PMC8559326, DOI: 10.1097/sla.0000000000002851.Peer-Reviewed Original ResearchConceptsPostoperative outcomesNonsurgical cliniciansPreoperative comorbiditiesShort-term postoperative outcomesIncreased healthcare utilizationMultivariable logistic regressionNational administrative databasePropensity-score matchingColectomy patientsElective colectomyModifiable comorbiditiesPreoperative optimizationMajor comorbiditiesMedical comorbiditiesPostoperative complicationsClinic visitsOperative interventionOperative riskSubsequent surgeryComorbid patientsSurgical riskAdjusted analysisHealthcare utilizationProspective studySame surgeon
2019
Early Discontinuation of Infliximab in Pregnant Women With Inflammatory Bowel Disease
Truta B, Leeds IL, Canner JK, Efron JE, Fang SH, Althumari A, Safar B. Early Discontinuation of Infliximab in Pregnant Women With Inflammatory Bowel Disease. Inflammatory Bowel Diseases 2019, 26: 1110-1117. PMID: 31670762, DOI: 10.1093/ibd/izz250.Peer-Reviewed Original ResearchConceptsInflammatory bowel diseaseIFX groupDisease activityIFX discontinuationSteroid prescriptionEarly discontinuationPregnancy outcomesPreterm babiesBowel diseaseRisk babiesPregnant womenTruven Health Analytics MarketScan databaseContinuation of infliximabMore preterm babiesAcute respiratory infectionsPoor pregnancy outcomesIntrauterine growth retardationRisk of diseaseDisease flareIBD mothersIBD patientsFetal exposureHospital admissionRespiratory infectionsMarketScan databaseOutcomes for Ulcerative Colitis With Delayed Emergency Colectomy Are Worse When Controlling for Preoperative Risk Factors
Leeds IL, Sundel MH, Gabre-Kidan A, Safar B, Truta B, Efron JE, Fang SH. Outcomes for Ulcerative Colitis With Delayed Emergency Colectomy Are Worse When Controlling for Preoperative Risk Factors. Diseases Of The Colon & Rectum 2019, Publish Ahead of Print: &na;. PMID: 30451754, PMCID: PMC6456379, DOI: 10.1097/dcr.0000000000001276.Peer-Reviewed Original ResearchConceptsTotal abdominal colectomyPreoperative risk factorsUlcerative colitisAbdominal colectomyRisk factorsEmergency colectomyEarly surgeryHospital daysPostoperative complicationsMortality rateSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseEarly operationNational Surgical Quality Improvement ProgramAcute fulminant ulcerative colitisQuality Improvement Program databaseSurgical Quality Improvement ProgramFulminant ulcerative colitisOngoing medical managementImmediate surgical interventionImprovement Program databaseSingle institution experienceAcute ulcerative colitisDay of admissionTiming of surgeryPsychosocial Risks are Independently Associated with Cancer Surgery Outcomes in Medically Comorbid Patients
Leeds IL, Meyers PM, Enumah ZO, He J, Burkhart RA, Haut ER, Efron JE, Johnston FM. Psychosocial Risks are Independently Associated with Cancer Surgery Outcomes in Medically Comorbid Patients. Annals Of Surgical Oncology 2019, 26: 936-944. PMID: 30617868, PMCID: PMC8710142, DOI: 10.1245/s10434-018-07136-3.Peer-Reviewed Original ResearchConceptsPsychosocial risk factorsRisk factorsPsychosocial risksSurgical outcomesPrimary tumorShort-term surgical outcomesMultiple psychosocial risk factorsCancer surgery patientsColorectal primary tumorsProspective observational studyCancer surgery outcomesMultiple psychosocial risksThreefold oddsChart reviewComplication ratePostoperative courseSurgery patientsComorbid patientsMedian ageCancer surgeryMultivariable analysisPreoperative assessmentCancer patientsSurgery outcomesObservational study
2018
Eye of the beholder: Risk calculators and barriers to adoption in surgical trainees
Leeds IL, Rosenblum AJ, Wise PE, Watkins AC, Goldblatt MI, Haut ER, Efron JE, Johnston FM. Eye of the beholder: Risk calculators and barriers to adoption in surgical trainees. Surgery 2018, 164: 1117-1123. PMID: 30149939, PMCID: PMC8383120, DOI: 10.1016/j.surg.2018.07.002.Peer-Reviewed Original ResearchConceptsRisk calculatorRisk assessment toolSurgical traineesCurrent risk calculatorsClinical workflow integrationPrimary outcomeMultivariable regressionDomain scoresRoutine useDirect verbal communicationSurgical residentsAccurate risk assessmentBehavioral factorsSystem usability scoreAssessment toolSurgical Gatekeeping — Modifiable Risk Factors and Ethical Decision Making
Leeds IL, Efron DT, Lehmann LS. Surgical Gatekeeping — Modifiable Risk Factors and Ethical Decision Making. New England Journal Of Medicine 2018, 379: 389-394. PMID: 30044939, DOI: 10.1056/nejmms1802079.Peer-Reviewed Original ResearchMalnutrition increases the risk of 30-day complications after surgery in pediatric patients with Crohn disease
Ladd MR, Garcia AV, Leeds IL, Haney C, Oliva-Hemker MM, Alaish S, Boss E, Rhee DS. Malnutrition increases the risk of 30-day complications after surgery in pediatric patients with Crohn disease. Journal Of Pediatric Surgery 2018, 53: 2336-2345. PMID: 29843908, PMCID: PMC8841062, DOI: 10.1016/j.jpedsurg.2018.04.026.Peer-Reviewed Original ResearchConceptsCrohn's diseaseAge z-scoreBowel surgeryPediatric patientsACS NSQIP-Pediatric databaseZ-scoreMajor bowel surgeryNSQIP-Pediatric databaseOdds of complicationsOverall complication ratePediatric CD patientsDegree of malnutritionSeverity of malnutritionEffects of malnutritionCDC growth chartsEffects of malnourishmentASA classImportant screening toolMalnutrition effectsPostoperative complicationsCD patientsComplication rateElective surgeryMultivariable analysisSevere malnutrition
2016
Outcomes of abdominoperineal resection for management of anal cancer in HIV-positive patients: a national case review
Leeds IL, Alturki H, Canner JK, Schneider EB, Efron JE, Wick EC, Gearhart SL, Safar B, Fang SH. Outcomes of abdominoperineal resection for management of anal cancer in HIV-positive patients: a national case review. World Journal Of Surgical Oncology 2016, 14: 208. PMID: 27495294, PMCID: PMC4974747, DOI: 10.1186/s12957-016-0970-x.Peer-Reviewed Original ResearchMeSH KeywordsAbdomenAdultAge FactorsAgedAnus NeoplasmsCarcinoma, Squamous CellComorbidityFemaleFollow-Up StudiesHealth Status DisparitiesHIV InfectionsHospital MortalityHumansIncidenceLength of StayMaleMiddle AgedNeoplasm Recurrence, LocalPerineumPostoperative ComplicationsRetrospective StudiesRisk FactorsSalvage TherapyTreatment OutcomeConceptsHIV-positive patientsLength of stayHIV-negative patientsAnal cancerNational Inpatient SampleAbdominoperineal resectionHospitalization costsHIV infectionAnal squamous cell cancerAnal squamous cell carcinomaUtilization Project National Inpatient SampleGreater hospitalization costsWorse postoperative recoveryHIV-positive groupMethodsA retrospective reviewAnal cancer patientsSquamous cell cancerHuman immunodeficiency virusMultivariable logistic regressionSquamous cell carcinomaHospital mortalityHospital stayPerioperative complicationsPostoperative hemorrhagePostoperative outcomes
2015
Patient Symptomatology in Anal Dysplasia
Hicks CW, Wick EC, Leeds IL, Efron JE, Gearhart SL, Safar B, Fang SH. Patient Symptomatology in Anal Dysplasia. JAMA Surgery 2015, 150: 563-569. PMID: 25874644, DOI: 10.1001/jamasurg.2015.28.Peer-Reviewed Original ResearchConceptsLow-grade dysplasiaAnal dysplasiaHigh-grade dysplasiaAnal painAnal lesionsMultivariable analysisPatient symptomatologyHigh-grade anal dysplasiaHigh-risk patientsMajority of patientsPhysical examination findingsHigh-risk factorsAnal PapanicolaouInitial presentationExamination findingsHIV statusPatient's symptomsPhysical examinationMedical historyBiopsy specimensSilent diseaseRoutine screeningMAIN OUTCOMEHigh riskPatients
2014
Does Close Temperature Regulation Affect Surgical Site Infection Rates?
Leeds IL, Wick EC, Melton GB. Does Close Temperature Regulation Affect Surgical Site Infection Rates? Advances In Surgery 2014, 48: 65-76. PMID: 25293608, DOI: 10.1016/j.yasu.2014.05.001.Peer-Reviewed Original Research
2013
Assessing clinical discharge data preferences among practicing surgeons
Leeds IL, Sadiraj V, Cox JC, Schnier KE, Sweeney JF. Assessing clinical discharge data preferences among practicing surgeons. Journal Of Surgical Research 2013, 184: 42-48.e3. PMID: 23706559, PMCID: PMC3758431, DOI: 10.1016/j.jss.2013.03.064.Peer-Reviewed Original Research
2012
Risk Factors for 30-Day Hospital Readmission among General Surgery Patients
Kassin MT, Owen RM, Perez SD, Leeds I, Cox JC, Schnier K, Sadiraj V, Sweeney JF. Risk Factors for 30-Day Hospital Readmission among General Surgery Patients. Journal Of The American College Of Surgeons 2012, 215: 322-330. PMID: 22726893, PMCID: PMC3423490, DOI: 10.1016/j.jamcollsurg.2012.05.024.Peer-Reviewed Original ResearchConceptsGeneral surgery proceduresGeneral surgery patientsRisk of readmissionPostoperative complicationsRisk factorsSurgery proceduresSurgery patientsHospital readmissionInpatient general surgery proceduresInstitutional clinical data warehousePoor quality patient careSignificant independent risk factorsPreoperative open woundSepsis/shockPostoperative pulmonary complicationsDays of dischargeIndependent risk factorUrinary tract infectionSingle academic centerType of procedureClinical data warehousePostoperative readmissionsPulmonary complicationsIndex hospitalizationPostoperative occurrence