2008
Real money: Complications and hospital costs in trauma patients
Hemmila MR, Jakubus JL, Maggio PM, Wahl WL, Dimick JB, Campbell DA, Taheri PA. Real money: Complications and hospital costs in trauma patients. Surgery 2008, 144: 307-316. PMID: 18656640, PMCID: PMC2583342, DOI: 10.1016/j.surg.2008.05.003.Peer-Reviewed Original ResearchConceptsMajor complication groupMinor complication groupComplication groupHospital costsTrauma patientsDuration of stayMinor complicationsMajor complicationsHospital chargesNational Surgical Quality Improvement Program methodologyEmergency department systolic blood pressureQuality careMedian total hospital costLevel 1 trauma centerNew Injury Severity ScoreGeneral surgery populationMajor postoperative complicationsInjury Severity ScoreSystolic blood pressureTotal hospital chargesTotal hospital costsTypes of complicationsMedian hospital chargesImproved quality carePostoperative complicationsAngioembolization Reduces Operative Intervention for Blunt Splenic Injury
Wei B, Hemmila MR, Arbabi S, Taheri PA, Wahl WL. Angioembolization Reduces Operative Intervention for Blunt Splenic Injury. Journal Of Trauma And Acute Care Surgery 2008, 64: 1472-1477. PMID: 18545111, DOI: 10.1097/ta.0b013e318174e8cd.Peer-Reviewed Original ResearchMeSH KeywordsAbdominal InjuriesAdultAngiographyCohort StudiesEmbolization, TherapeuticFemaleFollow-Up StudiesHumansInjury Severity ScoreMaleMiddle AgedMultivariate AnalysisProbabilityRadiography, InterventionalRetrospective StudiesRisk AssessmentSplenectomySplenic RuptureTrauma CentersTreatment OutcomeWounds, NonpenetratingConceptsBlunt splenic injuryAngiographic embolizationInjury Severity ScoreSplenic injuryOperative interventionInjury scoreSeverity scoreAE groupSimilar Injury Severity ScoresGlasgow Coma Scale scorePacked RBC transfusionSplenic salvage rateAdult trauma patientsAbbreviated Injury ScoreLength of stayOverall hospitalization costsAbdominal complicationsIntraabdominal complicationsThromboembolic eventsNonoperative managementOnly patientsRBC transfusionSalvage rateTrauma patientsPleural effusion
2007
Detecting the blind spot: Complications in the trauma registry and trauma quality improvement
Hemmila MR, Jakubus JL, Wahl WL, Arbabi S, Henderson WG, Khuri SF, Taheri PA, Campbell DA. Detecting the blind spot: Complications in the trauma registry and trauma quality improvement. Surgery 2007, 142: 439-449. PMID: 17950334, PMCID: PMC2080842, DOI: 10.1016/j.surg.2007.07.002.Peer-Reviewed Original ResearchConceptsNational Trauma Data BankGeneral surgery patientsNational Surgical Quality Improvement ProgramSurgery patientsTrauma patientsNSQIP methodologyNTDB patientsTrauma centerOutcome dataLevel 1 trauma centerSurgical Quality Improvement ProgramVeterans Affairs Healthcare SystemRisk adjustmentRisk-adjusted mannerTrauma patient groupsTrauma quality improvementTrauma Data BankQuality Improvement ProgramHigh rateRisk-adjusted ratesImportant comorbidityAdult patientsPatient comorbiditiesTrauma registryMore complicationsFinancial Impact of Hand Surgery Programs on Academic Medical Centers
Hasan JS, Chung KC, Storey AF, Bolg ML, Taheri PA. Financial Impact of Hand Surgery Programs on Academic Medical Centers. Plastic & Reconstructive Surgery 2007, 119: 627-635. PMID: 17230099, DOI: 10.1097/01.prs.0000246528.28652.11.Peer-Reviewed Original ResearchConceptsFacility revenueOperating incomeProfessional revenueCost accounting systemTotal costFinancial dataNet revenueFinancial performanceFinancial evaluationRevenueClinic chargesIncomeDollarsFinancial impactAccounting systemDirect costsOverhead costsCollection rateCharge categoriesHospital cost accounting systemCostDepartment of SurgeryAcademic medical centerFacility costsMedical Center
2006
Broken bodies, broken hearts? Limitations of the trauma system as a model for regionalizing care for ST-Elevation Myocardial Infarction in the United States
Nallamothu BK, Taheri PA, Barsan WG, Bates ER. Broken bodies, broken hearts? Limitations of the trauma system as a model for regionalizing care for ST-Elevation Myocardial Infarction in the United States. American Heart Journal 2006, 152: 613-618. PMID: 16996824, DOI: 10.1016/j.ahj.2006.03.025.Peer-Reviewed Original ResearchA New Prescription for Healthcare Leadership
Harkins D, Butz D, Taheri P. A New Prescription for Healthcare Leadership. Journal Of Trauma Nursing 2006, 13: 126-130. PMID: 17052094, DOI: 10.1097/00043860-200607000-00011.Peer-Reviewed Original ResearchAccountingBudgetsCommerceCurriculumEducation, Nursing, ContinuingEmergency Service, HospitalFinancial Management, HospitalForecastingHealth Services Needs and DemandHumansIntensive Care UnitsLeadershipLength of StayNurse AdministratorsNurse's RoleOperating RoomsOperations ResearchProfessional CompetenceProgram DevelopmentStaff DevelopmentTraumatology
2005
Perioperative Issues: Myocardial Ischemia and Protection — Beta-Blockade
Maggio P, Taheri P. Perioperative Issues: Myocardial Ischemia and Protection — Beta-Blockade. Surgical Clinics Of North America 2005, 85: 1091-1102. PMID: 16326195, DOI: 10.1016/j.suc.2005.09.016.Peer-Reviewed Original ResearchConceptsNoncardiac surgeryPeri-operative cardiac eventsHigh-risk patientsLow-risk patientsThird of patientsPreoperative risk assessmentCoronary artery diseaseLow complication rateCardiac complicationsCardiovascular complicationsPerioperative morbidityPerioperative outcomesCardiac eventsComplication rateArtery diseaseMyocardial ischemiaImportant causePatientsGreater riskMorbidityComplicationsSurgeryMortalityRiskGreat benefitReferral Patterns and Severity Distribution of Burn Care
Pacella S, Harkins D, Butz D, Kuzon W, Taheri P. Referral Patterns and Severity Distribution of Burn Care. Annals Of Plastic Surgery 2005, 54: 412-419. PMID: 15785284, DOI: 10.1097/01.sap.0000154877.59894.5e.Peer-Reviewed Original ResearchConceptsHigh-volume hospitalsLow-volume hospitalsNational Inpatient SampleReferral patternsBurn centerModerate-volume hospitalsHigh-volume centersRegional burn centerTotal burn admissionsState of MichiganBurn patientsEducation of surgeonsInpatient SamplePatient distributionBurn providersBurn careBurn admissionsSevere burnsPatientsSurgical programsSurgical training programsAdmissionHospitalHospital AssociationSurgical residents
2003
Aeromedical Service: How Does it Actually Contribute to the Mission?
Rosenberg B, Butz D, Comstock M, Taheri P. Aeromedical Service: How Does it Actually Contribute to the Mission? Journal Of Trauma And Acute Care Surgery 2003, 54: 681-688. PMID: 12707529, DOI: 10.1097/01.ta.0000054684.83538.45.Peer-Reviewed Original ResearchConceptsDiagnosis-related groupsSF patientsHealth systemAeromedical servicesIntensive care unit stayIntensive care unit daysMichigan Health SystemDownstream revenueAdmitting servicesUnit stayUnit daysClinical activityInpatient revenueInpatient daysPatientsPatient careAeromedical transportationProfessional feesStayDaysAdmissionHospitalOverall lengthCare
1999
Trauma services: a profit center?
Taheri P, Butz D, Watts C, Griffes L, Greenfield L. Trauma services: a profit center? Journal Of The American College Of Surgeons 1999, 188: 349-354. PMID: 10195717, DOI: 10.1016/s1072-7515(99)00021-6.Peer-Reviewed Original ResearchConceptsInjury Severity ScoreLength of stayGroup ATrauma centerGroup BProportion of costsTrauma serviceMean cost/patientLevel I trauma centerI trauma centerCost/patientCost of careFiscal year 1997Hospital cost accounting systemBlunt mechanism injuryMechanism injuriesTrauma registrySeverity scoreSick patientsInadequate reimbursementPatient basisPatientsPatient groupingsStayTotal service cost
1998
Trauma Service Cost
Taheri P, Wahl W, Butz D, Iteld L, Michaels A, Griffes L, Bishop G, Greenfield L. Trauma Service Cost. Annals Of Surgery 1998, 227: 720-725. PMID: 9605663, PMCID: PMC1191353, DOI: 10.1097/00000658-199805000-00012.Peer-Reviewed Original ResearchConceptsAverage Injury Severity ScoreLevel I trauma centerOperating roomEmergency room timeI trauma centerInjury Severity ScorePhysician-led teamsVariable direct costsHospital finance departmentCase management approachEmergency servicesLab drawsClinical pharmacistsEarly dischargeTrauma centerCost-containment strategiesSeverity scoreTrauma serviceTrauma careMean costRoom timeSurgeon involvementPatient volumeFiscal year 1996Study period
1997
Tumor Necrosis Factor Activity Increases in the Early Response to Trauma
Ferguson K, Taheri P, Rodriguez J, Tonapi V, Cardellio A, Dechert R. Tumor Necrosis Factor Activity Increases in the Early Response to Trauma. Academic Emergency Medicine 1997, 4: 1035-1040. PMID: 9383488, DOI: 10.1111/j.1553-2712.1997.tb03676.x.Peer-Reviewed Original ResearchConceptsTumor necrosis factorCytokine levelsTNF levelsTNF activityMean levelsAdult major trauma patientsBaseline IL-8 levelsPg/Injury Severity Scale scoreLate groupUniversity hospital EDMajor trauma patientsIL-8 levelsSeverity Scale scoreCross-sectional studyIL-6 activityPatient demographicsTrauma patientsEqual-sized groupsHospital EDMajor traumaPotential confoundersIL-8Necrosis factorHealthy volunteersPhysician Resource Utilization after Geriatric Trauma
Taheri P, Iteld L, Michaels A, Edelstein S, Di Ponio L, Rodriguez J. Physician Resource Utilization after Geriatric Trauma. Journal Of Trauma And Acute Care Surgery 1997, 43: 565-569.. PMID: 9356049, DOI: 10.1097/00005373-199710000-00001.Peer-Reviewed Original ResearchConceptsTrauma serviceGlasgow Coma Scale scorePMR consultationGeriatric trauma patientsInjury Severity ScoreGeneral surgical serviceLong-term outcomesPatients' functional outcomeLength of stayNursing home placementSignificant differencesHealth care resourcesMultidisciplinary trauma teamPhysician resource utilizationPMR interventionGeriatric traumaTrauma patientsGeriatric patientsSignificant group differencesPhysician consultationFunctional outcomeMultiple traumaSeverity scoreSubgroup analysisEarly consultation
1996
Blunt Force Injury of the Abdominal Aorta
Michaels A, Gerndt S, Taheri P, Wang S, Wahl W, Simeone D, Williams D, Greenfield L, Rodriguez J. Blunt Force Injury of the Abdominal Aorta. Journal Of Trauma And Acute Care Surgery 1996, 41: 105-109.. PMID: 8676400, DOI: 10.1097/00005373-199607000-00016.Peer-Reviewed Original ResearchConceptsAortic injuryAbdominal aortaAbdominal aortic injuryExtra-anatomic bypassLower extremity amputationEndovascular stent placementMichigan Medical CenterBlunt force mechanismManagement of injuriesBlunt force injuriesNonoperative optionsViable limbStable patientsClinical presentationOperative repairRetrospective reviewSurgical repairUnstable patientsExtremity amputationRadiologic placementGraft placementBlunt force traumaStent placementTraumatic injuryMedical CenterEarly Placement of Prophylactic Vena Caval Filters in Injured Patients at High Risk for Pulmonary Embolism
Rodriguez J, Lopez J, Proctor M, Conley J, Gerndt S, Marx M, Taheri P, Greenfield L. Early Placement of Prophylactic Vena Caval Filters in Injured Patients at High Risk for Pulmonary Embolism. Journal Of Trauma And Acute Care Surgery 1996, 40: 797-804.. PMID: 8614083, DOI: 10.1097/00005373-199605000-00020.Peer-Reviewed Original ResearchConceptsVena caval filtersPulmonary embolismVCF placementCaval filtersRisk factorsProphylaxis of PEIncidence of PEProphylactic VCF placementProspective study groupVenous thromboembolic prophylaxisLong-term morbidityMechanism of injuryMore risk factorsVena caval thrombusVenous stasis diseaseVCF groupThromboembolic prophylaxisCaval thrombusConsecutive patientsMultiple injuriesClinical reductionHistorical controlsStudy groupHigh riskOutcome data
1995
Prehospital classification combined with an in-hospital trauma radio system response reduces cost and duration of evaluation of the injured patient
Gerndt S, Conley J, Lowell M, Holmes J, Marsh E, Larin L, Taheri P, Polley T, Rodriquez J. Prehospital classification combined with an in-hospital trauma radio system response reduces cost and duration of evaluation of the injured patient. Surgery 1995, 118: 789-796. PMID: 7570338, DOI: 10.1016/s0039-6060(05)80051-0.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultChildEmergency Medical Service Communication SystemsHospital Communication SystemsHospital CostsHumansInterdepartmental RelationsMichiganMiddle AgedPatient Care TeamPhysical ExaminationRadioSeverity of Illness IndexSystems IntegrationTime FactorsTrauma CentersTriageWounds and InjuriesConceptsTrauma classification systemsInitial trauma evaluationHealth care resourcesTrauma system developmentBlunt mechanismTrauma patientsPediatric populationTrauma centerExpeditious careTrauma evaluationPatient outcomesEmergency treatmentEmergency carePatientsTrauma victimsCare resourcesDuration of evaluationClassification systemInitial evaluationAdverse effectsSignificant reductionTrauma responseCareAssociated reductionResponsePseudoaneurysms of the Intraparenchymal Splenic Artery after Blunt Abdominal Trauma
Sugg S, Gerndt S, Hamilton B, Francis I, Taheri P, Rodriguez J. Pseudoaneurysms of the Intraparenchymal Splenic Artery after Blunt Abdominal Trauma. Journal Of Trauma And Acute Care Surgery 1995, 39: 593-595.. PMID: 7473932, DOI: 10.1097/00005373-199509000-00034.Peer-Reviewed Original ResearchConceptsSplenic arteryNonoperative therapyBlunt abdominal traumaTraumatic splenic injurySplenic injuryAbdominal traumaAdult patientsBlunt injuryRare complicationPosttraumatic pseudoaneurysmPseudoaneurysm formationSplenic ruptureArterySuccessful managementPotential mechanismsPseudoaneurysmTherapyInjuryComplicationsPatientsSpleenDiagnosisTraumaBiliary Tract Injury following Blunt Abdominal Trauma
Gerndt S, Seidel S, Taheri P, Rodriguez J. Biliary Tract Injury following Blunt Abdominal Trauma. Journal Of Trauma And Acute Care Surgery 1995, 39: 612-615.. PMID: 7473937, DOI: 10.1097/00005373-199509000-00039.Peer-Reviewed Original ResearchConceptsBiliary tract injuryBlunt abdominal traumaEndoscopic retrograde cholangiopancreatographyTract injuryAbdominal traumaBiliary stent placementOperative interventionSurgical explorationRetrograde cholangiopancreatographyStent placementDiagnostic evaluationComputerized tomographyInjuryPatientsTraumaCholangiopancreatographyDiagnosisPolypropylene mesh closure of the complicated abdominal wound
Fansler R, Taheri P, Cullinane C, Sabates B, Flint L. Polypropylene mesh closure of the complicated abdominal wound. The American Journal Of Surgery 1995, 170: 15-18. PMID: 7793486, DOI: 10.1016/s0002-9610(99)80244-x.Peer-Reviewed Original ResearchConceptsSplit-thickness skinSecondary intentionPolypropylene meshAbdominal closureMesh removalComplicated abdominal woundDifficult abdominal closureFull-thickness coverageGross wound contaminationMyocutaneous flap coveragePolypropylene mesh closureFull-thickness closureUnacceptably high ratesAbdominal complicationsFistulous complicationsFrequent complicationEnterocutaneous fistulaFascial closureIntestinal edemaFascial necrosisFlap coverageMesh closurePrimary closureAbdominal woundsOperative procedure
1993
A convincing case for primary repair of penetrating colon injuries
Taheri P, Ferrara J, Johnson C, Lamberson K, Flint L. A convincing case for primary repair of penetrating colon injuries. The American Journal Of Surgery 1993, 166: 39-44. PMID: 8328627, DOI: 10.1016/s0002-9610(05)80579-3.Peer-Reviewed Original ResearchConceptsIntra-abdominal complicationsColon injuriesPrimary repairDC groupMajor intra-abdominal complicationsElective colostomy closurePercentage of patientsWound infection rateTerms of agePreoperative hypotensionColostomy closureLimited collateral damageComplication rateWound infectionSkin closureColon traumaPR groupIntergroup differencesPatientsInfection rateInjuryColostomyComplicationsTraumaRepair