2019
Effect of Travel Time for Thyroid Surgery on Treatment Cost and Morbidity
Ramirez A, Schneider E, Mehaffey J, Zeiger M, Hanks J, Smith P. Effect of Travel Time for Thyroid Surgery on Treatment Cost and Morbidity. The American Surgeon 2019, 85: 949-955. PMID: 31638505, DOI: 10.1177/000313481908500934.Peer-Reviewed Original ResearchConceptsHigh-volume centersThyroid surgeryPrimary outcomeHospital costsSingle high-volume centerMedian operative timeHealth care utilizationCertain patient populationsMultivariable regression modelingPatient's home addressHome addressPostoperative morbidityACS-NSQIPOperative timePatient populationUninsured statusThyroid diseaseEndocrine surgeryMorbidity riskThyroid proceduresSurgical careTime-related differencesPatient differencesDisease processPatients
2018
The “mortality ascent”
Herrera-Escobar JP, Rios-Diaz AJ, Zogg CK, Wolf LL, Harlow A, Schneider EB, Cooper Z, Ordonez CA, Salim A, Haider AH. The “mortality ascent”. Journal Of Trauma And Acute Care Surgery 2018, 84: 139-145. PMID: 28930947, DOI: 10.1097/ta.0000000000001706.Peer-Reviewed Original ResearchConceptsUnstable trauma patientsLevel I TCsLevel II TCsHours postadmissionTrauma patientsLevel ILevel IIMortality riskHospital mortalityLog-binomial regression modelsNational Trauma Data BankComparable mortality riskHospital-level confoundersInjury Severity ScoreSystolic blood pressureAvailable treatment modalitiesTrauma Data BankSpecific risk factorsRisk-adjusted modelsBlood pressureHigher relative mortalityUnstable patientsBurn patientsSeverity scoreTreatment modalities
2017
Variability in Gastrostomy Tube Placement for Intracerebral Hemorrhage Patients at US Hospitals
Hwang DY, George BP, Kelly AG, Schneider EB, Sheth KN, Holloway RG. Variability in Gastrostomy Tube Placement for Intracerebral Hemorrhage Patients at US Hospitals. Journal Of Stroke And Cerebrovascular Diseases 2017, 27: 978-987. PMID: 29221969, DOI: 10.1016/j.jstrokecerebrovasdis.2017.11.001.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCerebral HemorrhageClinical Decision-MakingDatabases, FactualFemaleGastrostomyHealthcare DisparitiesHospitalsHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPractice Patterns, Physicians'Process Assessment, Health CareRetrospective StudiesTime FactorsUnited StatesYoung AdultConceptsGastrostomy tube placementTube placementGastrostomy tubeICH patientsIntracerebral hemorrhageUS hospitalsMultilevel multivariable regression modelsHospital random effectsNationwide Inpatient SampleIntracerebral hemorrhage patientsMultivariable regression modelsLocal practice patternsMedian odds ratioICH hospitalizationsHospital factorsHospital covariatesRegression modelsHemorrhage patientsICH admissionsInpatient SampleOdds ratioPlacement ratesPractice patternsMedian increasePatients
2016
Predictors of emergency ventral hernia repair: Targets to improve patient access and guide patient selection for elective repair
Wolf LL, Scott JW, Zogg CK, Havens JM, Schneider EB, Smink DS, Salim A, Haider AH. Predictors of emergency ventral hernia repair: Targets to improve patient access and guide patient selection for elective repair. Surgery 2016, 160: 1379-1391. PMID: 27542434, DOI: 10.1016/j.surg.2016.06.027.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedAged, 80 and overConfidence IntervalsDatabases, FactualElective Surgical ProceduresEmergenciesFemaleFollow-Up StudiesHealth Services AccessibilityHernia, VentralHerniorrhaphyHospital MortalityHumansInsurance CoverageLogistic ModelsMaleMiddle AgedOdds RatioPatient SelectionPredictive Value of TestsQuality ImprovementRetrospective StudiesRisk AssessmentSeverity of Illness IndexSex FactorsTime FactorsTreatment OutcomeConceptsVentral hernia repairEmergency ventral hernia repairHospital-level factorsHernia repairIndependent predictorsPatient selectionElective operationsWorse outcomesEmergency repairLonger hospital stayNationwide Inpatient SampleMultivariable logistic regressionUnited States populationRace/ethnicityHospital deathHospital staySecondary outcomesElective repairPrimary outcomePayer statusInpatient SamplePatient outcomesVentral herniasElective careGreater oddsHospital readmission after multiple major operative procedures among patients with employer provided health insurance
Kim Y, Gani F, Canner J, Margonis G, Makary M, Schneider E, Pawlik T. Hospital readmission after multiple major operative procedures among patients with employer provided health insurance. Surgery 2016, 160: 178-190. PMID: 27085686, DOI: 10.1016/j.surg.2016.01.025.Peer-Reviewed Original ResearchConceptsMultiple operative proceduresDays of dischargeMajor operative proceduresOperative procedureSingle operative procedureIndex dischargeLate readmissionHospital readmissionMultivariable logistic regression analysisHigher preoperative comorbidityLate hospital readmissionLogistic regression analysisDuration of stayPreoperative comorbiditiesPostoperative complicationsPostoperative dischargeMarketScan databaseMultivariable analysisOverall incidenceAbdominal proceduresSame hospitalRisk factorsReadmissionCardiovascular proceduresGreater odds
2015
Analgesic Access for Acute Abdominal Pain in the Emergency Department Among Racial/Ethnic Minority Patients
Shah AA, Zogg CK, Zafar SN, Schneider EB, Cooper LA, Chapital AB, Peterson SM, Havens JM, Thorpe RJ, Roter DL, Castillo RC, Salim A, Haider AH. Analgesic Access for Acute Abdominal Pain in the Emergency Department Among Racial/Ethnic Minority Patients. Medical Care 2015, 53: 1000-1009. PMID: 26569642, DOI: 10.1097/mlr.0000000000000444.Peer-Reviewed Original ResearchMeSH KeywordsAbdominal PainAcute PainAdolescentAdultAgedAnalgesicsBlack or African AmericanDiagnostic Techniques and ProceduresEmergency Service, HospitalEthnicityFemaleHealth Care SurveysHealthcare DisparitiesHispanic or LatinoHospitalizationHumansLength of StayMaleMiddle AgedNarcoticsRacial GroupsResidence CharacteristicsRetrospective StudiesSocioeconomic FactorsTime FactorsWhite PeopleYoung AdultConceptsAcute abdominal painLower risk-adjusted oddsRisk-adjusted oddsAbdominal painRace/ethnicityEmergency departmentMinority patientsEthnic disparitiesNontraumatic acute abdominal painRisk-adjusted multivariable analysisNon-Hispanic black patientsNon-Hispanic white patientsRace/ethnicity-based differencesEthnic group patientsModerate-severe painPatient-reported painPatients 18 yearsProportion of patientsSubsequent inpatient admissionSurgery of TraumaRisk-adjusted differencesED wait timesNon-Hispanic blacksEthnic minority patientsUniform definitionUnderstanding Variation in 30-Day Surgical Readmission in the Era of Accountable Care: Effect of the Patient, Surgeon, and Surgical Subspecialties
Gani F, Lucas D, Kim Y, Schneider E, Pawlik T. Understanding Variation in 30-Day Surgical Readmission in the Era of Accountable Care: Effect of the Patient, Surgeon, and Surgical Subspecialties. JAMA Surgery 2015, 150: 1042-1049. PMID: 26244543, DOI: 10.1001/jamasurg.2015.2215.Peer-Reviewed Original ResearchMeSH KeywordsAccountable Care OrganizationsAdultAge FactorsAgedClinical CompetenceComprehensionDatabases, FactualDelivery of Health CareFemaleHumansIncidenceLogistic ModelsMaleMiddle AgedMultivariate AnalysisPatient ReadmissionPhysician's RolePostoperative ComplicationsRetrospective StudiesSex FactorsSocioeconomic FactorsSpecialties, SurgicalSurgical Procedures, OperativeTime FactorsConceptsMajor surgical proceduresSurgical proceduresSurgical subspecialtiesRace/ethnicityPostoperative complicationsEndocrine surgeryAfrican American race/ethnicitySurgeon-level factorsPatient-level factorsTertiary care centerLarge academic medical centerPatient-related factorsSubspecialty levelAdministrative claims dataAcademic medical centerIndividual surgeon levelDifferent surgical subspecialtiesPreoperative comorbiditiesHospital morbidityPatient ageSurgical readmissionsCardiac surgeryTransplant surgeryPayer typeCare centerEarly Versus Late Readmission After Surgery Among Patients With Employer-provided Health Insurance
Kim Y, Gani F, Lucas D, Ejaz A, Spolverato G, Canner J, Schneider E, Pawlik T. Early Versus Late Readmission After Surgery Among Patients With Employer-provided Health Insurance. Annals Of Surgery 2015, 262: 502-511. PMID: 26258319, DOI: 10.1097/sla.0000000000001429.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAgedCohort StudiesDatabases, FactualFemaleHealth Benefit Plans, EmployeeHealth Care CostsHospital CostsHumansLength of StayLogistic ModelsMaleMiddle AgedMultivariate AnalysisPatient DischargePatient ReadmissionRetrospective StudiesSurgical Procedures, OperativeTime FactorsConceptsNon-index hospitalsDays of dischargeMajor surgical proceduresSame-hospital readmissionsLate readmissionIndex hospitalHospital readmissionSurgical proceduresTruven Health MarketScan Commercial ClaimsMultivariable logistic regression analysisCharlson Comorbidity IndexMarketScan Commercial ClaimsLogistic regression analysisHospital mortalityComorbidity indexIndex dischargeEarly readmissionTrue incidenceEncounters DatabaseCommercial ClaimsReadmissionPatientsDifferent hospitalsHospitalHealth insuranceTrends in Incident Hemodialysis Access and Mortality
Malas MB, Canner JK, Hicks CW, Arhuidese IJ, Zarkowsky DS, Qazi U, Schneider EB, Black JH, Segev DL, Freischlag JA. Trends in Incident Hemodialysis Access and Mortality. JAMA Surgery 2015, 150: 441-448. PMID: 25738981, DOI: 10.1001/jamasurg.2014.3484.Peer-Reviewed Original ResearchConceptsEnd-stage renal diseaseHemodialysis cathetersArteriovenous fistulaArteriovenous graftsLower mortalityRenal diseaseVascular accessHD outcomesNational Kidney Foundation Kidney Disease Outcomes Quality InitiativeKidney Foundation Kidney Disease Outcomes Quality InitiativeMultivariable Cox proportional hazards modelsPrior renal replacement therapyUS Renal Data SystemCox proportional hazards modelArteriovenous fistula useIncident HD patientsInitiation of hemodialysisRetrospective cohort studyRenal replacement therapyProportional hazards modelFistula useCohort studySurvival benefitHD patientsPropensity score-matching techniqueEarly versus late hospital readmission after pancreaticoduodenectomy
Schneider E, Canner J, Gani F, Kim Y, Ejaz A, Spolverato G, Pawlik T. Early versus late hospital readmission after pancreaticoduodenectomy. Journal Of Surgical Research 2015, 196: 74-81. PMID: 25777825, DOI: 10.1016/j.jss.2015.02.043.Peer-Reviewed Original ResearchConceptsProcedure-related factorsLate readmissionEarly readmissionTruven Health MarketScan databaseLate hospital readmissionCoronary heart diseaseSubsequent medical managementPostoperative complicationsExtended LOSHospital readmissionRenal diseaseMarketScan databaseMedical managementMultivariable analysisPatient groupTrue burdenHeart diseaseCommon causeInclusion criteriaReadmissionPancreaticoduodenectomyPatientsDiseaseLonger lengthComplex procedures
2014
Development of a duplex-derived velocity risk prediction model of disease progression in patients with moderate asymptomatic carotid artery stenosis
Hicks CW, Canner JK, Arhuidese I, Glebova NO, Schneider E, Qazi U, Perler B, Malas MB. Development of a duplex-derived velocity risk prediction model of disease progression in patients with moderate asymptomatic carotid artery stenosis. Journal Of Vascular Surgery 2014, 60: 1585-1592. PMID: 25238724, DOI: 10.1016/j.jvs.2014.08.056.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overArea Under CurveAsymptomatic DiseasesBlood Flow VelocityCarotid Artery, CommonCarotid Artery, InternalCarotid StenosisChi-Square DistributionDecision Support TechniquesDisease ProgressionFemaleHumansMaleMiddle AgedMultivariate AnalysisPredictive Value of TestsProportional Hazards ModelsRegional Blood FlowRetrospective StudiesRisk AssessmentRisk FactorsROC CurveTime FactorsUltrasonography, Doppler, DuplexConceptsAsymptomatic carotid artery stenosisICA/CCA ratioCarotid artery stenosisInternal carotid arteryDisease progressionEnd-diastolic velocityPeak systolic velocityRisk prediction modelCCA ratioArtery stenosisSystolic velocityRisk factorsInitial peak systolic velocityProportional hazards regression modelsHigh-risk patientsRisk of progressionRisk-stratify patientsHazards regression modelsSignificant independent predictorsICA/CCACharacteristic curve analysisClinical prediction modelCarotid artery ratioIndependent predictorsDuplex imagingIncreased mortality associated with EMS transport of gunshot wound victims when compared to private vehicle transport
Zafar S, Haider A, Stevens K, Ray-Mazumder N, Kisat M, Schneider E, Chi A, Galvagno S, Cornwell E, Efron D, Haut E. Increased mortality associated with EMS transport of gunshot wound victims when compared to private vehicle transport. Injury 2014, 45: 1320-1326. PMID: 24957424, DOI: 10.1016/j.injury.2014.05.032.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAmbulancesAutomobilesEmergency Medical ServicesFemaleFluid TherapyGravity SuitsHospital MortalityHumansImmobilizationInjury Severity ScoreIntubation, IntratrachealMaleMiddle AgedMonitoring, PhysiologicOutcome and Process Assessment, Health CareRetrospective StudiesTime FactorsTransportation of PatientsTrauma CentersUnited StatesWounds, GunshotConceptsEmergency medical servicesProportion of patientsGSW patientsTrauma centerGunshot woundsNational Trauma Data BankGunshot wound victimsTrauma Data BankIndividual trauma centersMultivariable regression analysisHospital mortalityPatient demographicsUnadjusted mortalityTrauma patientsMultivariable analysisTwofold oddsEMS transportMortality differencesPatientsInjury severityPrivate vehicle transportMortalityWide variationMedical servicesFurther studiesUS emergency department visits for fireworks injuries, 2006–2010
Canner J, Haider A, Selvarajah S, Hui X, Wang H, Efron D, Haut E, Velopulos C, Schwartz D, Chi A, Schneider E. US emergency department visits for fireworks injuries, 2006–2010. Journal Of Surgical Research 2014, 190: 305-311. PMID: 24766725, DOI: 10.1016/j.jss.2014.03.066.Peer-Reviewed Original ResearchConceptsFirework injuriesEmergency departmentNinth RevisionInternational ClassificationClinical Modification external causeNationwide Emergency Department SampleClinical Modification diagnosis codesAnnual injury rateFireworks-related injuriesUS emergency departmentsLocation of injuryEmergency Department SampleUS population estimatesPublic health problemMajority of visitsNortheast census regionCommon injuriesMost injuriesDiagnosis codesSuperficial injuryInjury ratesUS populationHealth problemsInjuryOpen woundsDoes relative value unit–based compensation shortchange the acute care surgeon?
Schwartz D, Hui X, Velopulos C, Schneider E, Selvarajah S, Lucas D, Haut E, McQuay N, Pawlik T, Efron D, Haider A. Does relative value unit–based compensation shortchange the acute care surgeon? Journal Of Trauma And Acute Care Surgery 2014, 76: 84-94. PMID: 24368361, PMCID: PMC5995323, DOI: 10.1097/ta.0b013e3182ab1ae3.Peer-Reviewed Original ResearchConceptsLength of stayAcute care surgeonsEmergent casesRelative value unitsPatient careNational Surgical Quality Improvement ProgramSurgical Quality Improvement ProgramComorbidities of interestEmergent operative managementHigher mortality riskQuality Improvement ProgramCurrent Procedural TerminologyElective colectomyMinor complicationsComplication rateOperative timeEmergent proceduresMore complicationsOperative managementBiliary proceduresElective proceduresOpen techniqueElective patientsOdds ratioHernia repair
2013
The effect of ballooning following carotid stent deployment on hemodynamic stability
Qazi U, Obeid T, Enwerem N, Schneider E, White J, Freischlag J, Perler B, Malas M. The effect of ballooning following carotid stent deployment on hemodynamic stability. Journal Of Vascular Surgery 2013, 59: 756-760.e1. PMID: 24342066, DOI: 10.1016/j.jvs.2013.09.027.Peer-Reviewed Original ResearchConceptsCarotid artery stentingCoronary artery diseaseRecent myocardial infarctionHemodynamic depressionHemodynamic instabilityHemodynamic stabilitySymptomatic statusArtery diseaseMyocardial infarctionStent stenosisMajor adverse cardiovascular eventsCarotid stent deploymentPrevious carotid endarterectomyAdverse cardiovascular eventsPrimary end pointTertiary care centerLength of stayRisk of intraLong-term patencyHigh-risk statusGreater luminal diameterLogistic regression modelsBinary logistic regression modelCardiovascular eventsLack of evidenceInfluence of Patient, Physician, and Hospital Factors on 30-Day Readmission Following Pancreatoduodenectomy in the United States
Hyder O, Dodson R, Nathan H, Schneider E, Weiss M, Cameron J, Choti M, Makary M, Hirose K, Wolfgang C, Herman J, Pawlik T. Influence of Patient, Physician, and Hospital Factors on 30-Day Readmission Following Pancreatoduodenectomy in the United States. JAMA Surgery 2013, 148: 1095-1102. PMID: 24108580, PMCID: PMC3983984, DOI: 10.1001/jamasurg.2013.2509.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAttitude of Health PersonnelCohort StudiesComorbidityCross InfectionFemaleHealth Care SurveysHospital MortalityHumansLength of StayMaleMedicareOutcome Assessment, Health CarePancreatic NeoplasmsPancreaticoduodenectomyPatient ReadmissionPostoperative ComplicationsPractice Patterns, Physicians'Retrospective StudiesRisk FactorsSEER ProgramSurvival RateTime FactorsUnited StatesWorkloadConceptsPancreatoduodenectomy proceduresMedical comorbiditiesHospital factorsSurgeon volumeMedicare dataPopulation-based cancer registry dataPreoperative medical comorbiditiesRetrospective cohort studyDays of dischargeHospital-level factorsLow-volume hospitalsPatient-related factorsChance of readmissionLength of stayInfluence of patientCancer registry dataPancreatoduodenectomy patientsHospital morbidityCohort studyHospital volumeHospital readmissionMedian agePhysician factorsDistinct hospitalsPatient levelA protocol-driven approach to early extubation after heart surgery
Fitch Z, Debesa O, Ohkuma R, Duquaine D, Steppan J, Schneider E, Whitman G. A protocol-driven approach to early extubation after heart surgery. Journal Of Thoracic And Cardiovascular Surgery 2013, 147: 1344-1350. PMID: 24269120, DOI: 10.1016/j.jtcvs.2013.10.032.Peer-Reviewed Original ResearchConceptsPatient shiveringRisk factorsVentilation timePostoperative mechanical ventilation timeLow body temperatureStandardized protocolMechanical ventilation timeRate of reintubationIndependent risk factorPercent of patientsPeriod 1 patientProtocol-driven approachBody temperatureReintubation rateEarly extubationProlonged ventilationCoronary bypassHeart surgeryReminder sheetsMultidisciplinary committeePatientsLogistic regressionPatient safetyExtubationBaseline practiceComparison of open and endovascular treatment of acute mesenteric ischemia
Beaulieu R, Arnaoutakis K, Abularrage C, Efron D, Schneider E, Black J. Comparison of open and endovascular treatment of acute mesenteric ischemia. Journal Of Vascular Surgery 2013, 59: 159-164. PMID: 24199769, DOI: 10.1016/j.jvs.2013.06.084.Peer-Reviewed Original ResearchMeSH KeywordsAgedChi-Square DistributionDigestive System Surgical ProceduresEndovascular ProceduresFemaleHospital MortalityHumansIschemiaLength of StayMaleMesenteric IschemiaParenteral Nutrition, TotalRisk FactorsTime FactorsTreatment OutcomeUnited StatesVascular DiseasesVascular Surgical ProceduresConceptsAcute mesenteric ischemiaBowel resectionLength of stayEndovascular repairOpen revascularizationEndovascular treatmentEndovascular interventionMesenteric ischemiaParenteral nutritionVascular repairVascular interventionsDiagnosis of AMINational Inpatient Sample databaseSubsequent vascular interventionProportion of patientsSeverity of comorbiditiesTotal parenteral nutritionNinth Revision codesPatient-level dataStudy time periodCharlson indexTPN supportSame hospitalizationBowel perfusionGastrointestinal outcomesInfluence of gender on outcomes after thoracic endovascular aneurysm repair
Arnaoutakis G, Schneider E, Arnaoutakis D, Black J, Lum Y, Perler B, Freischlag J, Abularrage C. Influence of gender on outcomes after thoracic endovascular aneurysm repair. Journal Of Vascular Surgery 2013, 59: 45-51. PMID: 23896176, DOI: 10.1016/j.jvs.2013.06.058.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAortic Aneurysm, ThoracicChi-Square DistributionDatabases, FactualEmergenciesEndovascular ProceduresFemaleHumansIliac ArteryLinear ModelsLogistic ModelsMaleMultivariate AnalysisOdds RatioPostoperative ComplicationsRegistriesRetrospective StudiesRisk FactorsSex FactorsTime FactorsTreatment OutcomeUnited StatesConceptsIliac artery exposureNonruptured thoracic aortic aneurysmsAortic aneurysm repairThoracic aortic aneurysmAneurysm repairArtery exposureUnadjusted mortalityMultivariable analysisAortic aneurysmFemale genderSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseRisk-adjusted generalized linear modelsEndovascular abdominal aortic aneurysm repairQuality Improvement Program databaseAbdominal aortic aneurysm repairEndovascular aortic aneurysm repairACS-NSQIP databaseImprovement Program databasePrimary outcome measureEndovascular aneurysm repairHigh mortality rateHospital lengthPostoperative complicationsTransfusion rateComparison of surgical bypass with angioplasty and stenting of superficial femoral artery disease
Malas M, Enwerem N, Qazi U, Brown B, Schneider E, Reifsnyder T, Freischlag J, Perler B. Comparison of surgical bypass with angioplasty and stenting of superficial femoral artery disease. Journal Of Vascular Surgery 2013, 59: 129-135. PMID: 23891488, DOI: 10.1016/j.jvs.2013.05.100.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngioplasty, BalloonBaltimoreBlood Vessel Prosthesis ImplantationChi-Square DistributionFemaleFemoral ArteryHumansKaplan-Meier EstimateMaleMiddle AgedMultivariate AnalysisPeripheral Arterial DiseasePostoperative ComplicationsProportional Hazards ModelsRegistriesRisk FactorsStentsTime FactorsTreatment OutcomeVascular GraftingVascular PatencyVeinsConceptsPeripheral arterial diseaseFemoral-popliteal bypassPercutaneous transluminal angioplasty/stentingJohns Hopkins Bayview Medical CenterAngioplasty/stentingSuperficial femoral arteryReintervention rateTASC CSymptomatic patientsD lesionsMedical managementB lesionsFemoral arteryMedical CenterSuperficial femoral artery diseaseSymptomatic peripheral arterial diseaseFemoral artery diseaseTASC II ARate of reinterventionHigher reintervention rateBest treatment optionSimilar risk factorsProportional hazards modelTerms of patencyFisher's exact test