2024
Four-factor prothrombin complex concentrate is not inferior to andexanet alfa for the reversal or oral factor Xa inhibitors: An Eastern Association for the Surgery of Trauma multicenter study
Estroff J, Devlin J, Hoteit L, Hassoune A, Neal M, Brown J, Lu L, Kotch S, Hazelton J, Christian A, Yeates E, Nahmias J, Jacobson L, Williams J, Schuster K, O'Connor R, Semon G, Straughn A, Cullinane D, Egodage T, Kincaid M, Rollins A, Amdur R, Sarani B. Four-factor prothrombin complex concentrate is not inferior to andexanet alfa for the reversal or oral factor Xa inhibitors: An Eastern Association for the Surgery of Trauma multicenter study. Journal Of Trauma And Acute Care Surgery 2024, 97: 541-545. PMID: 38685190, DOI: 10.1097/ta.0000000000004345.Peer-Reviewed Original ResearchProthrombin complex concentrateAmount of RBC transfusionRed blood cell transfusionAndexanet alfaRed blood cellsRBC transfusionMulticenter study of adult patientsNon-inferiorityComparing prothrombin complex concentrateOral factor Xa inhibitorsStudy of adult patientsTransfused red blood cellsIncreased RBC transfusionsReversal of DOACsComplex concentrateFactor Xa inhibitorsTreatment of hemorrhageTraumatically injured patientsDOAC reversalMedian transfusionTransfusion rateUnit transfusionsMulticenter studyAdult patientsXa inhibitorsA novel preoperative score to predict severe acute cholecystitis
Kuhlenschmidt K, Taveras L, Schuster K, Kaafarani H, El Hechi M, Puri R, Crandall M, Schroeppel T, Cripps M. A novel preoperative score to predict severe acute cholecystitis. Journal Of Trauma And Acute Care Surgery 2024, 96: 870-875. PMID: 38523119, DOI: 10.1097/ta.0000000000004308.Peer-Reviewed Original ResearchAcute cholecystitisPreoperative scoresLogistic regression modelsGrading scaleAmerican Association for the SurgerySevere acute cholecystitisStepwise logistic regression modelSurgical decision makingPrognostic Level IIIMulticenter databaseMulticenter trialMulticenter validationCholecystitisCounseling patientsHigh-gradeLevel IIIC-statisticPatientsRegression modelsCholecystectomyMulticenterScoresSacPositive correlationGradePatient reported outcomes of emergency general surgery procedures
Mathew P, Ali Y, O'Connor R, Levinson R, Khan A, Schuster K. Patient reported outcomes of emergency general surgery procedures. The American Journal Of Surgery 2024, 232: 118-125. PMID: 38413350, DOI: 10.1016/j.amjsurg.2024.01.021.Peer-Reviewed Original ResearchEmergency general surgeryEmergency general surgery patientsMixed methods studyEmergency general surgery proceduresSemi-structured interviewsPatient experienceHealthcare systemMethods studyOutcome measuresInterpretation - PatientsPatient outcomesGeneral surgery proceduresDecision-makingCommunication issuesSeverity of complicationsCareFindings to clinical characteristicsPROMGeneral surgeryEmergency surgeryClinical characteristicsExpeditious treatmentOutcomesTeamSurgery procedures
2023
Contemporary management of acute pancreatitis: What you need to know
Palumbo R, Schuster K. Contemporary management of acute pancreatitis: What you need to know. Journal Of Trauma And Acute Care Surgery 2023, 96: 156-165. PMID: 37722072, DOI: 10.1097/ta.0000000000004143.Peer-Reviewed Original ResearchConceptsAcute care surgeonsSevere acute pancreatitisAcute pancreatitisPeripancreatic fluid collectionsFluid collectionEarly enteral nutritionTiming of cholecystectomyEndoscopic treatment modalitiesAcute care surgeryAcute Pancreatitis ScoreSpecific clinical scenariosCross-sectional imagingEnteral nutritionGallstone pancreatitisBiliary pancreatitisInitial managementOngoing symptomsSurgical debridementAtlanta criteriaBedside indexCare surgeryFluid resuscitationInvasive necrosectomyLandmark trialsTrauma gradeRoutine post-operative labs and healthcare system burden in acute appendicitis
Sznol J, Becher R, Maung A, Bhattacharya B, Davis K, Schuster K. Routine post-operative labs and healthcare system burden in acute appendicitis. The American Journal Of Surgery 2023, 226: 571-577. PMID: 37291012, DOI: 10.1016/j.amjsurg.2023.06.005.Peer-Reviewed Original ResearchConceptsHealthcare system burdenSystem burdenHealth care costsAppendicitis managementIncreased LOSUncomplicated AAAcute appendicitisRetrospective cohortClinical courseClinical variablesPatient populationMinimal comorbiditiesMultivariable modelingHealthcare costsCare costsPatientsLaboratory utilizationNational Health Expenditure AccountsLab utilizationLaboratory testingBurdenLaboratory testsAppendicitisComorbiditiesCohortCurrent use of the National Surgical Quality Improvement Program surgical risk calculator in academic surgery: a mixed-methods study
Miller S, Azar S, Farrelly J, Salzman G, Broderick M, Sanders K, Anto V, Patel N, Cordova A, Schuster K, Jones T, Kodadek L, Gross C, Morton J, Rosenthal R, Becher R. Current use of the National Surgical Quality Improvement Program surgical risk calculator in academic surgery: a mixed-methods study. Surgery In Practice And Science 2023, 13: 100173. PMID: 37502700, PMCID: PMC10373440, DOI: 10.1016/j.sipas.2023.100173.Peer-Reviewed Original ResearchNSQIP Surgical Risk CalculatorSurgical Risk CalculatorNonelective casesRisk calculatorNational Surgical Quality Improvement Program Surgical Risk CalculatorHigh-risk patientsGeneral clinical practiceSpecific clinical scenariosCross-sectional studyElectronic health recordsFrail patientsPrimary outcomeHalf of respondentsPreoperative assessmentContemporary surgical practiceClinical practiceClinical scenariosSurgical practicePast monthPatientsSurgeonsTraining statusSurrogate consentPotential interventionsHealth recordsContemporary management and outcomes of penetrating colon injuries: Validation of the 2020 AAST Colon Organ Injury Scale
Zeineddin A, Tominaga G, Crandall M, Almeida M, Schuster K, Jawad G, Maqbool B, Sheffield A, Dhillon N, Radow B, Moorman M, Martin N, Jacovides C, Lowry D, Kaups K, Horwood C, Werner N, Proaño-Zamudio J, Kaafarani H, Marshall W, Haines L, Schaffer K, Staudenmayer K, Kozar R. Contemporary management and outcomes of penetrating colon injuries: Validation of the 2020 AAST Colon Organ Injury Scale. Journal Of Trauma And Acute Care Surgery 2023, 95: 213-219. PMID: 37072893, DOI: 10.1097/ta.0000000000003969.Peer-Reviewed Original ResearchConceptsOrgan Injury ScaleExtra-abdominal infectionsColon injuriesInjury ScaleAbbreviated Injury Scale scoreContemporary managementLevel 1 trauma centerAcute kidney injuryDamage control laparotomyInjury Scale scoreInjury Severity ScoreStrong predictive valueType of interventionAmerican AssociationKidney injuryLung injuryOperative findingsClinical outcomesPrimary repairSurgical managementTrauma centerMulticenter studyOperative managementPreoperative imagingRetrospective studyEarly VTE prophylaxis in severe traumatic brain injury: A propensity score weighted EAST multicenter study
Ratnasekera A, Kim D, Seng S, Jacovides C, Kaufman E, Sadek H, Perea L, Monaco C, Shnaydman I, Lee A, Sharp V, Miciura A, Trevizo E, Rosenthal M, Lottenberg L, Zhao W, Keininger A, Hunt M, Cull J, Balentine C, Egodage T, Mohamed A, Kincaid M, Doris S, Cotterman R, Seegert S, Jacobson L, Williams J, Whitmill M, Palmer B, Mentzer C, Tackett N, Hranjec T, Dougherty T, Morrissey S, Donatelli-Seyler L, Rushing A, Tatebe L, Nevill T, Aboutanos M, Hamilton D, Redmond D, Cullinane D, Falank C, McMellen M, Duran C, Daniels J, Ballow S, Schuster K, Ferrada P. Early VTE prophylaxis in severe traumatic brain injury: A propensity score weighted EAST multicenter study. Journal Of Trauma And Acute Care Surgery 2023, 95: 94-104. PMID: 37017458, DOI: 10.1097/ta.0000000000003985.Peer-Reviewed Original ResearchConceptsVenous thromboembolism eventsIntracranial hemorrhage expansionSevere traumatic brain injuryTraumatic brain injuryVTE prophylaxisPropensity scoreBrain injuryHead CTHigh riskHigh incidenceAdult patients 18 yearsLevel II trauma centerEarly VTE prophylaxisEAST multicenter studyPatients 18 yearsUnivariate logistic regression modelMulti-center analysisLogistic regression modelsTiming of initiationProphylaxis initiationThromboembolism eventsPredictors of interestClinical characteristicsPrimary outcomeRetrospective reviewAlcohol withdrawal syndrome in trauma patients: a study using the Trauma Quality Program Participant User File
Jones T, Bhattacharya B, Schuster K, Becher R, Kodadek L, Davis K, Maung A. Alcohol withdrawal syndrome in trauma patients: a study using the Trauma Quality Program Participant User File. Trauma Surgery & Acute Care Open 2023, 8: e001047. PMID: 37188153, PMCID: PMC10175962, DOI: 10.1136/tsaco-2022-001047.Peer-Reviewed Original ResearchAlcohol withdrawal syndromeAlcohol use disorderPositive blood alcohol concentrationHistory of AUDBlood alcohol concentrationParticipant User FileAdult patientsTrauma patientsWithdrawal syndromeAbbreviated Injury Scale headHigh-risk patient populationInjury scale headAdult trauma patientsPositive toxicology screenMultivariable logistic regressionRetrospective reviewRetrospective studyToxicology screenPatient populationTricyclic antidepressantsMAIN OUTCOMEAmerican CollegePatientsUse disordersUncommon occurrenceImaging acute cholecystitis, one test is enough
Schuster K, Schroeppel T, O'Connor R, Enniss T, Cripps M, Cullinane D, Kaafarani H, Crandall M, Puri R, Tominaga G. Imaging acute cholecystitis, one test is enough. The American Journal Of Surgery 2023, 226: 99-103. PMID: 36882336, DOI: 10.1016/j.amjsurg.2023.02.018.Peer-Reviewed Original ResearchConceptsCommon bile duct diameterBile duct diameterAcute cholecystitisIntra-class correlation coefficientDuct diameterRight upper quadrant painUpper quadrant painSigns of inflammationSingle imaging studyChi-square testQuadrant painPericholecystic fluidWall thicknessMulticenter studyPatientsImaging studiesCholecystitisAbnormal valuesGold standardAdequate informationPainInflammationAdmissionStudyDiagnosisManagement and Outcome of High-Grade Hepatic and Splenic Injuries
Presser E, Sznol J, Schuster K. Management and Outcome of High-Grade Hepatic and Splenic Injuries. Current Surgery Reports 2023, 11: 55-63. DOI: 10.1007/s40137-023-00344-1.Peer-Reviewed Original ResearchSplenic injuryOperative interventionUnstable patientsTrauma grade IVHigh-grade injuriesModality of choiceTransient respondersActive bleedingGrade injuriesSerial examsStable patientsSignificant morbidityPermissive hypotensionEndovascular interventionPrehospital interventionsRadiological studiesTrauma bayBlood productsGrade IVPatientsSecondary surveyInjuryExact indicationsClass IIIActive signsFrom mild to gangrenous cholecystitis, laparoscopic cholecystectomy is safe 24 hours a day
Taveras L, Scrushy M, Cripps M, Kuhlenschmidt K, Crandall M, Puri R, Schroeppel T, Schuster K, Dumas R. From mild to gangrenous cholecystitis, laparoscopic cholecystectomy is safe 24 hours a day. The American Journal Of Surgery 2023, 226: 83-86. PMID: 36746709, DOI: 10.1016/j.amjsurg.2023.01.029.Peer-Reviewed Original Research
2022
Occult traumatic pneumothorax: Is routine follow up chest X-ray necessary?
Bhattacharya B, O'Connor R, Becher R, Schuster K, Davis K, Maung A. Occult traumatic pneumothorax: Is routine follow up chest X-ray necessary? Surgery In Practice And Science 2022, 9: 100073. DOI: 10.1016/j.sipas.2022.100073.Peer-Reviewed Original ResearchChest X-rayRoutine chest X-rayInjury Severity ScoreClinical managementInitial trauma evaluationUrban trauma centerComputerized tomography scanPaucity of evidenceOccult pneumothoracesPneumothorax progressionAdult patientsTrauma centerClinical evolutionClinical symptomsInjury scoreMean ageTrauma evaluationSeverity scoreTomography scanPatientsInterventionPneumothoracesSymptomsAgeX-ray
2020
Urgent Care Centers Delay Emergent Surgical Care Based on Patient Insurance Status in The United States.
Hsiang WR, Wiznia D, Yousman L, Najem M, Mosier-Mills A, Jin G, Jain S, Khunte A, Davis KA, Forman HP, Schuster KM. Urgent Care Centers Delay Emergent Surgical Care Based on Patient Insurance Status in The United States. Annals Of Surgery 2020, 272: 548-553. PMID: 32932304, DOI: 10.1097/sla.0000000000004373.Peer-Reviewed Original ResearchConceptsUrgent care centersMedicaid patientsCare centerInsurance typePrivate patientsEmergent surgical careEmergent surgical casesUrgent surgical conditionIncarcerated inguinal herniaEmergency department referralsPatient insurance statusED referralsInsurance statusReferral ratesInguinal herniaSurgical conditionsSurgical careSurgical casesPatientsPrivate insuranceCliniciansStandardized scriptMedicaidCareEmergent conditionsDoes Emergency General Surgery (EGS) Hospital Volume Contribute to Improved Outcomes?
DeWane M, Becher R, Schuster K. Does Emergency General Surgery (EGS) Hospital Volume Contribute to Improved Outcomes? Current Surgery Reports 2020, 8: 17. DOI: 10.1007/s40137-020-00262-6.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsImproved outcomesHospital-based outcomesHigh-volume centersRecent FindingsRecent evidenceEGS volumeHospital mortalitySurgeon volumePatient mortalityVolume centersHigh-risk operationsSurgery volumeReviewThis reviewOutcomesEGS operationsMortalitySpecific factorsPatientsCase complexityObserved improvementSpirometry not pain level predicts outcomes in geriatric patients with isolated rib fractures.
Schuster KM, Sanghvi M, O'Connor R, Becher R, Maung AA, Davis KA. Spirometry not pain level predicts outcomes in geriatric patients with isolated rib fractures. Journal Of Trauma And Acute Care Surgery 2020, 89: 947-954. PMID: 32467465, DOI: 10.1097/ta.0000000000002795.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overEmergency Service, HospitalFemaleHand StrengthHospitals, RehabilitationHumansIntensive Care UnitsLength of StayMalePainPain ManagementPain MeasurementPatient DischargePatient TransferPredictive Value of TestsProspective StudiesRib FracturesSpirometryTrauma CentersTreatment OutcomeConceptsLength of stayIsolated rib fracturesNegative inspiratory forceUnplanned ICU admissionRib fracturesPain levelsDay 1ICU admissionInspiratory forceGrip strengthMedian LOSHospital day 1Expiratory volume 1Complete spirometryPain controlDischarge dispositionPulmonary functionEarly dischargeGeriatric patientsVital capacityMean ageSpirometry measuresPulmonary capacityLevel IVFEV1Authors' Response to the Letter to the Editor.
Schuster KM, Crandall M. Authors' Response to the Letter to the Editor. Journal Of Trauma And Acute Care Surgery 2020, 88: e137. PMID: 32317580, DOI: 10.1097/ta.0000000000002596.Peer-Reviewed Original ResearchClosing the gap in care of blunt solid organ injury in children.
Yung N, Solomon D, Schuster K, Christison-Lagay E. Closing the gap in care of blunt solid organ injury in children. Journal Of Trauma And Acute Care Surgery 2020, 89: 894-899. PMID: 32345899, DOI: 10.1097/ta.0000000000002757.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentChildChild, PreschoolClinical Decision-MakingConsensusConservative TreatmentFemaleHospitals, PediatricHumansInfantInfant, NewbornInjury Severity ScoreLength of StayLiverMalePatient DischargePractice Guidelines as TopicProfessional Practice GapsRetrospective StudiesSpleenSurgical Procedures, OperativeTrauma CentersWounds, NonpenetratingYoung AdultConceptsAdult trauma centersPediatric trauma centerSolid organ injuryBlunt solid organ injuryOperative interventionOrgan injuryTrauma centerInjury gradeNonoperative managementLiver injuryPediatric blunt solid organ injuryPediatric solid organ injuryPhysiologic parametersNational Trauma Data BankTrauma center typeGrade of injuryTrauma Data BankBlunt spleenMean LOSHigher ORsConsensus guidelinesIsolated spleenOperative rateGrade ILevel IVTransfusion rates in emergency general surgery: high but modifiable
Medvecz A, Bernard A, Hamilton C, Schuster KM, Guillamondegui O, Davenport D. Transfusion rates in emergency general surgery: high but modifiable. Trauma Surgery & Acute Care Open 2020, 5: e000371. PMID: 32154373, PMCID: PMC7046949, DOI: 10.1136/tsaco-2019-000371.Peer-Reviewed Original ResearchNational Surgical Quality Improvement Program dataTransfusion rateRed blood cellsRBC transfusionSurgeons National Surgical Quality Improvement Program dataEmergency general surgery casesQuality Improvement Program dataBlood conservation technologiesNon-emergent casesCurrent Procedural Terminology codesEmergency general surgeryGeneral surgery casesProcedural Terminology codesAcademic medical centerComposite morbidityNSQIP complicationsRetrospective reviewSurgery casesGeneral surgeonsMedical CenterAmerican CollegeGeneral surgeryTerminology codesTransfusionPatient acuityHospital Variation in Geriatric Surgical Safety for Emergency Operation
Becher RD, Sukumar N, DeWane MP, Stolar MJ, Gill TM, Schuster KM, Maung AA, Zogg CK, Davis KA. Hospital Variation in Geriatric Surgical Safety for Emergency Operation. Journal Of The American College Of Surgeons 2020, 230: 966-973.e10. PMID: 32032720, PMCID: PMC7409563, DOI: 10.1016/j.jamcollsurg.2019.10.018.Peer-Reviewed Original ResearchConceptsStandardized mortality ratioHospital-level characteristicsGeneral surgery operationsGeriatric patientsEmergency operationHospital variationEmergency general surgery operationsMean standardized mortality ratioCalifornia State Inpatient DatabaseHospital-based mortalitySignificant hospital variationPatients 65 yearsSubstantial excess mortalitySurgery operationsState Inpatient DatabasesMixed effects logistic regression modelsCommon general surgery operationsLow-mortality outliersLogistic regression modelsPostoperative mortalityHospital deathOlder patientsInpatient DatabaseMortality outcomesNonelective operations