2020
Spirometry 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 IVFEV1Benchmarking the value of care: Variability in hospital costs for common operations and its association with procedure volume.
Zogg CK, Bernard AC, Hirji SA, Minei JP, Staudenmayer KL, Davis KA. Benchmarking the value of care: Variability in hospital costs for common operations and its association with procedure volume. Journal Of Trauma And Acute Care Surgery 2020, 88: 619-628. PMID: 32039972, PMCID: PMC7802807, DOI: 10.1097/ta.0000000000002611.Peer-Reviewed Original ResearchConceptsLaparoscopic appendectomyLaparoscopic cholecystectomyHospital costsMeans of USMedian costProcedure volumeEmergency general surgeryTotal hospital costsMedian hospital costsNational Inpatient SampleAdults 18 yearsNational cost savingsAnnual procedure volumeValue of careHospital complicationsIndex hospitalHealth care valuePatient characteristicsAdverse outcomesInpatient SampleInclusion criteriaGeneral surgeryHospitalLevel IIICommon operation
2019
Contemporary management of spontaneous retroperitoneal and rectus sheath hematomas
Warren MH, Bhattacharya B, Maung AA, Davis KA. Contemporary management of spontaneous retroperitoneal and rectus sheath hematomas. The American Journal Of Surgery 2019, 219: 707-710. PMID: 31109633, DOI: 10.1016/j.amjsurg.2019.05.002.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAngiographyAnticoagulantsBlood Component TransfusionEmbolization, TherapeuticFemaleHematomaHumansInternational Normalized RatioLength of StayMaleMiddle AgedPlatelet Aggregation InhibitorsProthrombin TimeRectal DiseasesRetroperitoneal SpaceRetrospective StudiesShock, HemorrhagicTomography, X-Ray ComputedConceptsSheath hematomaSurgical interventionBlood product transfusionOptimal treatment strategySpontaneous retroperitonealIntravenous heparinProduct transfusionAdult patientsMedian ageAntiplatelet agentsHemorrhagic shockDisease progressionBlood productsTreatment strategiesCT scanHematomaOutcome dataPatientsOne-year periodContemporary managementSpecific agentsAngioembolizationRetroperitonealInterventionAgentsThe Economic Footprint of Acute Care Surgery in the United States
Knowlton LM, Minei J, Tennakoon L, Davis KA, Doucet J, Bernard A, Haider A, Scherer L, Spain DA, Staudenmayer KL. The Economic Footprint of Acute Care Surgery in the United States. Journal Of Trauma And Acute Care Surgery 2019, Publish Ahead of Print: &na;. PMID: 30589750, PMCID: PMC6433481, DOI: 10.1097/ta.0000000000002181.Peer-Reviewed Original ResearchConceptsAcute care surgeryEmergency general surgeryACS patientsClinical Modification diagnosisInpatient populationInternational ClassificationAdult ACS patientsNon-surgical patientsHealth care utilizationHigher mean costSurgical critical careNonoperative conditionsACS diagnosisAdult patientsPatient characteristicsCare surgeryCare utilizationAdult admissionsEGS conditionsInpatient costsInpatient hospitalizationCritical careGeneral surgeryMean costPatientsSymptomatic human immunodeficiency virus–infected patients have poorer outcomes following emergency general surgery
Sandler BJ, Davis KA, Schuster KM. Symptomatic human immunodeficiency virus–infected patients have poorer outcomes following emergency general surgery. Journal Of Trauma And Acute Care Surgery 2019, 86: 479-488. PMID: 30531208, DOI: 10.1097/ta.0000000000002161.Peer-Reviewed Original ResearchConceptsHIV/AIDS patientsHIV-negative patientsAsymptomatic HIV-positive patientsHIV-positive patientsActive antiretroviral therapyAIDS patientsAntiretroviral therapyHospital stayPostoperative complicationsHuman immunodeficiency virus-infected patientsEmergency general surgery proceduresHigher median total chargesImmune deficiency syndrome (AIDS) patientsHuman immunodeficiency virus (HIV) infectionEmergency general surgeryLonger hospital stayRetrospective cohort studyAcute renal failureHIV-negative controlsImmunodeficiency virus infectionVirus-infected patientsRecords of patientsUrinary tract infectionMedian total chargesNationwide Inpatient Sample
2018
Opioid dependency is independently associated with inferior clinical outcomes after trauma
Hsiang WR, McGeoch C, Lee S, Cheung W, Becher R, Davis KA, Schuster K. Opioid dependency is independently associated with inferior clinical outcomes after trauma. Injury 2018, 50: 192-196. PMID: 30342762, DOI: 10.1016/j.injury.2018.10.015.Peer-Reviewed Original ResearchConceptsNon-home dischargeOpioid-dependent patientsLength of stayInjury Severity ScoreOpioid dependencyVentilator daysMajor complicationsClinical outcomesPrescription abuseIllicit abuseLonger LOSChronic pain subgroupsMore ventilator daysOpioid-naïve patientsUse of opioidsAcademic Level IHigher readmission ratesInferior clinical outcomesChronic pain patientsOpioid subgroupsNaïve patientsAdult patientsPain subgroupsPatient demographicsReadmission ratesComparison of Outcomes in Below-Knee Amputation between Vascular and General Surgeons
Pei KY, Zhang Y, Sarac T, Davis KA. Comparison of Outcomes in Below-Knee Amputation between Vascular and General Surgeons. Annals Of Vascular Surgery 2018, 50: 259-268. PMID: 29501591, DOI: 10.1016/j.avsg.2017.11.073.Peer-Reviewed Original ResearchMeSH KeywordsAgedAmputation, SurgicalChi-Square DistributionClinical CompetenceDatabases, FactualEmergenciesFemaleGeneral SurgeryHospitals, TeachingHumansLength of StayLinear ModelsLogistic ModelsLower ExtremityMaleMiddle AgedMultivariate AnalysisOdds RatioPostoperative ComplicationsRetrospective StudiesRisk FactorsSpecializationSurgeonsTime FactorsTreatment OutcomeUnited StatesVascular Surgical ProceduresConceptsVascular surgeonsGeneral surgeonsKnee amputationInfectious indicationsNational Surgical Quality Improvement Project databaseSurgeons National Surgical Quality Improvement Project databaseUnconditional logistic regression modelsRisk of pneumoniaPeripheral vascular diseaseLower extremity amputationBelow knee amputationComparison of outcomesEffect of specialtyLogistic regression modelsOverall complicationsVascular consultationPostoperative complicationsPatient demographicsPostoperative outcomesPulmonary embolismComorbid conditionsRegression modelsExtremity amputationRetrospective studyVascular diseaseRelationship between duration of preoperative symptoms and postoperative ileus for small bowel obstruction
Brandt WS, Wood J, Bhattacharya B, Pei K, Davis KA, Schuster K. Relationship between duration of preoperative symptoms and postoperative ileus for small bowel obstruction. Journal Of Surgical Research 2018, 225: 40-44. PMID: 29605033, DOI: 10.1016/j.jss.2017.12.031.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAscitesEquipment and Supplies UtilizationFemaleFood IntoleranceHumansIleusIntensive Care UnitsIntestinal ObstructionIntestine, SmallLength of StayMaleMiddle AgedParenteral NutritionPostoperative ComplicationsPreoperative PeriodRetrospective StudiesRisk FactorsTime FactorsTime-to-TreatmentYoung AdultConceptsTolerance of dietSmall bowel obstructionPreoperative symptomsLength of stayPostoperative ileusUnivariable analysisTotal durationIntensive care unit admissionTotal parenteral nutrition useParenteral nutrition useCare unit admissionIntensive care unitPreoperative ascitesBowel obstructionPrimary endpointSecondary endpointsSymptom durationUnit admissionMedian durationOperative interventionPostoperative outcomesCare unitMultivariable analysisRetrospective reviewNutrition useProphylactic Ureteral Stent Placement vs No Ureteral Stent Placement During Open Colectomy
Merola J, Arnold B, Luks V, Ibarra C, Resio B, Davis KA, Pei KY. Prophylactic Ureteral Stent Placement vs No Ureteral Stent Placement During Open Colectomy. JAMA Surgery 2018, 153: 87-90. PMID: 28973647, PMCID: PMC5833617, DOI: 10.1001/jamasurg.2017.3477.Peer-Reviewed Original Research
2017
Trends of ureteral stent usage in surgery for diverticulitis
Chiu AS, Jean RA, Gorecka J, Davis KA, Pei KY. Trends of ureteral stent usage in surgery for diverticulitis. Journal Of Surgical Research 2017, 222: 203-211.e3. PMID: 29100586, DOI: 10.1016/j.jss.2017.09.050.Peer-Reviewed Original ResearchLaparoscopic colectomy reduces complications and hospital length of stay in colon cancer patients with liver disease and ascites
Pei KY, Asuzu DT, Davis KA. Laparoscopic colectomy reduces complications and hospital length of stay in colon cancer patients with liver disease and ascites. Surgical Endoscopy 2017, 32: 1286-1292. PMID: 28812198, DOI: 10.1007/s00464-017-5806-4.Peer-Reviewed Original ResearchConceptsHospital lengthLaparoscopic colectomyColon cancerPostoperative complicationsOdds ratioNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement Program databaseQuality Improvement Program databaseOpen partial colectomyImprovement Program databaseShorter hospital lengthRisk of deathAdjusted odds ratioHigh-risk populationColon cancer patientsTwo-sample t-testConclusionsLaparoscopic colectomyOverall complicationsPerioperative complicationsPostoperative outcomesPostoperative riskAbsolute contraindicationLaparoscopic approachLiver diseaseOperative timeAssessing trends in laparoscopic colostomy reversal and evaluating outcomes when compared to open procedures
Pei KY, Davis KA, Zhang Y. Assessing trends in laparoscopic colostomy reversal and evaluating outcomes when compared to open procedures. Surgical Endoscopy 2017, 32: 695-701. PMID: 28726139, DOI: 10.1007/s00464-017-5725-4.Peer-Reviewed Original ResearchConceptsReversal surgeryLength of stayColostomy reversalComplication rateSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramSurgical Quality Improvement ProgramUnconditional logistic regression modelsStudy periodTotal hospital lengthOverall complication rateProbability of morbidityShorter operation timeQuality Improvement ProgramLogistic regression modelsLaparoscopic colostomyLaparoscopic reversalMethodsAll patientsPostsurgical diagnosisHospital lengthPostoperative complicationsNSQIP databasePatient demographicsHartmann's reversalComorbid conditionsImpact of hospital volume on outcomes for laparoscopic adhesiolysis for small bowel obstruction
Jean RA, O'Neill KM, Pei KY, Davis KA. Impact of hospital volume on outcomes for laparoscopic adhesiolysis for small bowel obstruction. Journal Of Surgical Research 2017, 214: 23-31. PMID: 28624050, DOI: 10.1016/j.jss.2017.02.045.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overDatabases, FactualFemaleHospital CostsHospitals, High-VolumeHospitals, Low-VolumeHumansIntestinal ObstructionIntestine, SmallLaparoscopyLength of StayLinear ModelsMaleMiddle AgedMultivariate AnalysisTissue AdhesionsTreatment OutcomeUnited StatesYoung AdultConceptsSmall bowel obstructionLength of stayHigh-volume hospitalsBowel obstructionHospital volumeVolume statusProcedural volumeSurgical proceduresDiagnosis of SBODecreased LOSShorter LOSNationwide Inpatient Sample dataHigh-volume statusHospital volume statusInstitutional procedural volumeIntra-abdominal malignanciesHigher hospital volumeLow-volume hospitalsHigh-volume centersMajor surgical proceduresSmall bowel resectionLow volume statusComplex surgical proceduresLaparoscopic lysisAdult patients
2016
Postoperative delirium is associated with increased intensive care unit and hospital length of stays after liver transplantation
Bhattacharya B, Maung A, Barre K, Maerz L, Rodriguez-Davalos MI, Schilsky M, Mulligan DC, Davis KA. Postoperative delirium is associated with increased intensive care unit and hospital length of stays after liver transplantation. Journal Of Surgical Research 2016, 207: 223-228. PMID: 27979481, DOI: 10.1016/j.jss.2016.08.084.Peer-Reviewed Original ResearchConceptsLiver transplantationHospital lengthEnd-stage liver disease (MELD) scoreIntensive care unit LOSHigher preoperative modelImportant postoperative complicationLiver Disease scoreLiver transplant patientsImpact of deliriumTertiary care centerRetrospective case seriesUrinary tract infectionFurther prospective studiesIntensive care unitLong-term outcomesSpecific risk factorsFrequency of hospitalPaucity of dataPostoperative deliriumPostoperative hospitalPostoperative complicationsTransplant patientsVentilator daysAdult patientsDelirious patientsWill laparoscopic lysis of adhesions become the standard of care? Evaluating trends and outcomes in laparoscopic management of small-bowel obstruction using the American College of Surgeons National Surgical Quality Improvement Project Database
Pei KY, Asuzu D, Davis KA. Will laparoscopic lysis of adhesions become the standard of care? Evaluating trends and outcomes in laparoscopic management of small-bowel obstruction using the American College of Surgeons National Surgical Quality Improvement Project Database. Surgical Endoscopy 2016, 31: 2180-2186. PMID: 27585468, DOI: 10.1007/s00464-016-5216-z.Peer-Reviewed Original ResearchConceptsSmall bowel obstructionHospital stayAmerican CollegeNational Surgical Quality Improvement Program data setNational Surgical Quality Improvement Project databaseSurgeons National Surgical Quality Improvement Project databasePost-surgical complication rateLonger hospital stayLarge retrospective analysisLysis of adhesionsSignificant healthcare burdenMultivariable logistic regressionStandard of carePost-surgical complicationsProgram data setTwo-sample t-testMann-Whitney testLaparoscopic lysisOpen lysisLaparoscopic managementComplication rateClinical benefitLargest comparison studyHealthcare burdenSBO cases
2014
Using the Rothman index to predict early unplanned surgical intensive care unit readmissions
Piper GL, Kaplan LJ, Maung AA, Lui FY, Barre K, Davis KA. Using the Rothman index to predict early unplanned surgical intensive care unit readmissions. Journal Of Trauma And Acute Care Surgery 2014, 77: 78-82. PMID: 24977759, DOI: 10.1097/ta.0000000000000265.Peer-Reviewed Original ResearchConceptsIntensive care unit readmissionRothman IndexSurgical floorRI scoresPotential quality metricElectronic medical recordsHours of transferSICU admissionSICU lengthReadmission groupSICU patientsMedical recordsPatient's conditionReadmissionPrognostic studiesPatientsControl groupLevel IIISICUAdmissionScoresDemographicsHoursGroupNumerical scoreThe Use of Magnetic Resonance Imaging in the Diagnosis of Suspected Appendicitis in Pregnancy : Shortened Length of Stay Without Increase in Hospital Charges
Fonseca AL, Schuster KM, Kaplan LJ, Maung AA, Lui FY, Davis KA. The Use of Magnetic Resonance Imaging in the Diagnosis of Suspected Appendicitis in Pregnancy : Shortened Length of Stay Without Increase in Hospital Charges. JAMA Surgery 2014, 149: 687-693. PMID: 24871698, DOI: 10.1001/jamasurg.2013.4658.Peer-Reviewed Original ResearchConceptsMR imaging groupHospital chargesNontherapeutic explorationsPregnant patientsImaging groupFetal outcomesShorter LOSEmergency departmentUniversity tertiary referral centerMean hospital chargesTertiary referral centerLength of stayMagnetic resonancePathology-confirmed appendicitisAbdominal painOperative interventionReferral centerClinical outcomesGestational ageMultivariable analysisRetrospective reviewFetal lossAppendicitisMAIN OUTCOMEPatientsPredictive factors for failure of nonoperative management in perforated appendicitis
Maxfield MW, Schuster KM, Bokhari J, McGillicuddy EA, Davis KA. Predictive factors for failure of nonoperative management in perforated appendicitis. Journal Of Trauma And Acute Care Surgery 2014, 76: 976-981. PMID: 24662860, DOI: 10.1097/ta.0000000000000187.Peer-Reviewed Original ResearchConceptsNonoperative managementAbdominal tendernessFailure groupIntensive care unit careUniversity tertiary care hospitalTertiary care hospitalLength of stayUnit careCare hospitalDefinitive treatmentLaboratory markersPerforated appendicitisNonsurgical treatmentClinical findingsPredictive factorsRadiographic findingsTomographic scanTherapeutic studiesAppendicitisEarly operationLevel IIIPatientsAbscessPhlegmonTachycardiaMorbid obesity predisposes trauma patients to worse outcomes
Ditillo M, Pandit V, Rhee P, Aziz H, Hadeed S, Bhattacharya B, Friese RS, Davis K, Joseph B. Morbid obesity predisposes trauma patients to worse outcomes. Journal Of Trauma And Acute Care Surgery 2014, 76: 176-179. PMID: 24368375, DOI: 10.1097/ta.0b013e3182ab0d7c.Peer-Reviewed Original ResearchConceptsBlunt traumatic injuryMorbidly obese patientsInjury Severity ScoreObese patientsGlasgow Coma ScaleHospital complicationsMorbid obesityTraumatic injuryNonobese patientsTrauma patientsIntensive care unit stayNational Trauma Data BankBlunt trauma patientsLonger hospital stayImpact of obesitySystolic blood pressureOverall mortality rateTrauma Data BankInjury prevention effortsConsequences of obesityTraumatic brain injuryUnit stayHospital staySecondary outcomesBlood pressure
2013
Routine Nasogastric Decompression in Small Bowel Obstruction: Is it Really Necessary?
Fonseca AL, Schuster KM, Maung AA, Kaplan LJ, Davis KA. Routine Nasogastric Decompression in Small Bowel Obstruction: Is it Really Necessary? The American Surgeon 2013, 79: 422-428. PMID: 23574854, DOI: 10.1177/000313481307900433.Peer-Reviewed Original ResearchConceptsSmall bowel obstructionNasogastric decompressionHospital lengthNG decompressionBowel obstructionRespiratory failureDiagnosis of SBOYale-New Haven HospitalNasogastric tube useRisk of pneumoniaRoutine nasogastric decompressionDevelopment of pneumoniaRetrospective chart reviewNew Haven HospitalBowel restIntravenous hydrationChart reviewAdult patientsTube useNGT placementPatientsStayOutcome variablesDecompressionNGT