2021
Transesophageal Echocardiography in Patients Undergoing Coronary Artery Bypass Graft Surgery
Metkus T, Thibault D, Grant M, Badhwar V, Jacobs J, Lawton J, O'Brien S, Thourani V, Wegermann Z, Zwischenberger B, Higgins R. Transesophageal Echocardiography in Patients Undergoing Coronary Artery Bypass Graft Surgery. Journal Of The American College Of Cardiology 2021, 78: 112-122. PMID: 33957241, PMCID: PMC8876254, DOI: 10.1016/j.jacc.2021.04.064.Peer-Reviewed Original ResearchConceptsIntraoperative transesophageal echocardiographyHigh-risk patientsTransesophageal echocardiographyCABG patientsOperative mortalityValve proceduresCoronary artery bypass graft surgeryThoracic Surgeons Adult Cardiac Surgery DatabaseArtery bypass graft surgeryAdult Cardiac Surgery DatabasePost-CABG mortalityBypass graft surgeryCoronary artery bypassRetrospective cohort studyLow operative mortalityPercentage of patientsCardiac Surgery DatabaseClinical decision makingArtery bypassGraft surgeryValve surgeryCohort studyCABG proceduresPrimary outcomeSurgery Database
2020
Goal-Directed Fluid Therapy and Postoperative Outcomes in an Enhanced Recovery Program for Colorectal Surgery: A Propensity Score-Matched Multicenter Study
Zorrilla-Vaca A, Mena G, Ripolles-Melchor J, Abad-Motos A, Aldecoa C, Lorente J, Ramirez-Rodriguez J, Grant M. Goal-Directed Fluid Therapy and Postoperative Outcomes in an Enhanced Recovery Program for Colorectal Surgery: A Propensity Score-Matched Multicenter Study. The American Surgeon 2020, 87: 1189-1195. PMID: 33342254, DOI: 10.1177/0003134820973365.Peer-Reviewed Original ResearchConceptsGoal-directed fluid therapyEnhanced recovery programmeAcute kidney injurySurgical site infectionColorectal surgeryPostoperative outcomesFluid therapyPostoperative acute kidney injuryPropensity score-matched analysisComparable baseline demographicsMajor postoperative outcomesAdequate tissue perfusionRates of morbidityHospital stayKidney injuryBaseline demographicsCohort studyConventional careERAS programAnastomotic dehiscenceMajor surgerySite infectionPulmonary edemaMulticenter studyTherapy patientsOpioid-Sparing Cardiac Anesthesia: Secondary Analysis of an Enhanced Recovery Program for Cardiac Surgery.
Grant M, Isada T, Ruzankin P, Gottschalk A, Whitman G, Lawton J, Dodd-O J, Barodka V. Opioid-Sparing Cardiac Anesthesia: Secondary Analysis of an Enhanced Recovery Program for Cardiac Surgery. Anesthesia & Analgesia 2020, 131: 1852-1861. PMID: 32889848, DOI: 10.1213/ane.0000000000005152.Peer-Reviewed Original ResearchConceptsIntraoperative opioid administrationEnhanced recovery programmeOpioid administrationCardiac surgeryNonopioid interventionsPostoperative outcomesNumber of interventionsOpioid patientsSecondary analysisSerratus anterior plane blockMorphine sulfate equivalentsOpioid-sparing strategiesPostoperative pain scoresFuture prospective studiesLength of stayLinear mixed-effects regression modelsMixed-effects regression modelsIntraoperative dexmedetomidineLower opioidPreoperative gabapentinMultimodal analgesiaPain scoresPostoperative complicationsOpioid usePlane blockRisk factors for acute kidney injury in an enhanced recovery pathway for colorectal surgery
Zorrilla-Vaca A, Mena G, Ripolles-Melchor J, Lorente J, Ramirez-Rodriguez J, Grant M. Risk factors for acute kidney injury in an enhanced recovery pathway for colorectal surgery. Surgery Today 2020, 51: 537-544. PMID: 32785846, DOI: 10.1007/s00595-020-02107-2.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAge FactorsAgedAged, 80 and overColonCreatinineDigestive System Surgical ProceduresEnhanced Recovery After SurgeryFemaleHumansMaleMalnutritionMiddle AgedMulticenter Studies as TopicNutritional StatusPostoperative ComplicationsProspective StudiesRectumRisk FactorsROC CurveSerum AlbuminConceptsPostoperative acute kidney injuryAcute kidney injuryColorectal surgeryRisk factorsKidney injuryLow preoperative albumin levelRecovery pathwaysPerioperative patient outcomesPreoperative albumin levelEnhanced recovery pathwayIndependent risk factorProspective cohort studyPoor clinical outcomeDirect healthcare costsOpen surgical approachMalnourished patientsCohort studyAlbumin levelsASA IIILarge multicenterPreoperative interventionClinical outcomesMultivariable analysisOverall incidenceModifiable factors
2019
Predictors of new persistent opioid use after coronary artery bypass grafting
Clement K, Canner J, Lawton J, Whitman G, Grant M, Sussman M. Predictors of new persistent opioid use after coronary artery bypass grafting. Journal Of Thoracic And Cardiovascular Surgery 2019, 160: 954-963.e4. PMID: 32007246, DOI: 10.1016/j.jtcvs.2019.09.137.Peer-Reviewed Original ResearchMeSH KeywordsAdministrative Claims, HealthcareAgedAmbulatory CareAnalgesics, OpioidCoronary Artery BypassDatabases, FactualDrug Administration ScheduleDrug PrescriptionsFemaleHumansMaleMiddle AgedOpioid-Related DisordersPain, PostoperativePractice Patterns, Physicians'Retrospective StudiesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeConceptsNew persistent opioid usePersistent opioid useCoronary artery bypassArtery bypassOpioid useOpioid prescriptionsPerioperative periodNaïve patientsChronic obstructive pulmonary diseaseAmount of opioidsAppropriate opioid prescribingObstructive pulmonary diseaseMultivariable logistic regressionPrescription opioid overdosePrior substance abuseInsurance claims dataOpioid requirementsOutpatient opioidsOpioid prescribingCardiac surgeryPulmonary diseaseOpioid dependenceProspective studyRisk factorsFemale genderOpioid tolerance impacts compliance with enhanced recovery pathway after major abdominal surgery
Owodunni O, Zaman M, Ighani M, Grant M, Bettick D, Sateri S, Magnuson T, Gearhart S. Opioid tolerance impacts compliance with enhanced recovery pathway after major abdominal surgery. Surgery 2019, 166: 1055-1060. PMID: 31526584, DOI: 10.1016/j.surg.2019.08.001.Peer-Reviewed Original ResearchConceptsEnhanced recovery pathwayMajor abdominal surgeryOpioid-tolerant patientsOpioid toleranceAbdominal surgeryLength of stayTolerant patientsRecovery pathwaysPostoperative outcomesMajor complicationsPathway complianceChallenging patient cohortNon-tolerant patientsPoor postoperative outcomesOperative Severity ScoreEnUmeration of MortalityRisk-adjusted analysisPrescribed opioid medicationsOutcomes of interestEvidence-based interventionsColorectal PhysiologicalOral morphineOpioid medicationsEmergency surgeryReadmission ratesOn‐label compared to off‐label four‐factor prothrombin complex concentrate use: a retrospective, observational study
Cho B, Jung Y, DeMario V, Lau E, Podlasek S, Grant M, Gehrie E, Frank S. On‐label compared to off‐label four‐factor prothrombin complex concentrate use: a retrospective, observational study. Transfusion 2019, 59: 2678-2684. PMID: 31121073, DOI: 10.1111/trf.15355.Peer-Reviewed Original ResearchConceptsUrgent reversalLabel useMortality rateFour-factor prothrombin complex concentrateAcute major bleedingVitamin K antagonistsProthrombin complex concentrate useProthrombin complex concentrateOff-label useCoagulation factor deficienciesHospital mortalityMajor bleedingK antagonistsPatient characteristicsClinical outcomesBlood utilizationExpensive treatment optionsLabel indicationsSingle institutionTreatment optionsComplex concentrateObservational studyFactor deficiencyInvasive proceduresOff labelDischarge Hemoglobin Level and 30-Day Readmission Rates After Coronary Artery Bypass Surgery
Cho B, DeMario V, Grant M, Hensley N, Brown C, Hebbar S, Mandal K, Whitman G, Frank S. Discharge Hemoglobin Level and 30-Day Readmission Rates After Coronary Artery Bypass Surgery. Anesthesia & Analgesia 2019, 128: 342-348. PMID: 30059402, PMCID: PMC6533067, DOI: 10.1213/ane.0000000000003671.Peer-Reviewed Original ResearchConceptsDischarge Hb levelsDischarge hemoglobin levelsReadmission ratesHb levelsPatient characteristicsHemoglobin levelsMultivariable analysisBlood utilizationCoronary artery bypass surgeryCertain patient comorbiditiesRestrictive transfusion strategyCharlson Comorbidity IndexCoronary artery bypassArtery bypass surgeryLarge randomized trialsRisk-adjusted oddsSimilar patient characteristicsLow Hb levelsCABG patientsDischarge HbPreoperative comorbiditiesArtery bypassComorbidity indexBypass surgeryPatient comorbiditiesThe Impact of Anesthesia-Influenced Process Measure Compliance on Length of Stay
Grant M, Pio Roda C, Canner J, Sommer P, Galante D, Hobson D, Gearhart S, Wu C, Wick E. The Impact of Anesthesia-Influenced Process Measure Compliance on Length of Stay. Anesthesia & Analgesia 2019, 128: 68-74. PMID: 29782405, DOI: 10.1213/ane.0000000000003458.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnesthesiaAnesthesiologistsColonDigestive System Surgical ProceduresFemaleGuideline AdherenceHumansInterdisciplinary CommunicationLength of StayMaleMiddle AgedOutcome and Process Assessment, Health CarePatient Care TeamPerioperative CarePractice Guidelines as TopicPractice Patterns, Physicians'Program EvaluationQuality ImprovementQuality Indicators, Health CareRecovery of FunctionRectumTime FactorsTreatment OutcomeConceptsProcess measure complianceMeasure complianceProcess measuresAcute pain servicePain medication useLength of staySpecific process measuresImpact of complianceBreakthrough painHospital lengthPain serviceSurgery cohortERAS programSurgical encountersConsecutive patientsMedication usePerioperative careShorter LOSAnesthesia protocolImproved outcomesMultivariable regressionSurgery programEnhanced recoveryPatientsLOS
2018
Early ambulation after colorectal oncologic resection with perineal reconstruction is safe and effective
Calotta N, Coon D, Bos T, Ostrander B, Scott A, Grant M, Efron J, Sacks J. Early ambulation after colorectal oncologic resection with perineal reconstruction is safe and effective. The American Journal Of Surgery 2018, 218: 125-130. PMID: 30471809, DOI: 10.1016/j.amjsurg.2018.10.005.Peer-Reviewed Original ResearchConceptsEarly ambulationPerineal reconstructionOncologic resectionPost-operative day oneEarly ambulation protocolRetrospective cohort studyMinor complication rateStandard of careOncological surgery patientsAmbulation capacityWound complicationsCohort studySurgery patientsComplication rateSurgical outcomesReconstructive outcomesAmbulationMore ambulatoryBedrestDay oneReoperationReadmissionResectionSignificant differencesPatientsThe effect of community socioeconomic status on sepsis-attributable mortality
Galiatsatos P, Brigham E, Pietri J, Littleton K, Hwang S, Grant M, Hansel N, Chen E. The effect of community socioeconomic status on sepsis-attributable mortality. Journal Of Critical Care 2018, 46: 129-133. PMID: 29370964, PMCID: PMC6014883, DOI: 10.1016/j.jcrc.2018.01.008.Peer-Reviewed Original Research
2017
Complications of CO2 insufflation during endoscopic vein harvesting
Suarez‐Pierre A, Terasaki Y, Magruder J, Kapoor A, Grant M, Lawton J. Complications of CO2 insufflation during endoscopic vein harvesting. Journal Of Cardiac Surgery 2017, 32: 783-789. PMID: 29169212, DOI: 10.1111/jocs.13249.Peer-Reviewed Original ResearchOptimizing an Enhanced Recovery Pathway Program: Development of a Postimplementation Audit Strategy
Grant M, Galante D, Hobson D, Lavezza A, Friedman M, Wu C, Wick E. Optimizing an Enhanced Recovery Pathway Program: Development of a Postimplementation Audit Strategy. The Joint Commission Journal On Quality And Patient Safety 2017, 43: 524-533. PMID: 28942777, DOI: 10.1016/j.jcjq.2017.02.011.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersClinical ProtocolsDigestive System Surgical ProceduresElectronic Health RecordsFemaleGroup ProcessesHumansLength of StayMaleMiddle AgedOrganizational CulturePatient Care BundlesPatient Care TeamPerioperative CarePostoperative ComplicationsQuality Indicators, Health CareRetrospective StudiesSafety ManagementConceptsLength of stayOverall LOSAverage LOSProcess measuresThree-month followProcess measure complianceAcademic medical centerSystem-level interventionsSignificant reductionElectronic health recordsColorectal surgeryConsecutive patientsPathway implementationEarly mobilityMeasure complianceMedical CenterPreventable harmOne-year periodPatientsRecovery pathwaysHealth recordsSystem-level changesSurgeryComplianceSame procedureIs enhanced recovery enough for reducing 30-d readmissions after surgery?
Fabrizio A, Grant M, Siddiqui Z, Alimi Y, Gearhart S, Wu C, Efron J, Wick E. Is enhanced recovery enough for reducing 30-d readmissions after surgery? Journal Of Surgical Research 2017, 217: 45-53. PMID: 28602223, DOI: 10.1016/j.jss.2017.04.007.Peer-Reviewed Original ResearchConceptsEnhanced recovery pathwaySurgical site infectionSite infectionSingle tertiary care centerPostoperative surgical site infectionIndex hospitalization lengthTertiary care centerEnhanced recovery programmeLength of stayTransitions of carePatient care experiencesColorectal surgeryReadmission ratesReduced readmissionsHospitalization lengthRetrospective studyCare transitionsCare centerPatient outcomesReadmissionSymptom monitoringSimilar cohortEnhanced recoveryHome transfersCare experiencesPreserved Analgesia With Reduction in Opioids Through the Use of an Acute Pain Protocol in Enhanced Recovery After Surgery for Open Hepatectomy
Grant M, Sommer P, He C, Li S, Page A, Stone A, Hobson D, Wick E, Wu C. Preserved Analgesia With Reduction in Opioids Through the Use of an Acute Pain Protocol in Enhanced Recovery After Surgery for Open Hepatectomy. Regional Anesthesia & Pain Medicine 2017, 42: 451-457. PMID: 28525409, DOI: 10.1097/aap.0000000000000615.Peer-Reviewed Original ResearchConceptsOpen hepatectomyPain scoresERAS pathwayERAS protocolEnd pointPain controlSelf-reported pain scoresAcute pain protocolsAverage pain scoreLess morphine equivalentsMorphine equivalent requirementsOpioid-based medicationsProvision of fluidsLiver resection surgeryOptimal pain controlUse of epiduralsLength of stayHigh-risk procedurePostoperative end pointsERAS settingMorphine equivalentsNonepidural groupOpioid requirementsPerioperative opioidsEpidural analgesia
2016
Patient outcomes and provider perceptions following implementation of a standardized perioperative care pathway for open liver resection
Page A, Gani F, Crowley K, Lee K, Grant M, Zavadsky T, Hobson D, Wu C, Wick E, Pawlik T. Patient outcomes and provider perceptions following implementation of a standardized perioperative care pathway for open liver resection. British Journal Of Surgery 2016, 103: 564-571. PMID: 26859713, DOI: 10.1002/bjs.10087.Peer-Reviewed Original ResearchConceptsPost-ERAS groupPerioperative care pathwaysERAS pathwayOpen liver surgeryHospital stayPerioperative outcomesPostoperative complicationsOpioid useLiver surgeryCare pathwayProviders' perceptionsMean pain scoreOpen liver resectionShorter hospital stayImproved perioperative outcomesGroup of patientsCent of providersPerioperative pathwayPain scoresERAS programLiver resectionSurgery pathwayDisease characteristicsHepatic surgeryHospital costs
2013
Clinical predictors of postoperative hemoglobin drift
Grant M, Whitman G, Savage W, Ness P, Frank S. Clinical predictors of postoperative hemoglobin drift. Transfusion 2013, 54: 1460-1468. PMID: 24236570, DOI: 10.1111/trf.12491.Peer-Reviewed Original ResearchConceptsSurgical proceduresClinical predictorsBlood requirementsClinical variablesPerioperative patient blood managementPositive perioperative fluid balanceIntraoperative intravenous fluidsPerioperative fluid balanceIntraoperative blood lossType of surgeryPatient blood managementCommon surgical procedureMultiple clinical variablesSpinal fusion proceduresPostoperative transfusionRed blood cellsBlood lossIndependent predictorsSurgical patientsIntravenous fluidsBlood managementSpinal fusionFluid balanceHemoglobin measurementHb concentration
2008
Intraoperative detection of intimal lipid in the radial artery predicts degree of postoperative spasm
Brown E, Burris N, Kon Z, Grant M, Brazio P, Xu C, Laird P, Gu J, Kallam S, Desai P, Poston R. Intraoperative detection of intimal lipid in the radial artery predicts degree of postoperative spasm. Atherosclerosis 2008, 205: 466-471. PMID: 19264305, PMCID: PMC2717172, DOI: 10.1016/j.atherosclerosis.2008.12.014.Peer-Reviewed Original ResearchConceptsPostoperative spasmRA conduitOptical coherence tomographyDistal RARisk of spasmCatheter-based optical coherence tomographyRA graftsCABG patientsBypass graftRadial arteryLuminal diameterIntimal abnormalitiesIntraoperative detectionSpasmIntimal lipidDay 5Lipid depositsCoherence tomographyProximal portionGraftDegree of attenuationDiameter changesOCT imagesSevere changesRiskOptical Coherence Tomography Imaging as a Quality Assurance Tool for Evaluating Endoscopic Harvest of the Radial Artery
Burris N, Brown E, Grant M, Kon Z, Gibber M, Gu J, Schwartz K, Kallam S, Joshi A, Vitali R, Poston R. Optical Coherence Tomography Imaging as a Quality Assurance Tool for Evaluating Endoscopic Harvest of the Radial Artery. The Annals Of Thoracic Surgery 2008, 85: 1271-1277. PMID: 18355508, PMCID: PMC2636971, DOI: 10.1016/j.athoracsur.2007.12.044.Peer-Reviewed Original ResearchMeSH KeywordsAgedCadaverCohort StudiesCoronary Artery BypassCoronary DiseaseEndoscopyEvaluation Studies as TopicFemaleHumansMaleMiddle AgedObserver VariationProbabilityQuality ControlRadial ArteryRadiographyReproducibility of ResultsRisk AssessmentSensitivity and SpecificitySurvival AnalysisTissue and Organ HarvestingTomography, Optical CoherenceVascular PatencyConceptsEndoscopic radial artery harvestOpen harvestOptical coherence tomography (OCT) imagingIntimal injuryIntimal disruptionCoronary artery bypass graft patientsLuminal volumeTomography imagingRadial artery conduitsBypass graft patientsRadial artery harvestOCT imagingLuminal surfaceRA graftsArtery conduitCABG patientsGraft patientsBranch injuryOCT findingsEndoscopic harvestRA harvestRadial arterySerial imagingCatheter-based OCTBranch ostiumWarm ischemia provokes inflammation and regional hypercoagulability within the heart during off-pump coronary artery bypass: a possible target for serine protease inhibition
Kon Z, Brown E, Grant M, Ozeki T, Burris N, Collins M, Kwon M, Poston R. Warm ischemia provokes inflammation and regional hypercoagulability within the heart during off-pump coronary artery bypass: a possible target for serine protease inhibition. European Journal Of Cardio-Thoracic Surgery 2008, 33: 215-221. PMID: 18068996, PMCID: PMC2605708, DOI: 10.1016/j.ejcts.2007.11.008.Peer-Reviewed Original ResearchConceptsPump coronary artery bypassCoronary artery bypassTranscardiac gradientCoronary occlusionArtery bypassMyocardial ischemiaTNF-alphaCoronary sinus bloodEarly graft failureRegional myocardial ischemiaProthrombotic stateGraft failureProtamine administrationSinus bloodConsecutive patientsIschemic injuryMyocardial injuryIL-8Warm ischemiaPathophysiologic consequencesSeries of biomarkersCoagulation systemOPCABIschemiaInflammation