2020
Geographic Variation in the Utilization of and Mortality After Emergency General Surgery Operations in the Northeastern and Southeastern United States
Becher RD, Jin L, Warren JL, Gill TM, DeWane MP, Davis KA, Zhang Y. Geographic Variation in the Utilization of and Mortality After Emergency General Surgery Operations in the Northeastern and Southeastern United States. Annals Of Surgery 2020, 275: 340-347. PMID: 32516232, PMCID: PMC7726051, DOI: 10.1097/sla.0000000000003939.Peer-Reviewed Original ResearchConceptsHospital service areasSubsequent mortalityEmergency general surgery careEmergency general surgery operationsEGS operationsCommon EGS operationsAge-standardized ratesGeneral surgery careState Inpatient DatabasesGeneral surgery operationsRandom-effects modelWide geographic variationHospital mortalityInpatient DatabaseSurgery careKruskal-Wallis testMortality rateUnwarranted variationMortalityStandardized ratesLinear random effects modelSurgery operationsUnited StatesGeographic variationCareHospital 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
2019
Hospital Operative Volume and Quality Indication for General Surgery Operations Performed Emergently in Geriatric Patients
Becher RD, DeWane MP, Sukumar N, Stolar MJ, Gill TM, Becher RM, Maung AA, Schuster KM, Davis KA. Hospital Operative Volume and Quality Indication for General Surgery Operations Performed Emergently in Geriatric Patients. Journal Of The American College Of Surgeons 2019, 228: 910-923. PMID: 31005629, PMCID: PMC6582986, DOI: 10.1016/j.jamcollsurg.2019.02.053.Peer-Reviewed Original ResearchConceptsHospital operative volumeGeneral surgery operationsGeriatric patientsOperative volumeEmergency operationHospital volumeProbability of survivalEmergency general surgery operationsCalifornia State Inpatient DatabaseRetrospective cohort studySurgery operationsState Inpatient DatabasesHigher operative volumesAverage mortality riskOlder patientsCohort studyInpatient DatabaseGeriatric populationSurgical careSurgical qualityAmerican CollegeMortality riskOptimizing outcomesStandardized increasePatients
2012
Systemic inflammation worsens outcomes in emergency surgical patients
Becher RD, Hoth JJ, Miller PR, Meredith JW, Chang MC. Systemic inflammation worsens outcomes in emergency surgical patients. Journal Of Trauma And Acute Care Surgery 2012, 72: 1140-1149. PMID: 22673238, DOI: 10.1097/ta.0b013e3182516a97.Peer-Reviewed Original ResearchMeSH KeywordsAgedDigestive System Surgical ProceduresDisease ProgressionEmergenciesFollow-Up StudiesHumansMiddle AgedMorbidityOutcome Assessment, Health CarePostoperative ComplicationsRetrospective StudiesRisk FactorsSeverity of Illness IndexSurvival RateSystemic Inflammatory Response SyndromeUnited StatesConceptsSystemic inflammatory response syndromeSevere sepsis/septic shockSepsis/septic shockPreoperative systemic inflammationEmergency surgical patientsSystemic inflammatory responseThirty-day survivalSystemic inflammationInflammatory responsePostoperative outcomesSurgical patientsSeptic shockEmergent colon surgeryEmergency general surgeryInflammatory response syndromeTimely surgical interventionAcute care surgeonsKaplan-Meier methodRisk of morbidityDamage control operationPreoperative inflammationColorectal operationsPostoperative complicationsHazard ratioSepsis patients
2011
A Critical Assessment of Outcomes in Emergency versus Nonemergency General Surgery Using the American College of Surgeons National Surgical Quality Improvement Program Database
Becher RD, Hoth JJ, Miller PR, Mowery NT, Chang MC, Meredith JW. A Critical Assessment of Outcomes in Emergency versus Nonemergency General Surgery Using the American College of Surgeons National Surgical Quality Improvement Program Database. The American Surgeon 2011, 77: 951-959. PMID: 21944366, DOI: 10.1177/000313481107700738.Peer-Reviewed Original ResearchMeSH KeywordsAgedDatabases, FactualEmergency TreatmentFemaleHumansMalePostoperative ComplicationsSurgical Procedures, OperativeTreatment OutcomeUnited StatesConceptsEmergent operationPostoperative morbidityAmerican CollegeNonemergent casesSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseGeneral surgery inpatientsGeneral surgery patientsImprovement Program databaseDeep vein thrombosisSpecific outcome dataGeneral surgery operationsGeneral surgery proceduresHigh mortality rateSystems of carePostoperative complicationsRenal failureSurgery patientsVein thrombosisNonemergent patientsHigh morbidityPoor outcomeUnique ClinicalInflammatory response