2023
Patient-, Clinician-, and Institution-level Variation in Inotrope Use for Cardiac Surgery: A Multicenter Observational Analysis
Mathis M, Janda A, Kheterpal S, Schonberger R, Pagani F, Engoren M, Mentz G, Shook D, Muehlschlegel J, Cassidy R, Clark D, Colquhoun D, Freundlich R, Jewell E. Patient-, Clinician-, and Institution-level Variation in Inotrope Use for Cardiac Surgery: A Multicenter Observational Analysis. Anesthesiology 2023, 139: 122-141. PMID: 37094103, PMCID: PMC10524016, DOI: 10.1097/aln.0000000000004593.Peer-Reviewed Original ResearchConceptsInotrope useCardiac surgeryHome medicationsAdjusted median odds ratioPulmonary circulation disordersAdult cardiac surgeryMechanical circulatory supportMedian odds ratioMedical school affiliationHome inotropesInotrope infusionInotrope therapyInotropic therapyCardiopulmonary bypassHeart failureMulticenter cohortPrimary outcomeCirculatory supportBlack raceCirculation disordersOdds ratioCommunity hospitalObservational studySame patientPatients
2022
Oxygen administration during surgery and postoperative organ injury: observational cohort study
McIlroy D, Shotwell M, Lopez M, Vaughn M, Olsen J, Hennessy C, Wanderer J, Semler M, Rice T, Kheterpal S, Billings F, Group M, Cuff G, Freundlich R, Kurz A, Naik B, Mathis M, Schonberger R. Oxygen administration during surgery and postoperative organ injury: observational cohort study. The BMJ 2022, 379: e070941. PMID: 36450405, PMCID: PMC9710248, DOI: 10.1136/bmj-2022-070941.Peer-Reviewed Original ResearchConceptsAcute kidney injuryObservational cohort studyLung injuryKidney injuryMyocardial injuryOxygen administrationGreater oddsCohort studyMedian age 59 yearsHospital discharge diagnosis codesGlobal Outcomes criteriaAge 59 yearsHours of surgeryDischarge diagnosis codesPotential confounding variablesHemoglobin oxygen saturationPostoperative kidneyPrimary endpointAdult patientsMedian durationOrgan injurySerum troponinEndotracheal intubationGeneral anesthesiaKidney disease
2017
The effect of race on postsurgical ambulatory medical follow-up among United States Veterans
Schonberger RB, Dai F, Brandt C, Burg MM. The effect of race on postsurgical ambulatory medical follow-up among United States Veterans. Journal Of Clinical Anesthesia 2017, 40: 55-61. PMID: 28625448, PMCID: PMC5490668, DOI: 10.1016/j.jclinane.2016.11.002.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAmbulatory CareBlack or African AmericanComorbidityContinuity of Patient CareFemaleFollow-Up StudiesHealthcare DisparitiesHumansLong-Term CareMaleMiddle AgedPatient Acceptance of Health CareRetrospective StudiesSurgical Procedures, OperativeUnited StatesVeteransVeterans HealthYoung AdultConceptsAfrican American raceAfrican American patientsInternal medicineAmerican patientsAmbulatory internal medicineAmerican raceUS Veterans Affairs hospitalsYear of surgeryDay of surgeryVeterans Affairs hospitalUnited States veteransQuality improvement initiativesRetrospective observationalUS veteransHispanic ethnicityInpatient daysStates veteransSurgeryDecreased likelihoodEffect of raceImprovement initiativesVeteransFurther studiesPatientsAfrican AmericansA Pilot Analysis of the Association Between Types of Monitored Anesthesia Care Drugs and Outcomes in Transfemoral Aortic Valve Replacement Performed Without General Anesthesia
Chen EY, Sukumar N, Dai F, Akhtar S, Schonberger RB. A Pilot Analysis of the Association Between Types of Monitored Anesthesia Care Drugs and Outcomes in Transfemoral Aortic Valve Replacement Performed Without General Anesthesia. Journal Of Cardiothoracic And Vascular Anesthesia 2017, 32: 666-671. PMID: 29277298, PMCID: PMC5766429, DOI: 10.1053/j.jvca.2017.07.009.Peer-Reviewed Original ResearchConceptsTransfemoral aortic valve replacementMonitored Anesthesia CareAortic valve replacementGeneral anesthesiaValve replacementAge incrementsMedication dose adjustmentUse of dexmedetomidineRetrospective observational studyType of sedationTertiary teaching hospitalHospital lengthPostoperative deliriumTAVR patientsDose adjustmentConscious sedationAnesthesia careCare drugsPossible differential effectsTeaching hospitalObservational studyAnesthetic agentsDose reductionDrug dosingPilot analysis
2016
A Retrospective Observational Study of Anesthetic Induction Dosing Practices in Female Elderly Surgical Patients: Are We Overdosing Older Patients?
Akhtar S, Heng J, Dai F, Schonberger RB, Burg MM. A Retrospective Observational Study of Anesthetic Induction Dosing Practices in Female Elderly Surgical Patients: Are We Overdosing Older Patients? Drugs & Aging 2016, 33: 737-746. PMID: 27581549, DOI: 10.1007/s40266-016-0394-x.Peer-Reviewed Original ResearchConceptsDoses of fentanylOlder patientsFemale patientsInduction dosesGeneral anesthesiaObservational studyTertiary care academic hospitalElderly surgical patientsIncidence of hypotensionDose of propofolRetrospective observational studyOld female patientIntravenous anesthetic agentPost-induction hypotensionAge-associated differencesQuality improvement effortsResultsOlder patientsVasopressor therapyElderly patientsSurgical patientsYounger patientsBlood pressureHemodynamic outcomesASA-PSStudy designWeDoes intravenous induction dosing among patients undergoing gastrointestinal surgical procedures follow current recommendations: a study of contemporary practice
Akhtar S, Liu J, Heng J, Dai F, Schonberger RB, Burg MM. Does intravenous induction dosing among patients undergoing gastrointestinal surgical procedures follow current recommendations: a study of contemporary practice. Journal Of Clinical Anesthesia 2016, 33: 208-215. PMID: 27555166, DOI: 10.1016/j.jclinane.2016.02.001.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAgingAlgorithmsAnesthesia, IntravenousAnesthetics, IntravenousBody WeightDigestive System Surgical ProceduresFemaleFentanylGuidelines as TopicHumansHypotensionIntraoperative ComplicationsMaleMidazolamMiddle AgedPropofolRetrospective StudiesSeverity of Illness IndexConceptsASA-PS classAge groupsInduction dosesSurgical proceduresAnesthesiologists physical status classMean arterial pressure changesYounger groupOlder groupAge-adjusted doseRate of hypotensionMean arterial pressureRetrospective chart reviewAnesthetic induction agentGastrointestinal surgical proceduresArterial pressure changesGI surgical proceduresAcademic medical centerCochran-Armitage trend testDifferent age groupsPostinduction hypotensionOlder patientsAdult patientsArterial pressureChart reviewIntravenous inductionIs There Evidence for Systematic Upcoding of ASA Physical Status Coincident with Payer Incentives? A Regression Discontinuity Analysis of the National Anesthesia Clinical Outcomes Registry
Schonberger RB, Dutton RP, Dai F. Is There Evidence for Systematic Upcoding of ASA Physical Status Coincident with Payer Incentives? A Regression Discontinuity Analysis of the National Anesthesia Clinical Outcomes Registry. Anesthesia & Analgesia 2016, 122: 243-250. PMID: 26360960, PMCID: PMC4684754, DOI: 10.1213/ane.0000000000000917.Peer-Reviewed Original Research
2015
Ambulatory Medical Follow-Up in the Year After Surgery and Subsequent Survival in a National Cohort of Veterans Health Administration Surgical Patients
Schonberger RB, Dai F, Brandt C, Burg MM. Ambulatory Medical Follow-Up in the Year After Surgery and Subsequent Survival in a National Cohort of Veterans Health Administration Surgical Patients. Journal Of Cardiothoracic And Vascular Anesthesia 2015, 30: 671-679. PMID: 27021176, PMCID: PMC5499041, DOI: 10.1053/j.jvca.2015.12.019.Peer-Reviewed Original ResearchConceptsFirst postoperative yearPostoperative yearNational cohortPostsurgical yearSurgical patientsLong-term postoperative survivalVeterans Health Administration facilitiesFirst postsurgical yearRetrospective cohort studyPostoperative year 1Day of surgeryAmbulatory medical careHazard of deathPostoperative year 2Medical Follow-UpYear 2US veterans' hospitalsYear 1Cause mortalityPostoperative survivalCohort studyPatient subgroupsCare coordinationFollow-upUS veteransBalancing Model Performance and Simplicity to Predict Postoperative Primary Care Blood Pressure Elevation
Schonberger RB, Dai F, Brandt CA, Burg MM. Balancing Model Performance and Simplicity to Predict Postoperative Primary Care Blood Pressure Elevation. Anesthesia & Analgesia 2015, 121: 632-641. PMID: 26214552, PMCID: PMC4545382, DOI: 10.1213/ane.0000000000000860.Peer-Reviewed Original ResearchConceptsClinic blood pressureBlood pressureNet reclassification indexSurgical patientsReclassification indexLong-term cardiovascular morbidityBlood pressure thresholdBroader public health effortsPreoperative blood pressureBlood pressure elevationComplex logistic regression modelLong-term morbidityBlood pressure readingsPerioperative blood pressureOutpatient clinic followBlood pressure measurementsRole of anesthesiologistsPublic health effortsPossible beneficial effectsLongitudinal patient careLogistic regression modelsCardiovascular morbidityClinic followHypertension historyHypertensive range
2014
Preoperative Depression Symptom Severity and Its Impact on Adherence to Preoperative Beta-Blocker Therapy
Schonberger RB, Feinleib J, Holt N, Dai F, Brandt C, Burg MM. Preoperative Depression Symptom Severity and Its Impact on Adherence to Preoperative Beta-Blocker Therapy. Journal Of Cardiothoracic And Vascular Anesthesia 2014, 28: 1467-1473. PMID: 25263776, PMCID: PMC4258545, DOI: 10.1053/j.jvca.2014.05.006.Peer-Reviewed Original ResearchConceptsBeta-blocker therapyDistressed personality typeMajor depressionChronic beta-blocker therapyPreoperative beta-blocker therapyRecent primary care visitBeta-blocker withdrawalMost surgical patientsUntreated major depressionPrimary care visitsProspective observational studyDay of surgeryPatient Health QuestionnaireDiagnosis of depressionMajor depressive disorderIndication of depressionSymptoms of depressionDepression symptom severityCare visitsSurgical patientsMedication nonadherenceDepression screeningTreatable conditionDepressive disorderSevere depressionHandheld Doppler to Improve Pulse Checks during Resuscitation of Putative Pulseless Electrical Activity Arrest
Schonberger RB, Lampert RJ, Mandel EI, Feinleib J, Gong Z, Honiden S. Handheld Doppler to Improve Pulse Checks during Resuscitation of Putative Pulseless Electrical Activity Arrest. Anesthesiology 2014, 120: 1042-1045. PMID: 24335750, PMCID: PMC3975650, DOI: 10.1097/aln.0000000000000106.Peer-Reviewed Original Research
2013
New Utility for an Old Tool
Odonkor CA, Schonberger RB, Dai F, Shelley KH, Silverman DG, Barash PG. New Utility for an Old Tool. American Journal Of Physical Medicine & Rehabilitation 2013, 92: 849-863. PMID: 24051992, PMCID: PMC3850792, DOI: 10.1097/phm.0b013e3182a51ac5.Peer-Reviewed Original ResearchConceptsElective ambulatory surgeryUnplanned admissionsAmbulatory surgeryGait speedOdds ratioPrimary outcomeDischarge readinessProspective observational cohort studyMultivariable logistic regression modelSeparate multivariable logistic regression modelsEarly home dischargeHome discharge timePreoperative gait speedObservational cohort studyTotal anesthesia timeAdjusted odds ratioGait speed testingLogistic regression modelsCohort studyHome dischargeCardiac surgeryAnesthesia timeHeart rateSurgeryAdmission
2012
Atenolol is Associated With Lower Day-of-Surgery Heart Rate Compared to Long- and Short-Acting Metoprolol
Schonberger RB, Brandt C, Feinleib J, Dai F, Burg MM. Atenolol is Associated With Lower Day-of-Surgery Heart Rate Compared to Long- and Short-Acting Metoprolol. Journal Of Cardiothoracic And Vascular Anesthesia 2012, 27: 298-304. PMID: 22889605, PMCID: PMC3557658, DOI: 10.1053/j.jvca.2012.06.021.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-AntagonistsAgedAmbulatory Surgical ProceduresAntihypertensive AgentsAtenololChemistry, PharmaceuticalCohort StudiesConfidence IntervalsDelayed-Action PreparationsFemaleHeart RateHemodynamicsHumansLeast-Squares AnalysisLinear ModelsMaleMetoprololMiddle AgedOutpatientsPatient CompliancePropensity ScoreTreatment OutcomeConceptsBeats/minTwice-daily dosing regimensAmbulatory surgical patientsHeart rateSurgical patientsDosing regimensMetoprolol formulationsPrimary care visitsDay of surgeryRetrospective observational studyVeterans Administration HospitalGeneral linear modelHeart rate differencesΒ-blocker typeCare visitsAdministration HospitalObservational studyPatientsMetoprololAtenololMetoprolol succinateRegimensDaysLow dayMinBeta-Blocker Withdrawal Among Patients Presenting for Surgery from Home
Schonberger RB, Lukens CL, Turkoglu OD, Feinleib JL, Haspel KL, Burg MM. Beta-Blocker Withdrawal Among Patients Presenting for Surgery from Home. Journal Of Cardiothoracic And Vascular Anesthesia 2012, 26: 1029-1033. PMID: 22418043, PMCID: PMC3419315, DOI: 10.1053/j.jvca.2012.01.024.Peer-Reviewed Original ResearchConceptsDay of surgeryΒ-blocker therapyLong-term β-blocker therapyHeart rateΒ-blockersVital signsFuture quality improvement initiativesBeta-blocker withdrawalΒ-blocker withdrawalProspective observational studyVeterans Administration HospitalQuality improvement initiativesSelf-reported complianceAdherent subjectsPreoperative clinicComorbidity dataPatient noncompliancePreoperative visitPrimary careMedical recordsAdministration HospitalObservational studyMedication instructionsPatient understandingOutcome data
2011
The Relationship Between Preoperative and Primary Care Blood Pressure Among Veterans Presenting from Home for Surgery
Schonberger RB, Burg MM, Holt N, Lukens CL, Dai F, Brandt C. The Relationship Between Preoperative and Primary Care Blood Pressure Among Veterans Presenting from Home for Surgery. Anesthesia & Analgesia 2011, 114: 205-214. PMID: 22075017, PMCID: PMC3282161, DOI: 10.1213/ane.0b013e318239c4c1.Peer-Reviewed Original ResearchMeSH KeywordsAgedBlood PressureBlood Pressure DeterminationConnecticutFemaleHumansHypertensionLinear ModelsMaleMiddle AgedPredictive Value of TestsPreoperative CarePrimary Health CareReferral and ConsultationRetrospective StudiesSensitivity and SpecificitySurgical Procedures, OperativeTime FactorsVeteransConceptsSystolic blood pressureBlood pressurePrimary care measurementCardiology/American Heart Association guidelinesClinic systolic blood pressureImproved blood pressure controlAmerican Heart Association guidelinesCare measurementBlood pressure elevationBlood pressure controlPrimary care referralsDiastolic blood pressureHeart Association guidelinesHigh blood pressurePrimary care centersEvidence-based fashionNegative predictive valueDBP thresholdPreoperative hypertensionSBP thresholdPerioperative evaluationCare referralMedication noncompliancePreoperative examinationPressure elevation