2018
Management outcomes of diverticulitis and colitis in patients with active cancer
Horwood C, Wisler J, Byrd S, Woodling K, Schneider E, Rushing A. Management outcomes of diverticulitis and colitis in patients with active cancer. Surgery 2018, 164: 350-353. PMID: 29801733, DOI: 10.1016/j.surg.2018.03.010.Peer-Reviewed Original ResearchConceptsActive cancer diagnosisColonic emergenciesActive cancerNonoperative managementIntensive care unit admissionEmergent general surgeryCare unit admissionPreoperative risk factorsCancer diagnosisNon-operative managementCancer patient populationIntensive care unitNonoperative groupNonoperative patientsUnit admissionPostoperative complicationsCare unitColonic pathologyOperative groupSurgery consultOperative managementPatient populationCancer DatabaseRisk factorsGeneral surgery
2016
Benefits of Bowel Preparation Beyond Surgical Site Infection
Althumairi A, Canner J, Pawlik T, Schneider E, Nagarajan N, Safar B, Efron J. Benefits of Bowel Preparation Beyond Surgical Site Infection. Annals Of Surgery 2016, 264: 1051-1057. PMID: 26727098, DOI: 10.1097/sla.0000000000001576.Peer-Reviewed Original ResearchConceptsOral antibiotic bowel preparationMechanical bowel preparationSurgical site infectionBowel preparationElective colectomyPostoperative complicationsAnastomotic leakSite infectionIncidence of SSIReduction of SSIOrgan space surgical site infectionDeep surgical site infectionParticipant Use Data FileReduced surgical site infectionsSpace surgical site infectionSuperficial surgical site infectionAntibiotic bowel preparationPostoperative ileusPostoperative outcomesSSI incidenceColectomy casesSeptic shockWound dehiscenceLower incidenceStudy populationA comparison of trends in operative approach and postoperative outcomes for colorectal cancer surgery
Addae J, Gani F, Fang S, Wick E, Althumairi A, Efron J, Canner J, Euhus D, Schneider E. A comparison of trends in operative approach and postoperative outcomes for colorectal cancer surgery. Journal Of Surgical Research 2016, 208: 111-120. PMID: 27993198, DOI: 10.1016/j.jss.2016.09.019.Peer-Reviewed Original ResearchConceptsLength of stayShorter LOSColorectal cancer surgerySurgical approachColorectal surgeryPostoperative morbidityPostoperative outcomesCancer surgeryOpen surgeryInvasive surgeryOpen colorectal surgeryInvasive colorectal surgeryTime of surgeryCochrane-Armitage testNationwide Inpatient SampleRobotic colorectal surgeryHigher mean costCRC surgeryPerioperative outcomesPostoperative complicationsInpatient SampleOpen procedureOperative approachMean costSurgeryHospital readmission after multiple major operative procedures among patients with employer provided health insurance
Kim Y, Gani F, Canner J, Margonis G, Makary M, Schneider E, Pawlik T. Hospital readmission after multiple major operative procedures among patients with employer provided health insurance. Surgery 2016, 160: 178-190. PMID: 27085686, DOI: 10.1016/j.surg.2016.01.025.Peer-Reviewed Original ResearchConceptsMultiple operative proceduresDays of dischargeMajor operative proceduresOperative procedureSingle operative procedureIndex dischargeLate readmissionHospital readmissionMultivariable logistic regression analysisHigher preoperative comorbidityLate hospital readmissionLogistic regression analysisDuration of stayPreoperative comorbiditiesPostoperative complicationsPostoperative dischargeMarketScan databaseMultivariable analysisOverall incidenceAbdominal proceduresSame hospitalRisk factorsReadmissionCardiovascular proceduresGreater odds
2015
Understanding Variation in 30-Day Surgical Readmission in the Era of Accountable Care: Effect of the Patient, Surgeon, and Surgical Subspecialties
Gani F, Lucas D, Kim Y, Schneider E, Pawlik T. Understanding Variation in 30-Day Surgical Readmission in the Era of Accountable Care: Effect of the Patient, Surgeon, and Surgical Subspecialties. JAMA Surgery 2015, 150: 1042-1049. PMID: 26244543, DOI: 10.1001/jamasurg.2015.2215.Peer-Reviewed Original ResearchMeSH KeywordsAccountable Care OrganizationsAdultAge FactorsAgedClinical CompetenceComprehensionDatabases, FactualDelivery of Health CareFemaleHumansIncidenceLogistic ModelsMaleMiddle AgedMultivariate AnalysisPatient ReadmissionPhysician's RolePostoperative ComplicationsRetrospective StudiesSex FactorsSocioeconomic FactorsSpecialties, SurgicalSurgical Procedures, OperativeTime FactorsConceptsMajor surgical proceduresSurgical proceduresSurgical subspecialtiesRace/ethnicityPostoperative complicationsEndocrine surgeryAfrican American race/ethnicitySurgeon-level factorsPatient-level factorsTertiary care centerLarge academic medical centerPatient-related factorsSubspecialty levelAdministrative claims dataAcademic medical centerIndividual surgeon levelDifferent surgical subspecialtiesPreoperative comorbiditiesHospital morbidityPatient ageSurgical readmissionsCardiac surgeryTransplant surgeryPayer typeCare centerThirty-day readmission after lower extremity bypass in diabetic patients
Najafian A, Selvarajah S, Schneider EB, Malas MB, Ehlert BA, Orion KC, Haider AH, Abularrage CJ. Thirty-day readmission after lower extremity bypass in diabetic patients. Journal Of Surgical Research 2015, 200: 356-364. PMID: 26216749, DOI: 10.1016/j.jss.2015.06.061.Peer-Reviewed Original ResearchConceptsInsulin-dependent diabetic mellitusLower extremity bypassUnplanned readmissionCardiac diseaseCardiac complicationsExtremity bypassDiabetic mellitusSurgeons National Surgery Quality Improvement Program databaseNational Surgery Quality Improvement Program databaseInfrainguinal lower extremity bypassQuality Improvement Program databaseConcomitant cardiac diseaseDependent diabetic mellitusThirty-day readmissionImprovement Program databasePeripheral vascular diseaseUnplanned readmission rateInfluence of diabetesSignificant risk factorsPostoperative complicationsCardiac workupReadmission ratesDiabetic patientsIndependent predictorsMultivariable analysisEarly versus late hospital readmission after pancreaticoduodenectomy
Schneider E, Canner J, Gani F, Kim Y, Ejaz A, Spolverato G, Pawlik T. Early versus late hospital readmission after pancreaticoduodenectomy. Journal Of Surgical Research 2015, 196: 74-81. PMID: 25777825, DOI: 10.1016/j.jss.2015.02.043.Peer-Reviewed Original ResearchConceptsProcedure-related factorsLate readmissionEarly readmissionTruven Health MarketScan databaseLate hospital readmissionCoronary heart diseaseSubsequent medical managementPostoperative complicationsExtended LOSHospital readmissionRenal diseaseMarketScan databaseMedical managementMultivariable analysisPatient groupTrue burdenHeart diseaseCommon causeInclusion criteriaReadmissionPancreaticoduodenectomyPatientsDiseaseLonger lengthComplex procedures
2014
Worse outcomes among uninsured general surgery patients: Does the need for an emergency operation explain these disparities?
Schwartz D, Hui X, Schneider E, Ali M, Canner J, Leeper W, Efron D, Haut E, Velopulos C, Pawlik T, Haider A. Worse outcomes among uninsured general surgery patients: Does the need for an emergency operation explain these disparities? Surgery 2014, 156: 345-351. PMID: 24953267, DOI: 10.1016/j.surg.2014.04.039.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultCross-Sectional StudiesEmergency TreatmentFemaleHealthcare DisparitiesHumansMaleMedicaidMedically UninsuredMedicareMiddle AgedOdds RatioPatient Protection and Affordable Care ActPostoperative ComplicationsRetrospective StudiesSurgical Procedures, OperativeTreatment OutcomeUnited StatesYoung AdultConceptsEmergent operative managementEmergent operationWorse outcomesOperative managementNationwide Inpatient Sample 2005Retrospective cross-sectional analysisGeneral surgery patientsUrgency of operationGreater odds ratioHealth care accessCross-sectional analysisCovariates of ageColorectal operationsPayor statusPostoperative complicationsComplication rateSurgery patientsYounger patientsHispanic patientsMore complicationsInsurance statusOdds ratioUninsured groupCare accessPatients
2013
Increased complications after appendectomy in patients with cerebral palsy: Are special needs patients at risk for disparities in outcomes?
Dhiman N, Chi A, Pawlik T, Efron D, Haut E, Schneider E, Hashmi Z, Scott V, Hui X, Ali M, Haider A. Increased complications after appendectomy in patients with cerebral palsy: Are special needs patients at risk for disparities in outcomes? Surgery 2013, 154: 479-485. PMID: 23972654, DOI: 10.1016/j.surg.2013.05.038.Peer-Reviewed Original ResearchConceptsCerebral palsyHospital stayPostoperative complicationsLaparoscopic appendectomyAcute respiratory distress syndromeNon-CP patientsOperation-related infectionOdds of complicationsRespiratory distress syndromeUrinary tract infectionNationwide Inpatient SampleHospital discharge dataSpecial needs patientsCommon operative procedureMultiple logistic regressionRecognition of symptomsCP patientsInpatient mortalityPostoperative outcomesTract infectionsDistress syndromeOrgan failureAdjusted analysisPatient assessmentInpatient SampleInfluence of gender on outcomes after thoracic endovascular aneurysm repair
Arnaoutakis G, Schneider E, Arnaoutakis D, Black J, Lum Y, Perler B, Freischlag J, Abularrage C. Influence of gender on outcomes after thoracic endovascular aneurysm repair. Journal Of Vascular Surgery 2013, 59: 45-51. PMID: 23896176, DOI: 10.1016/j.jvs.2013.06.058.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAortic Aneurysm, ThoracicChi-Square DistributionDatabases, FactualEmergenciesEndovascular ProceduresFemaleHumansIliac ArteryLinear ModelsLogistic ModelsMaleMultivariate AnalysisOdds RatioPostoperative ComplicationsRegistriesRetrospective StudiesRisk FactorsSex FactorsTime FactorsTreatment OutcomeUnited StatesConceptsIliac artery exposureNonruptured thoracic aortic aneurysmsAortic aneurysm repairThoracic aortic aneurysmAneurysm repairArtery exposureUnadjusted mortalityMultivariable analysisAortic aneurysmFemale genderSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseRisk-adjusted generalized linear modelsEndovascular abdominal aortic aneurysm repairQuality Improvement Program databaseAbdominal aortic aneurysm repairEndovascular aortic aneurysm repairACS-NSQIP databaseImprovement Program databasePrimary outcome measureEndovascular aneurysm repairHigh mortality rateHospital lengthPostoperative complicationsTransfusion rateHispanic ethnicity is associated with increased costs after carotid endarterectomy and carotid stenting in the United States
Propper B, Black J, Schneider E, Lum Y, Malas M, Arnold M, Abularrage C. Hispanic ethnicity is associated with increased costs after carotid endarterectomy and carotid stenting in the United States. Journal Of Surgical Research 2013, 184: 644-650. PMID: 23582759, DOI: 10.1016/j.jss.2013.03.057.Peer-Reviewed Original ResearchConceptsCarotid artery stentingTotal hospital chargesCarotid endarterectomyHospital chargesHispanic ethnicityBlack patientsUnivariate analysisOperative volumeCost of CEAHospital operative volumeSurgeon operative volumesLow-volume hospitalsNationwide Inpatient SampleCarotid artery stenosisICD-9 codesLow-volume surgeonsHigh-risk statusOnly Hispanic ethnicityPostoperative complicationsCarotid revascularizationSymptomatic statusArtery stentingPrimary outcomeSymptomatic presentationArtery stenosisRacial and ethnic disparities in the treatment of unruptured thoracoabdominal aortic aneurysms in the United States
Arnaoutakis D, Propper B, Black J, Schneider E, Lum Y, Freischlag J, Perler B, Abularrage C. Racial and ethnic disparities in the treatment of unruptured thoracoabdominal aortic aneurysms in the United States. Journal Of Surgical Research 2013, 184: 651-657. PMID: 23545407, DOI: 10.1016/j.jss.2013.03.018.Peer-Reviewed Original ResearchMeSH KeywordsAgedAortic Aneurysm, AbdominalAortic Aneurysm, ThoracicBlack or African AmericanComorbidityEthnicityFemaleHealthcare DisparitiesHispanic or LatinoHospital CostsHumansInsurance, HealthLinear ModelsMaleMiddle AgedMultivariate AnalysisRacial GroupsRisk FactorsUnited StatesVascular Surgical ProceduresWhite PeopleConceptsAortic aneurysm repairThoracoabdominal aortic aneurysm repairHospital operative volumePostoperative complicationsAneurysm repairThoracoabdominal aneurysmsHispanic patientsHispanic ethnicityOperative volumeMultivariate analysisEthnic disparitiesAbdominal aortic aneurysm repairAnnual surgical volumeThoracoabdominal aortic aneurysmsClinical Modification codesNationwide Inpatient SamplePreoperative comorbiditiesIndex hospitalizationSecondary outcomesDiabetes mellitusPrimary outcomeWhite patientsBlack patientsCerebrovascular diseaseNinth Revision
2012
Disparities in Outcomes for Hispanic Patients Undergoing Endovascular and Open Abdominal Aortic Aneurysm Repair
Williams T, Schneider E, Black J, Lum Y, Freischlag J, Perler B, Abularrage C. Disparities in Outcomes for Hispanic Patients Undergoing Endovascular and Open Abdominal Aortic Aneurysm Repair. Annals Of Vascular Surgery 2012, 27: 29-37. PMID: 23084731, DOI: 10.1016/j.avsg.2012.06.006.Peer-Reviewed Original ResearchMeSH KeywordsAgedAortic Aneurysm, AbdominalBlack or African AmericanBlood Vessel Prosthesis ImplantationChi-Square DistributionDatabases, FactualElective Surgical ProceduresEndovascular ProceduresFemaleHealthcare DisparitiesHispanic or LatinoHospital CostsHospital MortalityHumansLength of StayMaleMultivariate AnalysisPostoperative ComplicationsRisk FactorsTime FactorsTreatment OutcomeUnited StatesWhite PeopleConceptsAbdominal aortic aneurysm repairOpen AAAIndependent risk factorAortic aneurysm repairBlack patientsWhite patientsHispanic patientsHispanic ethnicityAAA repairAneurysm repairHospital chargesHospital characteristicsRisk factorsInsurance typeOpen abdominal aortic aneurysm repairMultivariate analysisICD-9-CM codesTotal hospital chargesNationwide Inpatient SampleInfluence of raceLength of stayUnruptured AAAPrimary hospitalizationHospital mortalityPostoperative complicationsPatient Readmission and Mortality after Colorectal Surgery for Colon Cancer: Impact of Length of Stay Relative to Other Clinical Factors
Schneider E, Hyder O, Brooke B, Efron J, Cameron J, Edil B, Schulick R, Choti M, Wolfgang C, Pawlik T. Patient Readmission and Mortality after Colorectal Surgery for Colon Cancer: Impact of Length of Stay Relative to Other Clinical Factors. Journal Of The American College Of Surgeons 2012, 214: 390-398. PMID: 22289517, DOI: 10.1016/j.jamcollsurg.2011.12.025.Peer-Reviewed Original ResearchMeSH KeywordsAdenocarcinomaAgedAged, 80 and overCohort StudiesColectomyColorectal NeoplasmsComorbidityFemaleHospital MortalityHumansKaplan-Meier EstimateLength of StayLogistic ModelsMaleMedicarePatient ReadmissionPostoperative ComplicationsQuality Indicators, Health CareRegistriesRetrospective StudiesRisk FactorsTreatment OutcomeUnited StatesConceptsColorectal surgeryReadmission ratesColon cancerEnd Results-Medicare datasetMultiple preoperative comorbiditiesLow anterior resectionPrimary surgical treatmentRisk of readmissionPrimary colorectal cancerNumber of patientsLogistic regression modelsHospital performance measuresPreoperative comorbiditiesAnterior resectionHospital morbidityNationwide cohortPostoperative complicationsAbdominoperineal resectionMean LOSPatient ageTotal colectomyClinical factorsMore patientsSurgical treatmentColorectal cancerVariations in surgical outcomes associated with hospital compliance with safety practices
Brooke B, Dominici F, Pronovost P, Makary M, Schneider E, Pawlik T. Variations in surgical outcomes associated with hospital compliance with safety practices. Surgery 2012, 151: 651-659. PMID: 22261296, PMCID: PMC3414538, DOI: 10.1016/j.surg.2011.12.001.Peer-Reviewed Original ResearchMeSH KeywordsAgedCross-Sectional StudiesFemaleGuideline AdherenceHealth Care SurveysHospitalsHumansLogistic ModelsMaleMiddle AgedOutcome Assessment, Health CarePatient SafetyPostoperative ComplicationsPractice Guidelines as TopicQuality Assurance, Health CareSurgical Procedures, OperativeUnited StatesConceptsHigh-risk operationsHospital compliancePostoperative complicationsSafe practiceOpen aortic aneurysm repairHospital-level confoundersRisk-adjusted oddsAortic aneurysm repairRandom effects logistic regression modelEffects logistic regression modelsCross-sectional analysisLogistic regression modelsSafety practicesNationwide hospitalsAneurysm repairRate of failureSurgical outcomesGastrectomy proceduresDecreased oddsComplicationsHospitalDecreased likelihoodHospital qualityLeapfrog GroupPatient safety
2011
Congestive Heart Failure and Chronic Obstructive Pulmonary Disease Predict Poor Surgical Outcomes in Older Adults Undergoing Elective Diverticulitis Surgery
Sheer AJ, Heckman JE, Schneider EB, Wu AW, Segal JB, Feinberg R, Lidor AO. Congestive Heart Failure and Chronic Obstructive Pulmonary Disease Predict Poor Surgical Outcomes in Older Adults Undergoing Elective Diverticulitis Surgery. Diseases Of The Colon & Rectum 2011, 54: 1430-1437. PMID: 21979190, DOI: 10.1097/dcr.0b013e31822c4e85.Peer-Reviewed Original ResearchConceptsChronic obstructive pulmonary diseaseCongestive heart failureObstructive pulmonary diseaseComorbid congestive heart failureHeart failurePulmonary diseaseHospital mortalityPostoperative complicationsOlder patientsElective surgeryOutcome measuresOlder adultsReview (MEDPAR) Inpatient FilesShock/sepsisRetrospective cohort studyPostoperative complication rateSecondary outcome measuresBenefits of surgeryPoor surgical outcomesPrimary outcome measureSubgroup of patientsAge 65 yearsLeft colon resectionCommon medical conditionsMedicare Provider Analysis