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 populationRethinking Priorities
Zogg CK, Najjar P, Diaz A, Zogg DL, Tsai TC, Rose JA, Scott JW, Gani F, Alshaikh H, Nagarajan N, Canner JK, Schneider EB, Goldberg JE, Haider AH. Rethinking Priorities. Annals Of Surgery 2016, 264: 312-322. PMID: 26501705, DOI: 10.1097/sla.0000000000001511.Peer-Reviewed Original ResearchConceptsElective colectomyPrimary diagnosisNationwide Inpatient Sample dataIncremental costBenign colonic neoplasmsSystem-based complicationsCost of complicationsSurgical quality improvement initiativesIncremental hospital costsLong-term treatmentQuality improvement initiativesExperienced complicationsInfectious complicationsCardiovascular complicationsComplication groupDiverticular diseaseOpen resectionAdult patientsFrequent diagnosisColonic neoplasmsHospital costsOperative techniqueColectomyComplicationsHealthcare costs“Halo effect” in trauma centers: does it extend to emergent colectomy?
Nagarajan N, Selvarajah S, Gani F, Alshaikh HN, Giuliano K, Zogg CK, Schneider EB, Haider AH. “Halo effect” in trauma centers: does it extend to emergent colectomy? Journal Of Surgical Research 2016, 203: 231-237. PMID: 27125867, DOI: 10.1016/j.jss.2016.01.037.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overColectomyDatabases, FactualDiverticulitis, ColonicEmergenciesFemaleHospital ChargesHospital MortalityHumansLength of StayLinear ModelsLogistic ModelsMaleMiddle AgedPoisson DistributionQuality Assurance, Health CareQuality Indicators, Health CareTrauma CentersTreatment OutcomeUnited StatesYoung AdultConceptsLength of stayNontrauma centersHospital-level characteristicsTrauma centerEmergent colectomyEmergency general surgery conditionsEmergency general surgery proceduresNationwide Emergency Department SampleEmergency surgical interventionOdds of mortalityEmergency Department SampleGeneral surgery proceduresNontrauma conditionsHospital mortalityMedian ageSurgical interventionSurgical conditionsImproved outcomesSex distributionSurgical careMedian chargePatientsSurgery proceduresSurgery conditionsCase mix
2014
Variation in Readmission by Hospital After Colorectal Cancer Surgery
Lucas D, Ejaz A, Bischof D, Schneider E, Pawlik T. Variation in Readmission by Hospital After Colorectal Cancer Surgery. JAMA Surgery 2014, 149: 1272-1277. PMID: 25337956, DOI: 10.1001/jamasurg.2014.988.Peer-Reviewed Original ResearchConceptsReadmission ratesColorectal surgeryAppropriate risk adjustmentHierarchical multivariable logistic regression analysisMultivariable logistic regression analysisRisk-adjusted readmission ratesRisk adjustmentRepresentative cancer registryColorectal cancer surgeryEnd Results-MedicareHospital readmission ratesHospital quality metricsRisk-adjusted variationLogistic regression analysisColorectal resectionStudy patientsHospital readmissionMedian agePatient characteristicsCancer surgeryCancer RegistryMAIN OUTCOMEReadmissionUS hospitalsHospitalDoes relative value unit–based compensation shortchange the acute care surgeon?
Schwartz D, Hui X, Velopulos C, Schneider E, Selvarajah S, Lucas D, Haut E, McQuay N, Pawlik T, Efron D, Haider A. Does relative value unit–based compensation shortchange the acute care surgeon? Journal Of Trauma And Acute Care Surgery 2014, 76: 84-94. PMID: 24368361, PMCID: PMC5995323, DOI: 10.1097/ta.0b013e3182ab1ae3.Peer-Reviewed Original ResearchConceptsLength of stayAcute care surgeonsEmergent casesRelative value unitsPatient careNational Surgical Quality Improvement ProgramSurgical Quality Improvement ProgramComorbidities of interestEmergent operative managementHigher mortality riskQuality Improvement ProgramCurrent Procedural TerminologyElective colectomyMinor complicationsComplication rateOperative timeEmergent proceduresMore complicationsOperative managementBiliary proceduresElective proceduresOpen techniqueElective patientsOdds ratioHernia repair
2013
State-by-state variation in emergency versus elective colon resections: Room for improvement
Obirieze A, Kisat M, Hicks C, Oyetunji T, Schneider E, Gaskin D, Haut E, Efron D, Cornwell E, Haider A. State-by-state variation in emergency versus elective colon resections: Room for improvement. Journal Of Trauma And Acute Care Surgery 2013, 74: 1286. PMID: 23609280, PMCID: PMC3645918, DOI: 10.1097/ta.0b013e31828b8478.Peer-Reviewed Original ResearchConceptsElective colon resectionColon surgeryColon resectionOdds ratioElective colon surgeryEmergency colon surgeryNationwide Inpatient SampleFinal study cohortElective surgical proceduresDischarge-level weightsSubstantial state variationsElective colectomyEmergency colectomyHospital factorsAdult patientsStudy cohortEmergent proceduresInpatient SampleNational averageColon operationsUnadjusted proportionRetrospective analysisSurgical proceduresEmergency proceduresColectomyAssessing short- and long-term outcomes among black vs white Medicare patients undergoing resection of colorectal cancer
Schneider E, Haider A, Hyder O, Efron J, Lidor A, Pawlik T. Assessing short- and long-term outcomes among black vs white Medicare patients undergoing resection of colorectal cancer. The American Journal Of Surgery 2013, 205: 402-408. PMID: 23375764, PMCID: PMC3999705, DOI: 10.1016/j.amjsurg.2012.08.005.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBlack or African AmericanCohort StudiesColectomyColorectal NeoplasmsFemaleHealth Status DisparitiesHospital MortalityHumansLength of StayLogistic ModelsMaleMedicareOdds RatioPatient ReadmissionProportional Hazards ModelsRectumSEER ProgramTreatment OutcomeUnited StatesWhite PeopleConceptsBlack patientsLong-term outcomesLong-term survivalColorectal cancerHospital mortalityWhite patientsGreater oddsWorse long-term survivalWhite Medicare patientsEnd Results-MedicareRisk of mortalityMore comorbiditiesPerioperative mortalityColorectal surgeryReduced oddsMedicare patientsInpatient dataPatientsReadmissionMortalityCancerComorbiditiesResectionWhite differencesOdds
2012
Patient 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 cancer
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 AnalysisGlobal Surgical Package Reimbursement and the Acute Care Surgeon: A Threat to Optimal Care
Schneider E, Haider A, Lidor A, Efron J, Villegas C, Stevens K, Hirani S, Haut E, Efron D. Global Surgical Package Reimbursement and the Acute Care Surgeon: A Threat to Optimal Care. Journal Of Trauma And Acute Care Surgery 2011, 70: 583-589. PMID: 21610346, DOI: 10.1097/ta.0b013e3182098a30.Peer-Reviewed Original ResearchConceptsLength of stayElective right hemicolectomyEmergency surgical patientsElective patientsRight hemicolectomyEmergent patientsInhospital mortalityGreater comorbiditySurgical patientsOptimal careNationwide Inpatient Sample dataAcute care surgery serviceEmergent right hemicolectomyPatient LOSAcute care surgeonsEmergency surgery patientsHigher mortality riskMann-Whitney testSurgery patientsSurgery serviceInpatient admissionsInsurance statusMortality riskMultivariable regressionGreater odds