2020
Spirometry not pain level predicts outcomes in geriatric patients with isolated rib fractures.
Schuster KM, Sanghvi M, O'Connor R, Becher R, Maung AA, Davis KA. Spirometry not pain level predicts outcomes in geriatric patients with isolated rib fractures. Journal Of Trauma And Acute Care Surgery 2020, 89: 947-954. PMID: 32467465, DOI: 10.1097/ta.0000000000002795.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overEmergency Service, HospitalFemaleHand StrengthHospitals, RehabilitationHumansIntensive Care UnitsLength of StayMalePainPain ManagementPain MeasurementPatient DischargePatient TransferPredictive Value of TestsProspective StudiesRib FracturesSpirometryTrauma CentersTreatment OutcomeConceptsLength of stayIsolated rib fracturesNegative inspiratory forceUnplanned ICU admissionRib fracturesPain levelsDay 1ICU admissionInspiratory forceGrip strengthMedian LOSHospital day 1Expiratory volume 1Complete spirometryPain controlDischarge dispositionPulmonary functionEarly dischargeGeriatric patientsVital capacityMean ageSpirometry measuresPulmonary capacityLevel IVFEV1Hospital 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
Top-tier emergency general surgery hospitals: Good at one operation, good at them all.
DeWane MP, Sukumar N, Stolar MJ, Gill TM, Maung AA, Schuster KM, Davis KA, Becher RD. Top-tier emergency general surgery hospitals: Good at one operation, good at them all. Journal Of Trauma And Acute Care Surgery 2019, 87: 289-296. PMID: 31349347, PMCID: PMC6771423, DOI: 10.1097/ta.0000000000002367.Peer-Reviewed Original ResearchConceptsRisk-adjusted mortalityEGS hospitalsHospital risk-adjusted mortalityOperation typeEGS operationsCalifornia State Inpatient DatabaseGeneral surgery hospitalsHospital-level factorsAcute care hospitalsState Inpatient DatabasesAmerican Hospital Association databasePoor-performing hospitalsSystems of careLow-risk operationAssessment of mortalityAdult patientsCare hospitalSurgery HospitalInpatient DatabaseHospital characteristicsMultinomial logistic regressionMortality rateHospitalLevel IIIZ-scoreHospital 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 increasePatientsEvaluation of Swallow Function Post-Extubation: Is It Necessary to Wait 24 Hours?
Leder SB, Warner HL, Suiter DM, Young NO, Bhattacharya B, Siner JM, Davis KA, Maerz LL, Rosenbaum SH, Marshall PS, Pisani MA, Siegel MD, Brennan JJ, Schuster KM. Evaluation of Swallow Function Post-Extubation: Is It Necessary to Wait 24 Hours? Annals Of Otology Rhinology & Laryngology 2019, 128: 619-624. PMID: 30841709, DOI: 10.1177/0003489419836115.Peer-Reviewed Original ResearchConceptsIntensive care unitSwallow evaluationDifferent intensive care unitsRe-intubation rateYale Swallow ProtocolMajority of patientsPost-extubation dysphagiaIntubation durationNosocomial pneumoniaPost extubationLonger hospitalizationCare unitProspective InvestigationSwallow ProtocolSwallowingHoursDysphagiaHospitalizationIntubationPneumoniaPatientsIncidenceEvaluation
2018
Racial/Ethnic Disparities in Longer-term Outcomes Among Emergency General Surgery Patients
Zogg CK, Jiang W, Ottesen TD, Shafi S, Schuster K, Becher R, Davis KA, Haider AH. Racial/Ethnic Disparities in Longer-term Outcomes Among Emergency General Surgery Patients. Annals Of Surgery 2018, 268: 968-979. PMID: 28742704, PMCID: PMC5783796, DOI: 10.1097/sla.0000000000002449.Peer-Reviewed Original ResearchConceptsEmergency general surgery patientsNon-Hispanic whitesGeneral surgery patientsLong-term outcomesNon-Hispanic blacksNon-Hispanic AsiansMinority patientsMajor morbidityUnplanned readmissionSurgery patientsOlder adultsRisk-adjusted Cox proportional hazards modelsEthnic disparitiesCox proportional hazards modelDiagnostic categoriesRacial/Ethnic DisparitiesUS population agesProportional hazards modelNHB patientsNonagenarian patientsNHW patientsBACKGROUND DATAHospital's percentageMortality differencesMedicare dataTransfer status
DeWane MP, Davis KA, Schuster KM, Erwin SP, Maung AA, Becher RD. Transfer status. Journal Of Trauma And Acute Care Surgery 2018, 85: 348-353. PMID: 29664889, DOI: 10.1097/ta.0000000000001939.Peer-Reviewed Original ResearchConceptsOutside emergency departmentHospital inpatient unitsEmergency departmentNursing homesInpatient unitTransfer statusSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseBackward multivariable logistic regressionOutside hospital emergency departmentEmergency general surgery patientsQuality Improvement Program databaseMultivariate Cox regression analysisEmergency colon surgeryGeneral surgery patientsThirty-day mortalityImprovement Program databaseChronic care facilitiesCox regression analysisRates of morbidityTransfer of patientsHospital emergency departmentHospital inpatient wardsEmergent colectomyPhysiologic decompensationTotal bilirubin trend as a predictor of common bile duct stones in acute cholecystitis and symptomatic cholelithiasis
Gillaspie DB, Davis KA, Schuster KM. Total bilirubin trend as a predictor of common bile duct stones in acute cholecystitis and symptomatic cholelithiasis. The American Journal Of Surgery 2018, 217: 98-102. PMID: 29929909, DOI: 10.1016/j.amjsurg.2018.06.011.Peer-Reviewed Original ResearchConceptsCommon bile duct stonesBile duct stonesAcute cholecystitisSymptomatic cholelithiasisDuct stonesBilirubin levelsProcedural interventionTotal bilirubinPresence of CBDSElevated total bilirubinTotal bilirubin levelsElevated serum bilirubinBiliary colicAdult patientsSerum bilirubinSerum makersImmediate imagingCholecystitisBilirubinCholelithiasisPatientsInterventionColicLevelsVenous Thromboembolism-Related Readmission in Emergency General Surgery Patients: A Role for Prophylaxis on Discharge?
DeWane MP, Davis KA, Schuster KM, Maung AA, Becher RD. Venous Thromboembolism-Related Readmission in Emergency General Surgery Patients: A Role for Prophylaxis on Discharge? Journal Of The American College Of Surgeons 2018, 226: 1072-1077.e3. PMID: 29574180, DOI: 10.1016/j.jamcollsurg.2018.03.021.Peer-Reviewed Original ResearchConceptsVenous thromboembolismEmergency general surgery operationsPost-discharge venous thromboembolismEmergency general surgery patientsMultivariable logistic regression modelingCommon EGS operationsGeneral surgery patientsRate of readmissionUrinary tract infectionSurgeons NSQIP databaseHigh-risk groupGeneral surgery operationsLogistic regression modelingEGS operationsProphylactic anticoagulationVTE formationVTE prophylaxisVTE ratesEGS patientsPostoperative sepsisNSQIP databaseProlonged lengthSurgery patientsTract infectionsPredictive factorsRelationship between duration of preoperative symptoms and postoperative ileus for small bowel obstruction
Brandt WS, Wood J, Bhattacharya B, Pei K, Davis KA, Schuster K. Relationship between duration of preoperative symptoms and postoperative ileus for small bowel obstruction. Journal Of Surgical Research 2018, 225: 40-44. PMID: 29605033, DOI: 10.1016/j.jss.2017.12.031.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAscitesEquipment and Supplies UtilizationFemaleFood IntoleranceHumansIleusIntensive Care UnitsIntestinal ObstructionIntestine, SmallLength of StayMaleMiddle AgedParenteral NutritionPostoperative ComplicationsPreoperative PeriodRetrospective StudiesRisk FactorsTime FactorsTime-to-TreatmentYoung AdultConceptsTolerance of dietSmall bowel obstructionPreoperative symptomsLength of stayPostoperative ileusUnivariable analysisTotal durationIntensive care unit admissionTotal parenteral nutrition useParenteral nutrition useCare unit admissionIntensive care unitPreoperative ascitesBowel obstructionPrimary endpointSecondary endpointsSymptom durationUnit admissionMedian durationOperative interventionPostoperative outcomesCare unitMultivariable analysisRetrospective reviewNutrition use
2016
The older they are the harder they fall: Injury patterns and outcomes by age after ground level falls
Bhattacharya B, Maung A, Schuster K, Davis KA. The older they are the harder they fall: Injury patterns and outcomes by age after ground level falls. Injury 2016, 47: 1955-1959. PMID: 27346422, DOI: 10.1016/j.injury.2016.06.019.Peer-Reviewed Original ResearchMeSH KeywordsAccidental FallsAgedAged, 80 and overAnticoagulantsAspirinComorbidityFemaleFollow-Up StudiesFractures, BoneGeriatric AssessmentHospitalizationHumansInjury Severity ScoreIntracranial HemorrhagesMaleMultiple TraumaPlatelet Aggregation InhibitorsRetrospective StudiesSurvival AnalysisTrauma CentersTreatment OutcomeUnited StatesConceptsGround-level fallInjury patternsAnticoagulation useAspirin useIntracranial bleedAnticoagulation agentsAbdominal solid organ injuriesCertain injury patternsAdult trauma patientsSolid organ injuryAntiplatelet useHome dischargePatient characteristicsLife expectancy increasesMean ISSOrgan injuryOverall mortalityRetrospective reviewTrauma patientsGeriatric patientsSignificant morbidityTrauma centerPatient populationPelvic fracturesCervical spine
2011
Adrenocorticotropic hormone and cortisol response to corticotropin releasing hormone in the critically ill—a novel assessment of the hypothalamic-pituitary-adrenal axis
Schuster KM, Macleod JB, Fernandez JB, Kumar M, Barquist ES. Adrenocorticotropic hormone and cortisol response to corticotropin releasing hormone in the critically ill—a novel assessment of the hypothalamic-pituitary-adrenal axis. The American Journal Of Surgery 2011, 203: 205-210. PMID: 21679920, DOI: 10.1016/j.amjsurg.2010.11.015.Peer-Reviewed Original ResearchMeSH KeywordsAdrenal InsufficiencyAdrenocorticotropic HormoneAgedAged, 80 and overArea Under CurveCorticotropin-Releasing HormoneCosyntropinCritical IllnessFemaleHumansHydrocortisoneHypothalamo-Hypophyseal SystemIntensive Care UnitsLinear ModelsMaleMiddle AgedPituitary-Adrenal SystemPostoperative ComplicationsPrognosisConceptsCorticotropin-releasing hormoneAdrenocorticotropic hormoneSurgical intensive care unitCosyntropin stimulation testIntensive care unitAdrenal insufficiencyCRH administrationACTH responseAdrenal functionCare unitStimulation testingAdrenal axisStimulation testACTH peakACTH responsivenessCortisol peakCortisol responseNormal responsePatientsChi-squareHormoneCortisolNonsurvivorsT-testP-valueRoutine or Protocol Evaluation of Trauma Patients With Suspected Syncope is Unnecessary
Maung AA, Kaplan LJ, Schuster KM, Johnson DC, Davis KA. Routine or Protocol Evaluation of Trauma Patients With Suspected Syncope is Unnecessary. Journal Of Trauma And Acute Care Surgery 2011, 70: 428-432. PMID: 21307745, DOI: 10.1097/ta.0b013e31820958be.Peer-Reviewed Original ResearchConceptsDiagnostic workupCardiac enzymesSyncope workupAbnormal resultsStudy entry criteriaInjury Severity ScoreCause of injuryMotor vehicle collisionsSignificant abnormal resultsStandardized workupRetrospective reviewTrauma patientsCarotid duplexPhysical examinationSeverity scoreTomography angiographyEntry criteriaFemale genderFurther interventionClinical informationLevel ISyncopePatientsSubsequent interventionsWorkup
2009
Factors Predicting Morbidity and Mortality in Emergency Colorectal Procedures in Elderly Patients
McGillicuddy EA, Schuster KM, Davis KA, Longo WE. Factors Predicting Morbidity and Mortality in Emergency Colorectal Procedures in Elderly Patients. JAMA Surgery 2009, 144: 1157-1162. PMID: 20026835, DOI: 10.1001/archsurg.2009.203.Peer-Reviewed Original ResearchConceptsEmergency colorectal proceduresEmergent colorectal proceduresColorectal proceduresHospital mortalityElderly patientsUniversity tertiary referral centerIntra-abdominal contaminationIntraoperative blood lossPatients 65 yearsAdvanced colorectal cancerCurrent Procedural Terminology codesModifiable risk factorsTertiary referral centerColorectal cancer screeningRecurrent respiratory failureProcedural Terminology codesPredicting MorbidityHospital morbidityPostoperative morbidityRenal insufficiencyRespiratory failureFrequent complicationReferral centerBlood lossRetrospective reviewPulseless Electrical Activity, Focused Abdominal Sonography for Trauma, and Cardiac Contractile Activity as Predictors of Survival After Trauma
Schuster KM, Lofthouse R, Moore C, Lui F, Kaplan LJ, Davis KA. Pulseless Electrical Activity, Focused Abdominal Sonography for Trauma, and Cardiac Contractile Activity as Predictors of Survival After Trauma. Journal Of Trauma And Acute Care Surgery 2009, 67: 1154-1157. PMID: 20009660, DOI: 10.1097/ta.0b013e3181c303e8.Peer-Reviewed Original ResearchMeSH KeywordsAbdominal InjuriesAdultAgedAged, 80 and overCardiopulmonary ResuscitationChildFemaleHeart ArrestHumansMaleMiddle AgedPericardial EffusionPredictive Value of TestsPrognosisPulseRetrospective StudiesSensitivity and SpecificityStatistics, NonparametricSurvival RateTrauma Severity IndicesUltrasonographyConceptsPulseless electrical activityCardiac contractile activityFocused abdominal sonographyInitial resuscitationAbdominal sonographyEmergency departmentContractile activityCardiac activityStudy period 25 patientsLevel I trauma centerGrave prognostic indicatorI trauma centerPredictors of survivalMechanism of injuryElectrical activityClosed head injuryPericardial viewTension hemothoraxOngoing resuscitationPericardial effusionBlunt traumaRetrospective reviewTrauma centerPrognostic indicatorHead injury