2024
Identifying and optimizing psychosocial frailty in surgical practice
Schultz K, Richburg C, Park E, Leeds I. Identifying and optimizing psychosocial frailty in surgical practice. Seminars In Colon And Rectal Surgery 2024, 35: 101061. DOI: 10.1016/j.scrs.2024.101061.Peer-Reviewed Original ResearchPsychosocial frailtySocial risk profilePatient-reported dataPreoperative periodIncentivized screeningPsychological well-beingUnder-treatedPatient levelReimbursement strategiesFrailtyPostoperative complicationsSurgical outcomesIncreased riskWell-beingRisk profileBenefit patientsPatientsSurgical practiceFor whom the bell tolls: assessing the incremental costs associated with failure to rescue after elective colorectal surgery
Schultz K, Moore M, Pantel H, Mongiu A, Reddy V, Schneider E, Leeds I. For whom the bell tolls: assessing the incremental costs associated with failure to rescue after elective colorectal surgery. Journal Of Gastrointestinal Surgery 2024, 28: 1812-1818. PMID: 39181234, DOI: 10.1016/j.gassur.2024.08.019.Peer-Reviewed Original ResearchFailure-to-rescueMedian total hospital costTotal hospital costsColorectal surgeryNational Inpatient SampleUneventful recoveryRetrospective study of adult patientsFailure-to-rescue patientsAssociated with increased healthcare costsStudy of adult patientsElective colorectal resectionHospital costsElective colorectal surgeryNationally representative cohortColorectal resectionElective colectomyPostoperative complicationsRetrospective studyAdult patientsRescue attemptsMedical futilityElective surgeryRepresentative cohortHealthcare costsPrimary outcome
2022
Short- and Long-term Outcomes of Ileal Pouch Anal Anastomosis Construction in Obese Patients With Ulcerative Colitis
Leeds IL, Holubar SD, Hull TL, Lipman JM, Lightner AL, Sklow B, Steele SR. Short- and Long-term Outcomes of Ileal Pouch Anal Anastomosis Construction in Obese Patients With Ulcerative Colitis. Diseases Of The Colon & Rectum 2022, 65: e782-e789. PMID: 34958050, DOI: 10.1097/dcr.0000000000002169.Peer-Reviewed Original ResearchConceptsLong-term pouch failureObese patientsUlcerative colitisNonobese patientsPostoperative complicationsPouch failurePouch surgeryColitis ulcerosaASA class 3Intraoperative technical difficultiesOutcomes of obeseAssociation of obesityPouch failure rateWorse clinical outcomesQuaternary referral centerLong-term outcomesLength of stayIleoanal pouch surgeryQuality of lifePouch leakPouch survivalPreoperative steroidsASA 3Anastomotic leakCohort study
2020
Frailer Patients Undergoing Robotic Colectomies for Colon Cancer Experience Increased Complication Rates Compared With Open or Laparoscopic Approaches.
Lo BD, Leeds IL, Sundel MH, Gearhart S, Nisly GRC, Safar B, Atallah C, Fang SH. Frailer Patients Undergoing Robotic Colectomies for Colon Cancer Experience Increased Complication Rates Compared With Open or Laparoscopic Approaches. Diseases Of The Colon & Rectum 2020, 63: 588-597. PMID: 32032198, DOI: 10.1097/dcr.0000000000001598.Peer-Reviewed Original ResearchConceptsInvasive surgical approachSurgical approachPrimary colon cancerFrailer patientsFrail patientsRobotic surgeryPostoperative complicationsComplication rateMajor complicationsRobotic colectomyOpen surgerySurgeons National Surgical Quality Improvement Program databaseColon cancerNational Surgical Quality Improvement Program databaseQuality Improvement Program databasePropensity scoreImprovement Program databaseColon cancer surgeryMultivariable logistic regressionFrailty indexLaparoscopic approachPrimary outcomeCancer surgeryOperative indicationsRetrospective studyIncreased Healthcare Utilization for Medical Comorbidities Prior to Surgery Improves Postoperative Outcomes
Leeds IL, Canner JK, Gani F, Meyers PM, Haut ER, Efron JE, Johnston FM. Increased Healthcare Utilization for Medical Comorbidities Prior to Surgery Improves Postoperative Outcomes. Annals Of Surgery 2020, Publish Ahead of Print: &na;. PMID: 29864092, PMCID: PMC8559326, DOI: 10.1097/sla.0000000000002851.Peer-Reviewed Original ResearchConceptsPostoperative outcomesNonsurgical cliniciansPreoperative comorbiditiesShort-term postoperative outcomesIncreased healthcare utilizationMultivariable logistic regressionNational administrative databasePropensity-score matchingColectomy patientsElective colectomyModifiable comorbiditiesPreoperative optimizationMajor comorbiditiesMedical comorbiditiesPostoperative complicationsClinic visitsOperative interventionOperative riskSubsequent surgeryComorbid patientsSurgical riskAdjusted analysisHealthcare utilizationProspective studySame surgeon
2019
Missed psychosocial risk factors during routine preoperative evaluations are associated with increased complications after elective cancer surgery
Meyers PM, Leeds IL, Enumah ZO, Burkhart RA, He J, Haut ER, Efron JE, Johnston FM. Missed psychosocial risk factors during routine preoperative evaluations are associated with increased complications after elective cancer surgery. Surgery 2019, 166: 177-183. PMID: 31160060, PMCID: PMC8828252, DOI: 10.1016/j.surg.2019.04.015.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAgedCohort StudiesDatabases, FactualDigestive System NeoplasmsDisease-Free SurvivalElective Surgical ProceduresFemaleHumansMaleMiddle AgedNeoplasm InvasivenessNeoplasm StagingPostoperative ComplicationsPreoperative CarePrognosisPsychologyRetrospective StudiesSurvival AnalysisConceptsPsychosocial risk factorsRisk factorsChart reviewCancer surgeryPostoperative outcomesComplication ratePreoperative evaluationThirty-day postoperative complicationsTertiary academic medical centerAbdominal cancer surgeryElective cancer surgeryPatient's preoperative evaluationRoutine preoperative evaluationOverall complication rateRetrospective chart reviewWorse postoperative outcomesPreoperative risk stratificationIndividual risk factorsAcademic medical centerInadequate social supportPostoperative complicationsAdult patientsMajor complicationsRisk stratificationFormal screeningOutcomes for Ulcerative Colitis With Delayed Emergency Colectomy Are Worse When Controlling for Preoperative Risk Factors
Leeds IL, Sundel MH, Gabre-Kidan A, Safar B, Truta B, Efron JE, Fang SH. Outcomes for Ulcerative Colitis With Delayed Emergency Colectomy Are Worse When Controlling for Preoperative Risk Factors. Diseases Of The Colon & Rectum 2019, Publish Ahead of Print: &na;. PMID: 30451754, PMCID: PMC6456379, DOI: 10.1097/dcr.0000000000001276.Peer-Reviewed Original ResearchConceptsTotal abdominal colectomyPreoperative risk factorsUlcerative colitisAbdominal colectomyRisk factorsEmergency colectomyEarly surgeryHospital daysPostoperative complicationsMortality rateSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseEarly operationNational Surgical Quality Improvement ProgramAcute fulminant ulcerative colitisQuality Improvement Program databaseSurgical Quality Improvement ProgramFulminant ulcerative colitisOngoing medical managementImmediate surgical interventionImprovement Program databaseSingle institution experienceAcute ulcerative colitisDay of admissionTiming of surgery
2018
Process measures facilitate maturation of pediatric enhanced recovery protocols
Leeds IL, Ladd MR, Sundel MH, Fannon ML, George JA, Boss EF, Jelin EB. Process measures facilitate maturation of pediatric enhanced recovery protocols. Journal Of Pediatric Surgery 2018, 53: 2266-2272. PMID: 29801659, PMCID: PMC8710141, DOI: 10.1016/j.jpedsurg.2018.04.037.Peer-Reviewed Original ResearchConceptsProcess measuresProcess measure adherenceRecovery protocolEnhanced recovery protocolQuality improvement databaseImplementation groupPediatric colorectal surgeryRegional anesthesia techniquesPediatric ColorectalPostoperative complicationsPreoperative medicationsColorectal surgeryPathway patientsSurgical patientsSurgery pathwayPreoperative educationAnesthesia techniquesPatient outcomesOutcome measuresMeasure adherencePatientsLevel IIITreatment studiesComplicationsAdherenceMalnutrition increases the risk of 30-day complications after surgery in pediatric patients with Crohn disease
Ladd MR, Garcia AV, Leeds IL, Haney C, Oliva-Hemker MM, Alaish S, Boss E, Rhee DS. Malnutrition increases the risk of 30-day complications after surgery in pediatric patients with Crohn disease. Journal Of Pediatric Surgery 2018, 53: 2336-2345. PMID: 29843908, PMCID: PMC8841062, DOI: 10.1016/j.jpedsurg.2018.04.026.Peer-Reviewed Original ResearchConceptsCrohn's diseaseAge z-scoreBowel surgeryPediatric patientsACS NSQIP-Pediatric databaseZ-scoreMajor bowel surgeryNSQIP-Pediatric databaseOdds of complicationsOverall complication ratePediatric CD patientsDegree of malnutritionSeverity of malnutritionEffects of malnutritionCDC growth chartsEffects of malnourishmentASA classImportant screening toolMalnutrition effectsPostoperative complicationsCD patientsComplication rateElective surgeryMultivariable analysisSevere malnutrition
2017
Early Surgical Intervention for Acute Ulcerative Colitis Is Associated with Improved Postoperative Outcomes
Leeds IL, Truta B, Parian AM, Chen SY, Efron JE, Gearhart SL, Safar B, Fang SH. Early Surgical Intervention for Acute Ulcerative Colitis Is Associated with Improved Postoperative Outcomes. Journal Of Gastrointestinal Surgery 2017, 21: 1675-1682. PMID: 28819916, PMCID: PMC6201293, DOI: 10.1007/s11605-017-3538-3.Peer-Reviewed Original ResearchConceptsAcute ulcerative colitisEarly surgical interventionUlcerative colitisLength of staySurgical interventionSurgery groupTotal colectomyHospitalization costsEarly operationMedian total hospitalization costModern immunotherapy eraRefractory ulcerative colitisHours of admissionImmediate surgical interventionUlcerative colitis patientsTotal hospitalization costsFurther prospective studiesNational Inpatient SampleImmunotherapy eraColitis patientsHospital outcomesPostoperative complicationsPostoperative outcomesUrgent surgeryComorbid patients
2012
Risk Factors for 30-Day Hospital Readmission among General Surgery Patients
Kassin MT, Owen RM, Perez SD, Leeds I, Cox JC, Schnier K, Sadiraj V, Sweeney JF. Risk Factors for 30-Day Hospital Readmission among General Surgery Patients. Journal Of The American College Of Surgeons 2012, 215: 322-330. PMID: 22726893, PMCID: PMC3423490, DOI: 10.1016/j.jamcollsurg.2012.05.024.Peer-Reviewed Original ResearchConceptsGeneral surgery proceduresGeneral surgery patientsRisk of readmissionPostoperative complicationsRisk factorsSurgery proceduresSurgery patientsHospital readmissionInpatient general surgery proceduresInstitutional clinical data warehousePoor quality patient careSignificant independent risk factorsPreoperative open woundSepsis/shockPostoperative pulmonary complicationsDays of dischargeIndependent risk factorUrinary tract infectionSingle academic centerType of procedureClinical data warehousePostoperative readmissionsPulmonary complicationsIndex hospitalizationPostoperative occurrence