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 IVFEV1
2019
The EGS Grading Scale For Skin And Soft Tissue Infections Is Predictive Of Poor Outcomes
Savage SA, Li SW, Utter GH, Cox JA, Wydo SM, Cahill K, Sarani B, Holzmacher J, Duane TM, Gandhi RR, Zielinski MD, Ray-Zack M, Tierney J, Chapin T, Murphy PB, Vogt KN, Schroeppel TJ, Callaghan E, Kobayashi L, Coimbra R, Schuster KM, Gillaspie D, Timsina L, Louis A, Crandall M. The EGS Grading Scale For Skin And Soft Tissue Infections Is Predictive Of Poor Outcomes. Journal Of Trauma And Acute Care Surgery 2019, Publish Ahead of Print: &na;. PMID: 30601458, PMCID: PMC6433490, DOI: 10.1097/ta.0000000000002175.Peer-Reviewed Original ResearchConceptsSoft tissue infectionsLength of stayDisease processGrading scaleInter-rater reliabilityGrade IVEmergency general surgery (EGS) diseasesDisparate disease processesRetrospective multicenter trialLaboratory Risk IndicatorNecrotizing Fasciitis (LRINEC) scoreSurgery of TraumaMulti-institutional trialHigh gradeDifferent disease processesClinical disease processesOverall complicationsHospital lengthICU lengthFasciitis (LRINEC) scoreMulticenter trialTissue infectionsValidation studyPoor outcomeDisease characteristics
2018
Opioid dependency is independently associated with inferior clinical outcomes after trauma
Hsiang WR, McGeoch C, Lee S, Cheung W, Becher R, Davis KA, Schuster K. Opioid dependency is independently associated with inferior clinical outcomes after trauma. Injury 2018, 50: 192-196. PMID: 30342762, DOI: 10.1016/j.injury.2018.10.015.Peer-Reviewed Original ResearchConceptsNon-home dischargeOpioid-dependent patientsLength of stayInjury Severity ScoreOpioid dependencyVentilator daysMajor complicationsClinical outcomesPrescription abuseIllicit abuseLonger LOSChronic pain subgroupsMore ventilator daysOpioid-naïve patientsUse of opioidsAcademic Level IHigher readmission ratesInferior clinical outcomesChronic pain patientsOpioid subgroupsNaïve patientsAdult patientsPain subgroupsPatient demographicsReadmission ratesValidation of a new American Association for the Surgery of Trauma (AAST) anatomic severity grading system for acute cholecystitis
Vera K, Pei KY, Schuster KM, Davis KA. Validation of a new American Association for the Surgery of Trauma (AAST) anatomic severity grading system for acute cholecystitis. Journal Of Trauma And Acute Care Surgery 2018, 84: 650-654. PMID: 29271871, DOI: 10.1097/ta.0000000000001762.Peer-Reviewed Original ResearchConceptsLength of stayAcute cholecystitisICU useGrade 2Anatomic gradingAdverse eventsGrade 1Longer LOSAnatomic grading systemGrade 1 diseaseEmergency general surgeryGrade 3 patientsRetrospective cohort studyIncidence of complicationsMajority of patientsTertiary medical centerLow-grade diseaseSurgery of TraumaRisk-adjusted outcomesGood inter-rater reliabilityAAST gradeAmerican AssociationCholecystitis severityCohort studyConsecutive patientsRelationship 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
Multicenter validation of American Association for the Surgery of Trauma grading system for acute colonic diverticulitis and its use for emergency general surgery quality improvement program
Shafi S, Priest EL, Crandall ML, Klekar CS, Nazim A, Aboutanos M, Agarwal S, Bhattacharya B, Byrge N, Dhillon TS, Eboli DJ, Fielder D, Guillamondegui O, Gunter O, Inaba K, Mowery NT, Nirula R, Ross SE, Savage SA, Schuster KM, Schmoker RK, Siboni S, Siparsky N, Trust MD, Utter GH, Whelan J, Feliciano DV, Rozycki G. Multicenter validation of American Association for the Surgery of Trauma grading system for acute colonic diverticulitis and its use for emergency general surgery quality improvement program. Journal Of Trauma And Acute Care Surgery 2016, 80: 405-411. PMID: 26670116, DOI: 10.1097/ta.0000000000000943.Peer-Reviewed Original ResearchConceptsAcute colonic diverticulitisQuality Improvement ProgramAAST gradeLength of stayColonic diverticulitisGrade IClinical eventsNational Surgical Quality Improvement ProgramEmergency general surgery (EGS) diseasesPhysiologic statusSurgical Quality Improvement ProgramGrading systemTrauma grading systemRisk of deathTime of admissionSurgery of TraumaNew grading systemHigher disease gradeRegression analysisAmerican AssociationEGS careEGS registryAdverse eventsMedian ageClinical outcomes
2014
The Use of Magnetic Resonance Imaging in the Diagnosis of Suspected Appendicitis in Pregnancy : Shortened Length of Stay Without Increase in Hospital Charges
Fonseca AL, Schuster KM, Kaplan LJ, Maung AA, Lui FY, Davis KA. The Use of Magnetic Resonance Imaging in the Diagnosis of Suspected Appendicitis in Pregnancy : Shortened Length of Stay Without Increase in Hospital Charges. JAMA Surgery 2014, 149: 687-693. PMID: 24871698, DOI: 10.1001/jamasurg.2013.4658.Peer-Reviewed Original ResearchConceptsMR imaging groupHospital chargesNontherapeutic explorationsPregnant patientsImaging groupFetal outcomesShorter LOSEmergency departmentUniversity tertiary referral centerMean hospital chargesTertiary referral centerLength of stayMagnetic resonancePathology-confirmed appendicitisAbdominal painOperative interventionReferral centerClinical outcomesGestational ageMultivariable analysisRetrospective reviewFetal lossAppendicitisMAIN OUTCOMEPatientsPredictive factors for failure of nonoperative management in perforated appendicitis
Maxfield MW, Schuster KM, Bokhari J, McGillicuddy EA, Davis KA. Predictive factors for failure of nonoperative management in perforated appendicitis. Journal Of Trauma And Acute Care Surgery 2014, 76: 976-981. PMID: 24662860, DOI: 10.1097/ta.0000000000000187.Peer-Reviewed Original ResearchConceptsNonoperative managementAbdominal tendernessFailure groupIntensive care unit careUniversity tertiary care hospitalTertiary care hospitalLength of stayUnit careCare hospitalDefinitive treatmentLaboratory markersPerforated appendicitisNonsurgical treatmentClinical findingsPredictive factorsRadiographic findingsTomographic scanTherapeutic studiesAppendicitisEarly operationLevel IIIPatientsAbscessPhlegmonTachycardia
2011
Can Acute Care Surgeons Perform Emergency Colorectal Procedures With Good Outcomes?
Schuster KM, McGillicuddy EA, Maung AA, Kaplan LJ, Davis KA. Can Acute Care Surgeons Perform Emergency Colorectal Procedures With Good Outcomes? Journal Of Trauma And Acute Care Surgery 2011, 71: 94-101. PMID: 21818018, DOI: 10.1097/ta.0b013e31821e43d2.Peer-Reviewed Original ResearchConceptsAcute care surgeonsEmergency colorectal proceduresColorectal proceduresColorectal emergenciesPatient characteristicsExact testIntensive care unit lengthElective colorectal casesOpen abdominal techniquePerioperative risk factorsExtended care facilitiesLength of stayFisher's exact testLow case volumeChi-square testLogistic regression modelsACS mortalityAnesthesiology classColorectal casesPreoperative hypotensionColorectal operationsElective resectionVentilator daysElderly patientsSignificant comorbidities
2010
Contrast-Induced Nephropathy in Elderly Trauma Patients
McGillicuddy EA, Schuster KM, Kaplan LJ, Maung AA, Lui FY, Maerz LL, Johnson DC, Davis KA. Contrast-Induced Nephropathy in Elderly Trauma Patients. Journal Of Trauma And Acute Care Surgery 2010, 68: 294-297. PMID: 20154540, DOI: 10.1097/ta.0b013e3181cf7e40.Peer-Reviewed Original ResearchConceptsAcute kidney injuryElderly trauma patientsTrauma patientsNoncontrast groupDevelopment of AKIRisk of AKILevel one trauma centerContrast-Induced NephropathyHours of admissionIndependent risk factorHours of presentationLength of stayAdministration of contrastHospital mortalityKidney injuryBaseline characteristicsElderly patientsOccult injuriesProlonged lengthRenal functionSerum creatinineTrauma centerIntravenous contrastMedical recordsRisk factors
2008
Trauma Team Oversight Improves Efficiency of Care and Augments Clinical and Economic Outcomes
Davis KA, Cabbad NC, Schuster KM, Kaplan LJ, Carusone C, Leary T, Udelsman R. Trauma Team Oversight Improves Efficiency of Care and Augments Clinical and Economic Outcomes. Journal Of Trauma And Acute Care Surgery 2008, 65: 1236-1244. PMID: 19077607, DOI: 10.1097/ta.0b013e31818ba311.Peer-Reviewed Original ResearchMeSH KeywordsAbbreviated Injury ScaleConnecticutCost-Benefit AnalysisCross-Sectional StudiesEfficiency, OrganizationalFees, MedicalHospital CostsHumansInjury Severity ScoreLength of StayLinear ModelsMultiple TraumaOutcome and Process Assessment, Health CarePatient Care TeamPersonnel Administration, HospitalQuality Assurance, Health CareTrauma CentersUtilization ReviewConceptsInjury Severity ScoreEfficiency of careHospital lengthTrauma serviceFull-time trauma surgeonsMean Injury Severity ScoreMedian Injury Severity ScoreTrauma team activation criteriaLevel I trauma centerPercentage of patientsShorter hospital lengthI trauma centerLength of stayActual hospital costsMost patientsPatient demographicsTrauma activationsTrauma centerHospital contribution marginInjury patternsSeverity scoreHospital costsPatient managementTrauma surgeonsPatients