2019
Symptomatic human immunodeficiency virus–infected patients have poorer outcomes following emergency general surgery
Sandler BJ, Davis KA, Schuster KM. Symptomatic human immunodeficiency virus–infected patients have poorer outcomes following emergency general surgery. Journal Of Trauma And Acute Care Surgery 2019, 86: 479-488. PMID: 30531208, DOI: 10.1097/ta.0000000000002161.Peer-Reviewed Original ResearchConceptsHIV/AIDS patientsHIV-negative patientsAsymptomatic HIV-positive patientsHIV-positive patientsActive antiretroviral therapyAIDS patientsAntiretroviral therapyHospital stayPostoperative complicationsHuman immunodeficiency virus-infected patientsEmergency general surgery proceduresHigher median total chargesImmune deficiency syndrome (AIDS) patientsHuman immunodeficiency virus (HIV) infectionEmergency general surgeryLonger hospital stayRetrospective cohort studyAcute renal failureHIV-negative controlsImmunodeficiency virus infectionVirus-infected patientsRecords of patientsUrinary tract infectionMedian total chargesNationwide Inpatient Sample
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 dataInsurance Status Biases Trauma-system Utilization and Appropriate Interfacility Transfer
Zogg CK, Schuster KM, Maung AA, Davis KA. Insurance Status Biases Trauma-system Utilization and Appropriate Interfacility Transfer. Annals Of Surgery 2018, 268: 681-689. PMID: 30004929, DOI: 10.1097/sla.0000000000002954.Peer-Reviewed Original ResearchConceptsNTC patientsMajor injuriesOlder adult trauma patientsNationwide Emergency Department SampleOptimal trauma careAdult trauma patientsEmergency department admissionsEmergency Department SampleTrauma center careTransfer of patientsComplex traumatic injuriesMultilevel logistic regressionTrauma patientsDepartment admissionsHigh morbidityTC careDirect admissionInsurance statusInterfacility transferUninsured patientsTrauma careTraumatic injuryOutcome measuresTrauma systemCenter careCan acute care surgeons perform while fatigued? An EAST multicenter study
Schuster KM, Hazelton JP, Rattigan D, Nguyen L, Kim D, Spence LH, Turay D, Luo-Owen X, Perez JM, Dayal S, Blatt M, Hill C, Bhattacharya B. Can acute care surgeons perform while fatigued? An EAST multicenter study. Journal Of Trauma And Acute Care Surgery 2018, 85: 476-484. PMID: 29787535, DOI: 10.1097/ta.0000000000001975.Peer-Reviewed Original ResearchConceptsAcute care surgeonsMajor morbidityPatient outcomesAcute care surgery serviceEAST multicenter studyPatient-level factorsEmergency casesFour-level ordinal scaleHours of sleepHierarchical logistic regression modelsImpact of fatigueLogistic regression modelsPatient factorsFemale patientsSurgery serviceMulticenter studyLevel IVImmediate operationPrognostic studiesSleep timePatient volumeSimilar outcomesMorbiditySurgeonsMortalityTransfer 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 decompensationVenous 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
Trauma patients on new oral anticoagulation agents have lower mortality than those on warfarin
Maung AA, Bhattacharya B, Schuster KM, Davis KA. Trauma patients on new oral anticoagulation agents have lower mortality than those on warfarin. Journal Of Trauma And Acute Care Surgery 2016, 81: 652-657. PMID: 27438683, DOI: 10.1097/ta.0000000000001189.Peer-Reviewed Original ResearchConceptsNew oral agentsNew oral anticoagulation agentsOral anticoagulation agentsAnticoagulation agentsControl groupLevel 1 trauma center databaseLower mortalityTrauma-related mortalityInjury Severity ScoreMechanism of injuryIntensive care unitMultivariable logistic regressionHigher overall mortalityTrauma center databaseTraumatic brain injuryElectronic medical recordsWarfarin groupHospital courseOral agentsControl patientsIndependent predictorsOverall mortalityTrauma patientsCare unitRetrospective review
2014
Predictive 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
2012
Non-operative management of acute cholecystitis in the elderly
McGillicuddy E, Schuster K, Barre K, Suarez L, Hall M, Kaml G, Davis K, Longo W. Non-operative management of acute cholecystitis in the elderly. British Journal Of Surgery 2012, 99: 1254-1261. PMID: 22829411, DOI: 10.1002/bjs.8836.Peer-Reviewed Original ResearchConceptsRecurrent acute cholecystitisAcute cholecystitisNon-operative managementDiagnosis of ACNon-operative groupAcute respiratory failureNon-operative treatmentTertiary care centerMonth of deathElective cholecystectomyIndex admissionInterval cholecystectomyOperative morbidityPostoperative morbidityRespiratory failureCholecystectomy ratesComplication ratePercutaneous cholecystostomyStandard therapyMajor complicationsPostoperative detailsMedical managementMyocardial infarctionMedical recordsPhysiological reserve
2011
Risk of Venous Thromboembolism After Spinal Cord Injury: Not All Levels Are the Same
Maung AA, Schuster KM, Kaplan LJ, Maerz LL, Davis KA. Risk of Venous Thromboembolism After Spinal Cord Injury: Not All Levels Are the Same. Journal Of Trauma And Acute Care Surgery 2011, 71: 1241-1245. PMID: 22071925, DOI: 10.1097/ta.0b013e318235ded0.Peer-Reviewed Original ResearchConceptsLevel of SCISpinal cord injuryRate of VTEIndependent risk factorVenous thromboembolismRisk factorsHospital complicationsSpine injuriesCord injuryHigh thoracic spinal cord injuryHigh cervical spine injuryLikelihood of VTENational Trauma Data BankThoracic spinal cord injuryMultiple logistic regression modelException of pneumoniaHigh thoracic injuriesInjury Severity ScoreThoracic spine injuriesCervical spine injuryDeep vein thrombosisHigh cervical injuriesTrauma Data BankMultiple risk factorsTraumatic brain injuryDevelopment of a Computed Tomography-Based Scoring System for Necrotizing Soft-Tissue Infections
McGillicuddy EA, Lischuk AW, Schuster KM, Kaplan LJ, Maung A, Lui FY, Bokhari SA, Davis KA. Development of a Computed Tomography-Based Scoring System for Necrotizing Soft-Tissue Infections. Journal Of Trauma And Acute Care Surgery 2011, 70: 894-899. PMID: 21610394, DOI: 10.1097/ta.0b013e3182134a76.Peer-Reviewed Original ResearchConceptsSoft tissue infectionsComputed tomographyScoring systemTertiary care medical centerCT-based scoring systemCT scoring systemSoft tissue necrosisDiagnosis of NSTICharacteristic curveCT findingsPathologic findingsSignificant morbidityPhysical examinationLaboratory findingsOperative notesPathology reportsProspective validationMedical CenterCT scanNSTIDiagnostic adjunctCT scanningDiagnostic testsPatientsStudy period
2010
Ischemic colitis: risk factors for eventual surgery
Paterno F, McGillicuddy EA, Schuster KM, Longo WE. Ischemic colitis: risk factors for eventual surgery. The American Journal Of Surgery 2010, 200: 646-650. PMID: 21056146, DOI: 10.1016/j.amjsurg.2010.07.005.Peer-Reviewed Original ResearchConceptsComputed tomography scanRisk factorsIschemic colitisImmediate surgeryIntraperitoneal fluidTomography scanIntensive care unit admissionCare unit admissionPeripheral vascular diseaseFree intraperitoneal fluidUnit admissionSame admissionEventual surgerySubsequent surgeryMechanical ventilationSurgical managementAtrial fibrillationSurgical interventionVascular diseaseUnivariate analysisCommon disorderDiseases codesClinical conditionsLactate levelsInternational ClassificationContrast-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
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 reviewUncovering System Errors Using a Rapid Response Team: Cross-Coverage Caught in the Crossfire
Kaplan LJ, Maerz LL, Schuster K, Lui F, Johnson D, Roesler D, Luckianow G, Davis KA. Uncovering System Errors Using a Rapid Response Team: Cross-Coverage Caught in the Crossfire. Journal Of Trauma And Acute Care Surgery 2009, 67: 173-179. PMID: 19590331, DOI: 10.1097/ta.0b013e31819ea514.Peer-Reviewed Original ResearchConceptsRapid response teamRRT activationPatient's diseaseAcute volume overloadPatient care errorsBlood component therapyRRT needRRT therapyRespiratory failureComorbid diseasesVolume overloadPatient morbidityComponent therapyResponse teamsFluid balanceCommon reasonCare errorsNursing DatabaseNursing errorsPatientsPreventable errorsActivation criteriaDiseaseComplete dataTherapy