2019
Regionalization of emergency general surgery operations: A simulation study.
Becher RD, Sukumar N, DeWane MP, Gill TM, Maung AA, Schuster KM, Stolar MJ, Davis KA. Regionalization of emergency general surgery operations: A simulation study. Journal Of Trauma And Acute Care Surgery 2019, 88: 366-371. PMID: 31804419, PMCID: PMC7472889, DOI: 10.1097/ta.0000000000002543.Peer-Reviewed Original ResearchConceptsEmergency general surgeryHigh-volume hospitalsEGS careEmergency general surgery operationsCalifornia inpatient databaseCommon EGS operationsRisk-adjusted deathsSignificant survival benefitLow-volume hospitalsUmbilical hernia repairSmall bowel resectionHigh-mortality hospitalsGeneral surgery operationsRegional trauma systemEGS operationsBowel resectionAdult patientsPrimary outcomeSurvival benefitInpatient DatabaseHernia repairTrauma systemLevel IVGeneral surgeryCare managementHigh-performance acute care hospitals: Excelling across multiple emergency general surgery operations in the geriatric patient.
DeWane MP, Sukumar N, Stolar MJ, Gill TM, Maung AA, Schuster KM, Davis KA, Becher RD. High-performance acute care hospitals: Excelling across multiple emergency general surgery operations in the geriatric patient. Journal Of Trauma And Acute Care Surgery 2019, 87: 140-146. PMID: 31259872, PMCID: PMC7656193, DOI: 10.1097/ta.0000000000002273.Peer-Reviewed Original ResearchConceptsCommon EGS operationsEmergency general surgeryOlder patientsGeriatric patientsEmergency general surgery operationsEGS operationsCalifornia State Inpatient DatabaseGeneral surgery hospitalsPatients 65 yearsRisk-adjusted mortalitySurvival rates 1State Inpatient DatabasesGeneral surgery operationsClusters of hospitalsOperation typeHospital performanceEGS patientsSurgery HospitalInpatient DatabaseGroup of hospitalsGeriatric populationGeneral surgeryPatientsHospitalLevel IIIEvaluating mortality outlier hospitals to improve the quality of care in emergency general surgery.
Becher RD, DeWane MP, Sukumar N, Stolar MJ, Gill TM, Maung AA, Schuster KM, Davis KA. Evaluating mortality outlier hospitals to improve the quality of care in emergency general surgery. Journal Of Trauma And Acute Care Surgery 2019, 87: 297-306. PMID: 30908450, PMCID: PMC6660354, DOI: 10.1097/ta.0000000000002271.Peer-Reviewed Original ResearchConceptsStandardized mortality ratioOutlier hospitalsHospital variationMortality ratioStandardized mortalityEmergency general surgery operationsCalifornia State Inpatient DatabaseEGS operationsCommon EGS operationsSignificant hospital variationEmergency general surgeryHospital-level characteristicsHospital-level variablesSignificant excess mortalityGeneral surgery operationsState Inpatient DatabasesQuality improvement initiativesQuality of careHospital quality indicatorsNational Quality ForumEGS outcomesInpatient DatabaseExcess mortalityOnly hospitalEpidemiologic studies
2016
Damage control operations in non-trauma patients: defining criteria for the staged rapid source control laparotomy in emergency general surgery
Becher RD, Peitzman AB, Sperry JL, Gallaher JR, Neff LP, Sun Y, Miller PR, Chang MC. Damage control operations in non-trauma patients: defining criteria for the staged rapid source control laparotomy in emergency general surgery. World Journal Of Emergency Surgery 2016, 11: 10. PMID: 26913055, PMCID: PMC4765073, DOI: 10.1186/s13017-016-0067-4.Peer-Reviewed Original ResearchSevere sepsis/septic shockSepsis/septic shockEGS patientsLethal triadEmergent laparotomyControl laparotomySeptic shockEmergency general surgery patientsPhysiologic parametersEmergency general surgeryGeneral surgery patientsPre-existing comorbiditiesNon-trauma patientsSimilar survival advantageMultivariable regression analysisDamage control operationLogistic regression modelsMultiple comorbiditiesPostoperative complicationsAcute indicationsPerioperative variablesSurgery patientsTrauma patientsOperative managementElevated lactate
2012
Systemic inflammation worsens outcomes in emergency surgical patients
Becher RD, Hoth JJ, Miller PR, Meredith JW, Chang MC. Systemic inflammation worsens outcomes in emergency surgical patients. Journal Of Trauma And Acute Care Surgery 2012, 72: 1140-1149. PMID: 22673238, DOI: 10.1097/ta.0b013e3182516a97.Peer-Reviewed Original ResearchMeSH KeywordsAgedDigestive System Surgical ProceduresDisease ProgressionEmergenciesFollow-Up StudiesHumansMiddle AgedMorbidityOutcome Assessment, Health CarePostoperative ComplicationsRetrospective StudiesRisk FactorsSeverity of Illness IndexSurvival RateSystemic Inflammatory Response SyndromeUnited StatesConceptsSystemic inflammatory response syndromeSevere sepsis/septic shockSepsis/septic shockPreoperative systemic inflammationEmergency surgical patientsSystemic inflammatory responseThirty-day survivalSystemic inflammationInflammatory responsePostoperative outcomesSurgical patientsSeptic shockEmergent colon surgeryEmergency general surgeryInflammatory response syndromeTimely surgical interventionAcute care surgeonsKaplan-Meier methodRisk of morbidityDamage control operationPreoperative inflammationColorectal operationsPostoperative complicationsHazard ratioSepsis patients