2023
Routine post-operative labs and healthcare system burden in acute appendicitis
Sznol J, Becher R, Maung A, Bhattacharya B, Davis K, Schuster K. Routine post-operative labs and healthcare system burden in acute appendicitis. The American Journal Of Surgery 2023, 226: 571-577. PMID: 37291012, DOI: 10.1016/j.amjsurg.2023.06.005.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAppendectomyAppendicitisComorbidityDelivery of Health CareHealth Care CostsHumansRetrospective StudiesConceptsHealthcare system burdenSystem burdenHealth care costsAppendicitis managementIncreased LOSUncomplicated AAAcute appendicitisRetrospective cohortClinical courseClinical variablesPatient populationMinimal comorbiditiesMultivariable modelingHealthcare costsCare costsPatientsLaboratory utilizationNational Health Expenditure AccountsLab utilizationLaboratory testingBurdenLaboratory testsAppendicitisComorbiditiesCohort
2022
The extent to which geography explains one of trauma’s troubling trends: Insurance-based differences in appropriate interfacility transfer
Zogg CK, Schuster KM, Maung AA, Davis KA. The extent to which geography explains one of trauma’s troubling trends: Insurance-based differences in appropriate interfacility transfer. Journal Of Trauma And Acute Care Surgery 2022, 93: 686-694. PMID: 35293375, PMCID: PMC9470786, DOI: 10.1097/ta.0000000000003605.Peer-Reviewed Original ResearchMeSH KeywordsAdultGeographyHumansInsurance CoverageMedically UninsuredPatient TransferRetrospective StudiesTrauma CentersUnited StatesConceptsNontrauma centersEmergency departmentMajor injuriesTrauma centerSignificant geographic variationInsurance-based differencesRisk-adjusted oddsLarge trauma centersNeighborhood socioeconomic disadvantageHierarchical logistic regressionInsured adultsTransfer patientsInsurance statusInterfacility transferStratified analysisED claimsUninsured adultsLevel IIISecondary objectiveTriage patternsDeprived populationsLogistic regressionInjurySocioeconomic disadvantageAdmission differences
2021
Clinical significance of “positive” cervical spine MRI findings following a negative CT
Khurana B, Keraliya A, Velmahos G, Maung AA, Bono CM, Harris MB. Clinical significance of “positive” cervical spine MRI findings following a negative CT. Emergency Radiology 2021, 29: 307-316. PMID: 34850316, DOI: 10.1007/s10140-021-01992-5.Peer-Reviewed Original ResearchMeSH KeywordsCervical VertebraeHumansMagnetic Resonance ImagingRetrospective StudiesSpinal InjuriesTomography, X-Ray ComputedTrauma CentersWounds, NonpenetratingConceptsCareful retrospective reviewNeurological deficitsCervical spineTraumatic findingsClinical significanceUnevaluable patientsRetrospective reviewNegative CTCervical spine MRI findingsSub-cohort analysisAcute traumatic findingsPrevious multicenter studyNormal CTCStable injuriesSpine traumaMRI findingsMulticenter studyUnstable injuriesNegative CTCsEmergency radiologistsSignificant findingsPatientsSpine surgeonsSubtle findingsCervicalgiaIncreased mortality with resuscitative endovascular balloon occlusion of the aorta only mitigated by strong unmeasured confounding: An expanded analysis using the National Trauma Data Bank
Linderman GC, Lin W, Becher RD, Maung AA, Bhattacharya B, Davis KA, Schuster KM. Increased mortality with resuscitative endovascular balloon occlusion of the aorta only mitigated by strong unmeasured confounding: An expanded analysis using the National Trauma Data Bank. Journal Of Trauma And Acute Care Surgery 2021, 91: 790-797. PMID: 33951027, PMCID: PMC8547242, DOI: 10.1097/ta.0000000000003265.Peer-Reviewed Original ResearchConceptsAcute kidney injuryResuscitative endovascular balloon occlusionLower extremity amputationEndovascular balloon occlusionBalloon occlusionExtremity amputationTraumatic injuryTreatment weightingREBOA placementNational Trauma Data BankInverse probabilityPlacement of REBOATrauma Data BankSevere traumatic injuryMortality effectsUnmeasured confoundersNoncompressible torso hemorrhagePotent confounderTQIP dataTQIP databaseAortic injuryKidney injuryRetrospective studyInjury patternsBaseline variablesImproved outcomes using laparoscopy for emergency colectomy after mitigating bias by negative control exposure analysis
Linderman GC, Lin W, Sanghvi MR, Becher RD, Maung AA, Bhattacharya B, Davis KA, Schuster KM. Improved outcomes using laparoscopy for emergency colectomy after mitigating bias by negative control exposure analysis. Surgery 2021, 171: 305-311. PMID: 34332782, DOI: 10.1016/j.surg.2021.06.048.Peer-Reviewed Original ResearchConceptsOpen surgeryEmergency colectomyNational Surgical Quality Improvement Program dataQuality Improvement Program dataPostoperative septic shockLow-risk patientsSurgical site infectionPatients meeting criteriaColorectal emergenciesElective colectomyUnderwent laparoscopyHospital stayOverall morbidityNationwide registryAnastomotic leakColectomy casesConverted groupSeptic shockSite infectionPatient selectionBaseline variablesImproved outcomesLaparoscopic surgeryTreatment weightingColectomyAnticoagulation Is Associated with Increased Mortality in Splenic Injuries
Bhattacharya B, Becher RD, Schuster KM, Davis KA, Maung AA. Anticoagulation Is Associated with Increased Mortality in Splenic Injuries. Journal Of Surgical Research 2021, 266: 1-5. PMID: 33975026, DOI: 10.1016/j.jss.2021.04.002.Peer-Reviewed Original ResearchConceptsNon-ACS patientsSplenic injuryAC patientsMultivariable binary logistic regressionIndependent risk factorEffect of anticoagulationInjury Severity ScoreUnits of RBCsBinary logistic regressionHospital courseMedian LOSIncreased MortalitySeverity scoreRisk factorsWorse outcomesAnticoagulationSplenic surgeryAC groupPatientsHigh mortalityInjuryLogistic regressionMortalitySerious injuriesAngiographySex-based differences in helmet performance in bicycle trauma
Feler J, Maung AA, O'Connor R, Davis KA, Gerrard J. Sex-based differences in helmet performance in bicycle trauma. Journal Of Epidemiology & Community Health 2021, 75: 994-1000. PMID: 33827896, DOI: 10.1136/jech-2020-215544.Peer-Reviewed Original ResearchMeSH KeywordsAccidents, TrafficBicyclingCraniocerebral TraumaFemaleHead Protective DevicesHumansMaleMiddle AgedRetrospective StudiesConceptsSex-based differencesBicycle traumaHead injuryHelmet useMultivariable logistic regression modelPatients 18 yearsRetrospective cohort studyNational Trauma DatabaseCervical spine fracturesSevere head injuryShort-term outcomesMotor vehicle collisionsSerious head injuryLogistic regression modelsAnticoagulant useCohort studyInjury overallIntracranial bleedingSpine fracturesTrauma databaseIntracranial hemorrhageCommon injuriesOdds reductionReduced oddsSkull fracture
2020
Choosing the Best Approach to Warfarin Reversal After Traumatic Intracranial Hemorrhage
Lumas SG, Hsiang W, Becher RD, Maung AA, Davis KA, Schuster KM. Choosing the Best Approach to Warfarin Reversal After Traumatic Intracranial Hemorrhage. Journal Of Surgical Research 2020, 260: 369-376. PMID: 33388533, DOI: 10.1016/j.jss.2020.12.004.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnticoagulantsBlood Coagulation FactorsCoagulantsConnecticutFemaleFollow-Up StudiesHospital CostsHumansIntracranial Hemorrhage, TraumaticLinear ModelsLogistic ModelsMaleMultivariate AnalysisPlasmaPractice Patterns, Physicians'Retrospective StudiesTomography, X-Ray ComputedTrauma CentersTreatment OutcomeWarfarinConceptsProthrombin complex concentrateFresh frozen plasmaTraumatic intracranial hemorrhageIntracranial hemorrhageWarfarin reversalReversal agentsUse of FFPAcademic level 1 trauma centerFollow-up computed tomography scanProgression of ICHFollow-up computed tomographyLevel 1 trauma centerComputed tomography scanTerms of mortalityElectronic medical recordsPreinjury warfarinElderly patientsHospital lengthInitial bleedICH progressionICH patientsMultivariable analysisRetrospective studyTrauma centerSurgical interventionThe effect of anticoagulation on outcomes after liver and spleen injuries: A research consortium of New England centers for trauma (ReCONECT) study
Bhattacharya B, Askari R, Davis KA, Dorfman J, Eid AI, Elsharkawy AE, Kasotakis G, Mackey S, Odom S, Okafor BU, Rosenblatt M, Ruditsky A, Velmahos G, Maung AA. The effect of anticoagulation on outcomes after liver and spleen injuries: A research consortium of New England centers for trauma (ReCONECT) study. Injury 2020, 51: 1994-1998. PMID: 32482426, DOI: 10.1016/j.injury.2020.05.002.Peer-Reviewed Original ResearchMeSH KeywordsAnticoagulantsHumansInjury Severity ScoreLiverMiddle AgedNew EnglandRetrospective StudiesSpleenTrauma CentersWounds, NonpenetratingConceptsNon-ACS patientsEffect of anticoagulationNon-operative managementSpleen injurySplenic injuryLiver injuryInitial non-operative managementSignificant differencesUse of anticoagulationBlood product transfusionMulticenter retrospective studyAC drugsMore PRBCsInjury gradeProduct transfusionCommon indicationAC patientsAtrial fibrillationRetrospective studyAnticoagulationSolid organsPatientsInjuryStudy periodLiverHospital 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
2013
Pneumatosis Intestinalis Predictive Evaluation Study (PIPES)
DuBose JJ, Lissauer M, Maung AA, Piper GL, O’Callaghan T, Luo-Owen X, Inaba K, Okoye O, Shestopalov A, Fielder WD, Ferrada P, Wilson A, Channel J, Moore FO, Paul DB, Johnson S. Pneumatosis Intestinalis Predictive Evaluation Study (PIPES). Journal Of Trauma And Acute Care Surgery 2013, 75: 15-23. PMID: 23778433, DOI: 10.1097/ta.0b013e318298486e.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge DistributionAgedAnalysis of VarianceCause of DeathCohort StudiesCombined Modality TherapyDigestive System Surgical ProceduresFemaleHospital MortalityHumansIncidenceLogistic ModelsMaleMiddle AgedPneumatosis Cystoides IntestinalisPredictive Value of TestsPrognosisRetrospective StudiesRisk AssessmentSeverity of Illness IndexSex DistributionSocieties, MedicalSurvival AnalysisTomography, X-Ray ComputedConceptsPathologic pneumatosis intestinalisPneumatosis intestinalisClinical prediction ruleIndependent predictorsPrediction ruleAcute renal failureRetrospective multicenter studySmall retrospective seriesStrong independent predictorRegression tree analysisAbsent bowelVasopressor needVasopressor useRenal failurePrimary outcomeClinical presentationRetrospective seriesBenign diseaseMechanical ventilationMulticenter studyTransmural ischemiaCase reportMedical historyClinical significanceProspective validation
2012
Compared to conventional ventilation, airway pressure release ventilation may increase ventilator days in trauma patients
Maung AA, Schuster KM, Kaplan LJ, Ditillo MF, Piper GL, Maerz LL, Lui FY, Johnson DC, Davis KA. Compared to conventional ventilation, airway pressure release ventilation may increase ventilator days in trauma patients. Journal Of Trauma And Acute Care Surgery 2012, 73: 507-510. PMID: 23019679, DOI: 10.1097/ta.0b013e31825ff653.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedContinuous Positive Airway PressureCritical CareDatabases, FactualFemaleFollow-Up StudiesHumansInjury Severity ScoreIntra-Abdominal HypertensionLength of StayLinear ModelsMaleMiddle AgedMultivariate AnalysisPulmonary Gas ExchangeRespiration, ArtificialRetrospective StudiesRisk AssessmentSurvival RateTime FactorsTrauma CentersTreatment OutcomeVentilator WeaningWounds and InjuriesConceptsAirway pressure release ventilationTotal ventilator daysVentilator daysHospital complicationsMechanical ventilationAIS scoreChest Abbreviated Injury Scale scoreAbbreviated Injury Scale scoreSpontaneous breathing trialAbdominal compartment syndromeAcute lung injuryAcute renal failureInjury Scale scoreStudy entry criteriaInjury Severity ScorePotential confounding factorsAPRV groupAPRV modeBreathing trialRescue therapyCompartment syndromeLung injuryRenal failureIndependent predictorsRetrospective reviewLessons learned from airway pressure release ventilation
Maung AA, Luckianow G, Kaplan LJ. Lessons learned from airway pressure release ventilation. Journal Of Trauma And Acute Care Surgery 2012, 72: 624-628. PMID: 22491545, DOI: 10.1097/ta.0b013e318247668f.Peer-Reviewed Original ResearchConceptsAirway pressure release ventilationPercent of patientsIntensive care unitMean timeVentilator strategiesCare unitMinute ventilationUniversity hospital surgical intensive care unitCO2 clearanceSurgical intensive care unitHypercarbic respiratory failurePressure-targeted modesPressure-targeted ventilationVentilator-associated complicationsSingle institution experienceLower minute ventilationMean minute ventilationBag-valve ventilationUnpaired t-testRespiratory failureCardiac surgeryInstitution experienceVascular surgeryLaboratory valuesHypoxemia
2011
Routine 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