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 study
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 screeningPsychosocial Risks are Independently Associated with Cancer Surgery Outcomes in Medically Comorbid Patients
Leeds IL, Meyers PM, Enumah ZO, He J, Burkhart RA, Haut ER, Efron JE, Johnston FM. Psychosocial Risks are Independently Associated with Cancer Surgery Outcomes in Medically Comorbid Patients. Annals Of Surgical Oncology 2019, 26: 936-944. PMID: 30617868, PMCID: PMC8710142, DOI: 10.1245/s10434-018-07136-3.Peer-Reviewed Original ResearchConceptsPsychosocial risk factorsRisk factorsPsychosocial risksSurgical outcomesPrimary tumorShort-term surgical outcomesMultiple psychosocial risk factorsCancer surgery patientsColorectal primary tumorsProspective observational studyCancer surgery outcomesMultiple psychosocial risksThreefold oddsChart reviewComplication ratePostoperative courseSurgery patientsComorbid patientsMedian ageCancer surgeryMultivariable analysisPreoperative assessmentCancer patientsSurgery outcomesObservational study
2018
Using Audience Response Systems for Real-Time Learning Assessments During Surgical Morbidity and Mortality Conference
Leeds IL, DiBrito SR, Jones CD, Higgins RSD, Haut ER. Using Audience Response Systems for Real-Time Learning Assessments During Surgical Morbidity and Mortality Conference. Journal Of Surgical Education 2018, 75: 1535-1543. PMID: 30523799, DOI: 10.1016/j.jsurg.2018.05.010.Peer-Reviewed Original ResearchConceptsTertiary academic medical centerMortality conferencesGeneral surgical residency programsSurgical risk estimationUnique case presentationAcademic medical centerTargeted educational interventionsComplication rateSurgical morbiditySurgical residency programsMedical CenterCase presentationClinical fellowsMorbidityMajority of respondentsEducational interventionCategorical residentsPreliminary residentsJunior residentsCohen's kappaResidency programsResponse systemRisk estimationCauseConcordanceMalnutrition 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
Racial and Socioeconomic Differences Manifest in Process Measure Adherence for Enhanced Recovery After Surgery Pathway
Leeds IL, Alimi Y, Hobson DR, Efron JE, Wick EC, Haut ER, Johnston FM. Racial and Socioeconomic Differences Manifest in Process Measure Adherence for Enhanced Recovery After Surgery Pathway. Diseases Of The Colon & Rectum 2017, 60: 1092-1101. PMID: 28891854, PMCID: PMC5647878, DOI: 10.1097/dcr.0000000000000879.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCohort StudiesColectomyColonic DiseasesColorectal SurgeryElective Surgical ProceduresFemaleHumansMaleMiddle AgedOutcome and Process Assessment, Health CarePatient CompliancePostoperative ComplicationsQuality ImprovementRacial GroupsSocioeconomic FactorsUnited StatesConceptsSurgery pathwayPathway implementationSocioeconomic statusWhite patientsPopulation subgroupsOverall adherenceShort-term surgical outcomesTertiary academic medical centerProcess measure adherenceThirty-day outcomesEnhanced recovery pathwayProcess measuresAcademic medical centerHigher socioeconomic statusElective colonPreoperative characteristicsQuality improvement purposesCohort studyComplication rateNonwhite patientsRectal resectionPain therapyMedian lengthSurgical outcomesMedical CenterThe independent effect of cancer on outcomes: a potential limitation of surgical risk prediction
Leeds IL, Canner JK, Efron JE, Ahuja N, Haut ER, Wick EC, Johnston FM. The independent effect of cancer on outcomes: a potential limitation of surgical risk prediction. Journal Of Surgical Research 2017, 220: 402-409.e6. PMID: 28923559, PMCID: PMC5712450, DOI: 10.1016/j.jss.2017.08.039.Peer-Reviewed Original ResearchConceptsCancer patientsDiagnosis of cancerBenign diseaseCancer populationNational Surgical Quality Improvement Program 2005Chronic obstructive pulmonary diseaseSurgical risk modelsSurgical risk predictionObstructive pulmonary diseaseWorse surgical outcomesMalignant gastrointestinal diseasesOdds of deathHigh complication rateMultivariable logistic regressionParticipant Use FileRisk of deathPrimary procedure codeHigh mortality rateComplication rateSurgical complicationsIndependent predictorsMultiple complicationsPulmonary diseaseElective surgeryNoncancer patients
2016
Preparing enhanced recovery after surgery for implementation in pediatric populations
Leeds IL, Boss EF, George JA, Strockbine V, Wick EC, Jelin EB. Preparing enhanced recovery after surgery for implementation in pediatric populations. Journal Of Pediatric Surgery 2016, 51: 2126-2129. PMID: 27663124, PMCID: PMC5373552, DOI: 10.1016/j.jpedsurg.2016.08.029.Peer-Reviewed Original ResearchConceptsERAS pathwayERAS programSurgery patientsSurgical outcomesColorectal surgery patientsPediatric surgery patientsLength of stayEfficiency of careEvidence-based best practicesComplication rateERAS principlesPerioperative carePediatric populationPatient satisfactionClinical pathwayPediatric providersSurgery programPatient's familyAdult evidenceLimited direct evidencePatientsSurgeryOutcomesCareDirect evidence