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 testsAppendicitisComorbiditiesCohortContemporary management and outcomes of penetrating colon injuries: Validation of the 2020 AAST Colon Organ Injury Scale
Zeineddin A, Tominaga G, Crandall M, Almeida M, Schuster K, Jawad G, Maqbool B, Sheffield A, Dhillon N, Radow B, Moorman M, Martin N, Jacovides C, Lowry D, Kaups K, Horwood C, Werner N, Proaño-Zamudio J, Kaafarani H, Marshall W, Haines L, Schaffer K, Staudenmayer K, Kozar R. Contemporary management and outcomes of penetrating colon injuries: Validation of the 2020 AAST Colon Organ Injury Scale. Journal Of Trauma And Acute Care Surgery 2023, 95: 213-219. PMID: 37072893, DOI: 10.1097/ta.0000000000003969.Peer-Reviewed Original ResearchMeSH KeywordsAbdominal InjuriesColonFemaleHumansInjury Severity ScoreMalePrognosisRetrospective StudiesThoracic InjuriesWounds, GunshotWounds, PenetratingConceptsOrgan Injury ScaleExtra-abdominal infectionsColon injuriesInjury ScaleAbbreviated Injury Scale scoreContemporary managementLevel 1 trauma centerAcute kidney injuryDamage control laparotomyInjury Scale scoreInjury Severity ScoreStrong predictive valueType of interventionAmerican AssociationKidney injuryLung injuryOperative findingsClinical outcomesPrimary repairSurgical managementTrauma centerMulticenter studyOperative managementPreoperative imagingRetrospective studyEarly VTE prophylaxis in severe traumatic brain injury: A propensity score weighted EAST multicenter study
Ratnasekera A, Kim D, Seng S, Jacovides C, Kaufman E, Sadek H, Perea L, Monaco C, Shnaydman I, Lee A, Sharp V, Miciura A, Trevizo E, Rosenthal M, Lottenberg L, Zhao W, Keininger A, Hunt M, Cull J, Balentine C, Egodage T, Mohamed A, Kincaid M, Doris S, Cotterman R, Seegert S, Jacobson L, Williams J, Whitmill M, Palmer B, Mentzer C, Tackett N, Hranjec T, Dougherty T, Morrissey S, Donatelli-Seyler L, Rushing A, Tatebe L, Nevill T, Aboutanos M, Hamilton D, Redmond D, Cullinane D, Falank C, McMellen M, Duran C, Daniels J, Ballow S, Schuster K, Ferrada P. Early VTE prophylaxis in severe traumatic brain injury: A propensity score weighted EAST multicenter study. Journal Of Trauma And Acute Care Surgery 2023, 95: 94-104. PMID: 37017458, DOI: 10.1097/ta.0000000000003985.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnticoagulantsBrain Injuries, TraumaticHumansIntracranial HemorrhagesPropensity ScoreRetrospective StudiesTreatment OutcomeVenous ThromboembolismConceptsVenous thromboembolism eventsIntracranial hemorrhage expansionSevere traumatic brain injuryTraumatic brain injuryVTE prophylaxisPropensity scoreBrain injuryHead CTHigh riskHigh incidenceAdult patients 18 yearsLevel II trauma centerEarly VTE prophylaxisEAST multicenter studyPatients 18 yearsUnivariate logistic regression modelMulti-center analysisLogistic regression modelsTiming of initiationProphylaxis initiationThromboembolism eventsPredictors of interestClinical characteristicsPrimary outcomeRetrospective reviewImaging acute cholecystitis, one test is enough
Schuster K, Schroeppel T, O'Connor R, Enniss T, Cripps M, Cullinane D, Kaafarani H, Crandall M, Puri R, Tominaga G. Imaging acute cholecystitis, one test is enough. The American Journal Of Surgery 2023, 226: 99-103. PMID: 36882336, DOI: 10.1016/j.amjsurg.2023.02.018.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseCholecystitisCholecystitis, AcuteCommon Bile DuctHumansMagnetic Resonance ImagingRetrospective StudiesUltrasonographyConceptsCommon bile duct diameterBile duct diameterAcute cholecystitisIntra-class correlation coefficientDuct diameterRight upper quadrant painUpper quadrant painSigns of inflammationSingle imaging studyChi-square testQuadrant painPericholecystic fluidWall thicknessMulticenter studyPatientsImaging studiesCholecystitisAbnormal valuesGold standardAdequate informationPainInflammationAdmissionStudyDiagnosisFrom mild to gangrenous cholecystitis, laparoscopic cholecystectomy is safe 24 hours a day
Taveras L, Scrushy M, Cripps M, Kuhlenschmidt K, Crandall M, Puri R, Schroeppel T, Schuster K, Dumas R. From mild to gangrenous cholecystitis, laparoscopic cholecystectomy is safe 24 hours a day. The American Journal Of Surgery 2023, 226: 83-86. PMID: 36746709, DOI: 10.1016/j.amjsurg.2023.01.029.Peer-Reviewed Original Research
2020
Closing the gap in care of blunt solid organ injury in children.
Yung N, Solomon D, Schuster K, Christison-Lagay E. Closing the gap in care of blunt solid organ injury in children. Journal Of Trauma And Acute Care Surgery 2020, 89: 894-899. PMID: 32345899, DOI: 10.1097/ta.0000000000002757.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentChildChild, PreschoolClinical Decision-MakingConsensusConservative TreatmentFemaleHospitals, PediatricHumansInfantInfant, NewbornInjury Severity ScoreLength of StayLiverMalePatient DischargePractice Guidelines as TopicProfessional Practice GapsRetrospective StudiesSpleenSurgical Procedures, OperativeTrauma CentersWounds, NonpenetratingYoung AdultConceptsAdult trauma centersPediatric trauma centerSolid organ injuryBlunt solid organ injuryOperative interventionOrgan injuryTrauma centerInjury gradeNonoperative managementLiver injuryPediatric blunt solid organ injuryPediatric solid organ injuryPhysiologic parametersNational Trauma Data BankTrauma center typeGrade of injuryTrauma Data BankBlunt spleenMean LOSHigher ORsConsensus guidelinesIsolated spleenOperative rateGrade ILevel IVHospital 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
2019
Hospital Operative Volume and Quality Indication for General Surgery Operations Performed Emergently in Geriatric Patients
Becher RD, DeWane MP, Sukumar N, Stolar MJ, Gill TM, Becher RM, Maung AA, Schuster KM, Davis KA. Hospital Operative Volume and Quality Indication for General Surgery Operations Performed Emergently in Geriatric Patients. Journal Of The American College Of Surgeons 2019, 228: 910-923. PMID: 31005629, PMCID: PMC6582986, DOI: 10.1016/j.jamcollsurg.2019.02.053.Peer-Reviewed Original ResearchConceptsHospital operative volumeGeneral surgery operationsGeriatric patientsOperative volumeEmergency operationHospital volumeProbability of survivalEmergency general surgery operationsCalifornia State Inpatient DatabaseRetrospective cohort studySurgery operationsState Inpatient DatabasesHigher operative volumesAverage mortality riskOlder patientsCohort studyInpatient DatabaseGeriatric populationSurgical careSurgical qualityAmerican CollegeMortality riskOptimizing outcomesStandardized increasePatientsThe 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 characteristicsSymptomatic 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
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 ratesTotal bilirubin trend as a predictor of common bile duct stones in acute cholecystitis and symptomatic cholelithiasis
Gillaspie DB, Davis KA, Schuster KM. Total bilirubin trend as a predictor of common bile duct stones in acute cholecystitis and symptomatic cholelithiasis. The American Journal Of Surgery 2018, 217: 98-102. PMID: 29929909, DOI: 10.1016/j.amjsurg.2018.06.011.Peer-Reviewed Original ResearchConceptsCommon bile duct stonesBile duct stonesAcute cholecystitisSymptomatic cholelithiasisDuct stonesBilirubin levelsProcedural interventionTotal bilirubinPresence of CBDSElevated total bilirubinTotal bilirubin levelsElevated serum bilirubinBiliary colicAdult patientsSerum bilirubinSerum makersImmediate imagingCholecystitisBilirubinCholelithiasisPatientsInterventionColicLevelsValidation 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
2017
A highly sensitive and specific combined clinical and sonographic score to diagnose appendicitis
Reddy SB, Kelleher M, Bokhari SAJ, Davis KA, Schuster KM. A highly sensitive and specific combined clinical and sonographic score to diagnose appendicitis. Journal Of Trauma And Acute Care Surgery 2017, 83: 643-649. PMID: 28459797, DOI: 10.1097/ta.0000000000001551.Peer-Reviewed Original Research
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 reviewThe older they are the harder they fall: Injury patterns and outcomes by age after ground level falls
Bhattacharya B, Maung A, Schuster K, Davis KA. The older they are the harder they fall: Injury patterns and outcomes by age after ground level falls. Injury 2016, 47: 1955-1959. PMID: 27346422, DOI: 10.1016/j.injury.2016.06.019.Peer-Reviewed Original ResearchMeSH KeywordsAccidental FallsAgedAged, 80 and overAnticoagulantsAspirinComorbidityFemaleFollow-Up StudiesFractures, BoneGeriatric AssessmentHospitalizationHumansInjury Severity ScoreIntracranial HemorrhagesMaleMultiple TraumaPlatelet Aggregation InhibitorsRetrospective StudiesSurvival AnalysisTrauma CentersTreatment OutcomeUnited StatesConceptsGround-level fallInjury patternsAnticoagulation useAspirin useIntracranial bleedAnticoagulation agentsAbdominal solid organ injuriesCertain injury patternsAdult trauma patientsSolid organ injuryAntiplatelet useHome dischargePatient characteristicsLife expectancy increasesMean ISSOrgan injuryOverall mortalityRetrospective reviewTrauma patientsGeriatric patientsSignificant morbidityTrauma centerPatient populationPelvic fracturesCervical spineOutcomes of acute care surgical cases performed at night
Dalton MK, McDonald E, Bhatia P, Davis KA, Schuster KM. Outcomes of acute care surgical cases performed at night. The American Journal Of Surgery 2016, 212: 831-836. PMID: 27263405, DOI: 10.1016/j.amjsurg.2016.02.024.Peer-Reviewed Original ResearchConceptsAcute care surgeonsRetrospective cohort studyConditional logistic regressionMore hypotensionCohort studyOperative interventionOperative delayDay casesSurgical careOutcome differencesSurgical casesEmergency operationLogistic regressionSurgeonsPotent predictorTeam fatigueComorbiditiesSimilar degreeConfoundersOutcomesMortalityUnmeasured factorsDaysHypotensionSepsisMulticenter 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 OUTCOMEPatients