2020
Benchmarking the value of care: Variability in hospital costs for common operations and its association with procedure volume.
Zogg CK, Bernard AC, Hirji SA, Minei JP, Staudenmayer KL, Davis KA. Benchmarking the value of care: Variability in hospital costs for common operations and its association with procedure volume. Journal Of Trauma And Acute Care Surgery 2020, 88: 619-628. PMID: 32039972, PMCID: PMC7802807, DOI: 10.1097/ta.0000000000002611.Peer-Reviewed Original ResearchConceptsLaparoscopic appendectomyLaparoscopic cholecystectomyHospital costsMeans of USMedian costProcedure volumeEmergency general surgeryTotal hospital costsMedian hospital costsNational Inpatient SampleAdults 18 yearsNational cost savingsAnnual procedure volumeValue of careHospital complicationsIndex hospitalHealth care valuePatient characteristicsAdverse outcomesInpatient SampleInclusion criteriaGeneral surgeryHospitalLevel IIICommon operationHospital 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
The Economic Footprint of Acute Care Surgery in the United States
Knowlton LM, Minei J, Tennakoon L, Davis KA, Doucet J, Bernard A, Haider A, Scherer L, Spain DA, Staudenmayer KL. The Economic Footprint of Acute Care Surgery in the United States. Journal Of Trauma And Acute Care Surgery 2019, Publish Ahead of Print: &na;. PMID: 30589750, PMCID: PMC6433481, DOI: 10.1097/ta.0000000000002181.Peer-Reviewed Original ResearchConceptsAcute care surgeryEmergency general surgeryACS patientsClinical Modification diagnosisInpatient populationInternational ClassificationAdult ACS patientsNon-surgical patientsHealth care utilizationHigher mean costSurgical critical careNonoperative conditionsACS diagnosisAdult patientsPatient characteristicsCare surgeryCare utilizationAdult admissionsEGS conditionsInpatient costsInpatient hospitalizationCritical careGeneral surgeryMean costPatients
2018
Transfer 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 factorsRisk of Surgical Site Infection (SSI) following Colorectal Resection Is Higher in Patients With Disseminated Cancer: An NCCN Member Cohort Study
Kamboj M, Childers T, Sugalski J, Antonelli D, Bingener-Casey J, Cannon J, Cluff K, Davis KA, Dellinger EP, Dowdy SC, Duncan K, Fedderson J, Glasgow R, Hall B, Hirsch M, Hutter M, Kimbro L, Kuvshinoff B, Makary M, Morris M, Nehring S, Ramamoorthy S, Scott R, Sovel M, Strong V, Webster A, Wick E, Aguilar JG, Carlson R, Sepkowitz K. Risk of Surgical Site Infection (SSI) following Colorectal Resection Is Higher in Patients With Disseminated Cancer: An NCCN Member Cohort Study. Infection Control And Hospital Epidemiology 2018, 39: 555-562. PMID: 29553001, PMCID: PMC6707075, DOI: 10.1017/ice.2018.40.Peer-Reviewed Original ResearchConceptsSurgical site infectionDisseminated cancerHealthcare-associated infectionsSSI ratesColorectal surgeryASA scoreSite infectionSSI riskColorectal proceduresRate of SSIRisk of SSIDevelopment of SSICommon healthcare-associated infectionsChronic obstructive pulmonary diseaseInfect Control Hosp EpidemiolBackgroundSurgical site infectionCurrent Procedural Technology codesPooled SSI rateNational Comprehensive Cancer Network (NCCN) member institutionsObstructive pulmonary diseaseClinical Modification codesLonger durationPotential risk factorsRisk-adjusted outcomesSurgical quality improvementComparison of Outcomes in Below-Knee Amputation between Vascular and General Surgeons
Pei KY, Zhang Y, Sarac T, Davis KA. Comparison of Outcomes in Below-Knee Amputation between Vascular and General Surgeons. Annals Of Vascular Surgery 2018, 50: 259-268. PMID: 29501591, DOI: 10.1016/j.avsg.2017.11.073.Peer-Reviewed Original ResearchMeSH KeywordsAgedAmputation, SurgicalChi-Square DistributionClinical CompetenceDatabases, FactualEmergenciesFemaleGeneral SurgeryHospitals, TeachingHumansLength of StayLinear ModelsLogistic ModelsLower ExtremityMaleMiddle AgedMultivariate AnalysisOdds RatioPostoperative ComplicationsRetrospective StudiesRisk FactorsSpecializationSurgeonsTime FactorsTreatment OutcomeUnited StatesVascular Surgical ProceduresConceptsVascular surgeonsGeneral surgeonsKnee amputationInfectious indicationsNational Surgical Quality Improvement Project databaseSurgeons National Surgical Quality Improvement Project databaseUnconditional logistic regression modelsRisk of pneumoniaPeripheral vascular diseaseLower extremity amputationBelow knee amputationComparison of outcomesEffect of specialtyLogistic regression modelsOverall complicationsVascular consultationPostoperative complicationsPatient demographicsPostoperative outcomesPulmonary embolismComorbid conditionsRegression modelsExtremity amputationRetrospective studyVascular disease
2017
Laparoscopic colectomy reduces complications and hospital length of stay in colon cancer patients with liver disease and ascites
Pei KY, Asuzu DT, Davis KA. Laparoscopic colectomy reduces complications and hospital length of stay in colon cancer patients with liver disease and ascites. Surgical Endoscopy 2017, 32: 1286-1292. PMID: 28812198, DOI: 10.1007/s00464-017-5806-4.Peer-Reviewed Original ResearchConceptsHospital lengthLaparoscopic colectomyColon cancerPostoperative complicationsOdds ratioNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement Program databaseQuality Improvement Program databaseOpen partial colectomyImprovement Program databaseShorter hospital lengthRisk of deathAdjusted odds ratioHigh-risk populationColon cancer patientsTwo-sample t-testConclusionsLaparoscopic colectomyOverall complicationsPerioperative complicationsPostoperative outcomesPostoperative riskAbsolute contraindicationLaparoscopic approachLiver diseaseOperative timeAssessing trends in laparoscopic colostomy reversal and evaluating outcomes when compared to open procedures
Pei KY, Davis KA, Zhang Y. Assessing trends in laparoscopic colostomy reversal and evaluating outcomes when compared to open procedures. Surgical Endoscopy 2017, 32: 695-701. PMID: 28726139, DOI: 10.1007/s00464-017-5725-4.Peer-Reviewed Original ResearchConceptsReversal surgeryLength of stayColostomy reversalComplication rateSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramSurgical Quality Improvement ProgramUnconditional logistic regression modelsStudy periodTotal hospital lengthOverall complication rateProbability of morbidityShorter operation timeQuality Improvement ProgramLogistic regression modelsLaparoscopic colostomyLaparoscopic reversalMethodsAll patientsPostsurgical diagnosisHospital lengthPostoperative complicationsNSQIP databasePatient demographicsHartmann's reversalComorbid conditionsImpact of hospital volume on outcomes for laparoscopic adhesiolysis for small bowel obstruction
Jean RA, O'Neill KM, Pei KY, Davis KA. Impact of hospital volume on outcomes for laparoscopic adhesiolysis for small bowel obstruction. Journal Of Surgical Research 2017, 214: 23-31. PMID: 28624050, DOI: 10.1016/j.jss.2017.02.045.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overDatabases, FactualFemaleHospital CostsHospitals, High-VolumeHospitals, Low-VolumeHumansIntestinal ObstructionIntestine, SmallLaparoscopyLength of StayLinear ModelsMaleMiddle AgedMultivariate AnalysisTissue AdhesionsTreatment OutcomeUnited StatesYoung AdultConceptsSmall bowel obstructionLength of stayHigh-volume hospitalsBowel obstructionHospital volumeVolume statusProcedural volumeSurgical proceduresDiagnosis of SBODecreased LOSShorter LOSNationwide Inpatient Sample dataHigh-volume statusHospital volume statusInstitutional procedural volumeIntra-abdominal malignanciesHigher hospital volumeLow-volume hospitalsHigh-volume centersMajor surgical proceduresSmall bowel resectionLow volume statusComplex surgical proceduresLaparoscopic lysisAdult patients
2016
Will laparoscopic lysis of adhesions become the standard of care? Evaluating trends and outcomes in laparoscopic management of small-bowel obstruction using the American College of Surgeons National Surgical Quality Improvement Project Database
Pei KY, Asuzu D, Davis KA. Will laparoscopic lysis of adhesions become the standard of care? Evaluating trends and outcomes in laparoscopic management of small-bowel obstruction using the American College of Surgeons National Surgical Quality Improvement Project Database. Surgical Endoscopy 2016, 31: 2180-2186. PMID: 27585468, DOI: 10.1007/s00464-016-5216-z.Peer-Reviewed Original ResearchConceptsSmall bowel obstructionHospital stayAmerican CollegeNational Surgical Quality Improvement Program data setNational Surgical Quality Improvement Project databaseSurgeons National Surgical Quality Improvement Project databasePost-surgical complication rateLonger hospital stayLarge retrospective analysisLysis of adhesionsSignificant healthcare burdenMultivariable logistic regressionStandard of carePost-surgical complicationsProgram data setTwo-sample t-testMann-Whitney testLaparoscopic lysisOpen lysisLaparoscopic managementComplication rateClinical benefitLargest comparison studyHealthcare burdenSBO casesOutcomes 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 factorsDaysHypotensionSepsis
2014
Morbid obesity predisposes trauma patients to worse outcomes
Ditillo M, Pandit V, Rhee P, Aziz H, Hadeed S, Bhattacharya B, Friese RS, Davis K, Joseph B. Morbid obesity predisposes trauma patients to worse outcomes. Journal Of Trauma And Acute Care Surgery 2014, 76: 176-179. PMID: 24368375, DOI: 10.1097/ta.0b013e3182ab0d7c.Peer-Reviewed Original ResearchConceptsBlunt traumatic injuryMorbidly obese patientsInjury Severity ScoreObese patientsGlasgow Coma ScaleHospital complicationsMorbid obesityTraumatic injuryNonobese patientsTrauma patientsIntensive care unit stayNational Trauma Data BankBlunt trauma patientsLonger hospital stayImpact of obesitySystolic blood pressureOverall mortality rateTrauma Data BankInjury prevention effortsConsequences of obesityTraumatic brain injuryUnit stayHospital staySecondary outcomesBlood pressure
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 review