2022
Reconceptualizing high-quality emergency general surgery care: Non–mortality-based quality metrics enable meaningful and consistent assessment
Zogg CK, Staudenmayer KL, Kodadek LM, Davis KA. Reconceptualizing high-quality emergency general surgery care: Non–mortality-based quality metrics enable meaningful and consistent assessment. Journal Of Trauma And Acute Care Surgery 2022, 94: 68-77. PMID: 36245079, PMCID: PMC9805506, DOI: 10.1097/ta.0000000000003818.Peer-Reviewed Original ResearchConceptsEmergency general surgeryHospital-level factorsEGS conditionsEmergency general surgery careOlder adultsNationwide Readmissions DatabaseComplex older adultsSurgery of TraumaGeneral surgery careQuality improvement initiativesOlder adult populationEGS careEGS hospitalsEGS patientsPatient frailtySurgery careGeneral surgeryHospitalLevel IIIAdult populationCohortPatientsComplex adultCareAdultsBeyond In-hospital Mortality
Zogg CK, Cooper Z, Peduzzi P, Falvey JR, Tinetti ME, Lichtman JH. Beyond In-hospital Mortality. Annals Of Surgery 2022, 278: e314-e330. PMID: 36111845, PMCID: PMC10014495, DOI: 10.1097/sla.0000000000005707.Peer-Reviewed Original ResearchConceptsOlder trauma patientsHospital mortalityOlder adultsTrauma patientsHealthy daysSevere traumatic brain injuryAdult trauma careCause of deathUnique health needsTraumatic brain injuryLoss of independenceIndex admissionHip fracturePrimary diagnosisBrain injuryTrauma careTraumatic injuryMedicare claimsHealth needsMortalityAverage numberReadmissionAdultsPatientsQuintile ranks
2021
In defense of Direct Care: Limiting access to military hospitals could worsen quality and safety
Zogg CK, Lichtman JH, Dalton MK, Learn PA, Schoenfeld AJ, Koehlmoos T, Weissman JS, Cooper Z. In defense of Direct Care: Limiting access to military hospitals could worsen quality and safety. Health Services Research 2021, 57: 723-733. PMID: 34608642, PMCID: PMC9264466, DOI: 10.1111/1475-6773.13885.Peer-Reviewed Original ResearchMeSH KeywordsAdultHospital MortalityHospitals, MilitaryHumansMilitary PersonnelPatient SafetyRetrospective StudiesUnited StatesConceptsMilitary treatment facilitiesMHS beneficiariesMilitary Health SystemCivilian hospitalsMHS patientsDirect carePatient safetyHealth care reformUS Military Health SystemNationwide Readmissions DatabasePatient safety indicatorsHealth policy planningInpatient Quality IndicatorsLocal civilian hospitalsCare reformEvidence-based evaluationHospital mortalityHospital morbidityAdult patientsAdverse eventsRetrospective cohortAdult admissionsNational inpatientInpatient claimsWorse outcomes
2020
The critical threshold value of systolic blood pressure for aortic occlusion in trauma patients in profound hemorrhagic shock.
Ordoñez CA, Rodríguez F, Orlas CP, Parra MW, Caicedo Y, Guzmán M, Serna JJ, Salcedo A, Zogg CK, Herrera-Escobar JP, Meléndez JJ, Angamarca E, Serna CA, Martínez D, García AF, Brenner M. The critical threshold value of systolic blood pressure for aortic occlusion in trauma patients in profound hemorrhagic shock. Journal Of Trauma And Acute Care Surgery 2020, 89: 1107-1113. PMID: 32925582, DOI: 10.1097/ta.0000000000002935.Peer-Reviewed Original ResearchMeSH KeywordsAdultAorta, AbdominalAorta, ThoracicBalloon OcclusionBlood PressureEndovascular ProceduresFemaleHeart ArrestHospital MortalityHumansInjury Severity ScoreLogistic ModelsMaleMultivariate AnalysisProspective StudiesResuscitationShock, HemorrhagicTrauma CentersWounds and InjuriesYoung AdultConceptsSystolic blood pressureProfound hemorrhagic shockTraumatic cardiac arrestAortic occlusionBlood pressureCardiac arrestHemorrhagic shockLevel I trauma centerValues of SBPResuscitative endovascular balloon occlusionI trauma centerAortic cross clampingInjury Severity ScoreMechanism of injuryEndovascular balloon occlusionLogistic regression analysisProbability of deathAdult patientsCross clampingTrauma patientsBalloon occlusionTrauma centerSeverity scorePrehospital settingCardiopulmonary resuscitationQuantifying the Impact of Care Fragmentation on Outcomes After Transcatheter Aortic Valve Implantation
Hirji SA, Zogg CK, Vaduganathan M, Kiehm S, Percy ED, Yazdchi F, Pelletier M, Shah PB, Bhatt DL, O'Gara P, Kaneko T. Quantifying the Impact of Care Fragmentation on Outcomes After Transcatheter Aortic Valve Implantation. The American Journal Of Cardiology 2020, 128: 113-119. PMID: 32650903, DOI: 10.1016/j.amjcard.2020.05.005.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCardiac CatheterizationCenters for Medicare and Medicaid Services, U.S.ComorbidityContinuity of Patient CareCoronary AngiographyDiabetes MellitusFemaleHospital CostsHospital MortalityHospitalsHumansHypertensionLength of StayLung DiseasesMaleMultivariate AnalysisPacemaker, ArtificialPatient ReadmissionPericardiocentesisPostoperative ComplicationsProsthesis ImplantationStrokeTranscatheter Aortic Valve ReplacementUnited StatesConceptsNonindex hospitalNonindex readmissionsCare fragmentationTranscatheter aortic valve implantation outcomesTranscatheter aortic valve implantationHigher co-morbidity burdenNational Readmission DatabaseAortic valve implantationCo-morbidity burdenTotal hospital costsMajor cardiac proceduresUS adult patientsFuture health policyValue of careIndex readmissionTAVI patientsCause mortalityIndex hospitalNoncardiac causesAdult patientsPatient characteristicsReadmission ratesValve implantationReadmission lengthCardiac proceduresHospital 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 operationsChest Trauma Outcomes: Public Versus Private Level I Trauma Centers
Orlas CP, Herrera‐Escobar J, Zogg CK, Serna JJ, Meléndez JJ, Gómez A, Martínez D, Parra MW, García AF, Rosso F, Pino LF, Gonzalez A, Ordoñez CA. Chest Trauma Outcomes: Public Versus Private Level I Trauma Centers. World Journal Of Surgery 2020, 44: 1824-1834. PMID: 31993723, PMCID: PMC7380545, DOI: 10.1007/s00268-020-05400-w.Peer-Reviewed Original ResearchMeSH KeywordsAdultFemaleHospital MortalityHumansInjury Severity ScoreLogistic ModelsMaleThoracic InjuriesTrauma CentersWounds, PenetratingYoung AdultConceptsTrauma centerMedian Injury Severity ScoreLogistic regressionInjury Severity ScorePost-operative complicationsMultivariable logistic regressionRetained hemothoraxHospital mortalityChest traumaClinical characteristicsMedian ageClinical outcomesThoracic traumaUnstable hemodynamicsEmergency roomSeverity scoreHigher oddsLevel IPatientsTraumaSignificant differencesMortalityHemothoraxMediastinitisEmpyema
2019
Debunking the July Effect in Cardiac Surgery: A National Analysis of More Than 470,000 Procedures
Shah RM, Hirji SA, Kiehm S, Goel S, Yazdchi F, Bellavia A, Zogg CK, Pelletier MP, Shekar P, Kaneko T. Debunking the July Effect in Cardiac Surgery: A National Analysis of More Than 470,000 Procedures. The Annals Of Thoracic Surgery 2019, 108: 929-934. PMID: 31353035, DOI: 10.1016/j.athoracsur.2019.06.015.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAdultAgedCardiac Surgical ProceduresClinical CompetenceCohort StudiesDatabases, FactualEducation, Medical, GraduateFemaleHospital MortalityHospitals, TeachingHumansInpatientsInternship and ResidencyMaleMedical Staff, HospitalMiddle AgedPostoperative ComplicationsQuality of Health CareRisk AdjustmentSeasonsUnited StatesConceptsAortic valve replacementCardiac surgeryJuly effectHospital mortalityPatient outcomesTeaching hospitalMajor cardiac surgery proceduresSurgical aortic valve replacementCoronary artery bypassCardiac surgery proceduresNational Inpatient SampleRisk-adjusted mortalityMitral valve repairCardiac surgery outcomesHospital complicationsArtery bypassMV surgeryNoncardiac surgeryValve replacementAdjusted mortalityValve repairSurgery outcomesInpatient SampleWorse outcomesHospital support systemsCoding algorithms for defining Charlson and Elixhauser co-morbidities in Read-coded databases
Metcalfe D, Masters J, Delmestri A, Judge A, Perry D, Zogg C, Gabbe B, Costa M. Coding algorithms for defining Charlson and Elixhauser co-morbidities in Read-coded databases. BMC Medical Research Methodology 2019, 19: 115. PMID: 31170931, PMCID: PMC6554904, DOI: 10.1186/s12874-019-0753-5.Peer-Reviewed Original ResearchConceptsCharlson Comorbidity IndexClinical Practice Research DatalinkElixhauser methodHip fractureLogistic regression modelsRead codesLarge primary care databaseUK primary care practicesPrimary care databasePrimary care practicesComorbidity categoriesComorbidity indexRegression modelsComorbidity measuresCare databaseComorbidity codesMethodsTwo researchersPredictive valueCare practicesControl populationPredictive propertiesReceiver Operating Characteristic (ROC) curveCharacteristic curveComorbiditiesOperating Characteristic curveImpact of Affordable Care Act–related insurance expansion policies on mortality and access to post-discharge care for trauma patients
Scott JW, Neiman PU, Uribe-Leitz T, Scott KW, Zogg CK, Salim A, Haider AH. Impact of Affordable Care Act–related insurance expansion policies on mortality and access to post-discharge care for trauma patients. Journal Of Trauma And Acute Care Surgery 2019, 86: 196-205. PMID: 30694984, DOI: 10.1097/ta.0000000000002117.Peer-Reviewed Original ResearchConceptsPost-discharge careTrauma patientsInpatient mortalityPost-acute careAffordable Care ActCoverage expansion policiesUninsured ratePost-acute care facilitiesState-level Medicaid expansionMedicaid expansionNational Trauma Data BankPolicy-associated changesAdult trauma patientsTrauma Data BankPost-acute servicesUninsured trauma patientsCare ActHome health servicesInsurance coverage expansionCoverage expansionPost-policy periodPatients 18Discharge dispositionPatient demographicsInjury characteristics
2018
Racial/Ethnic Disparities in Longer-term Outcomes Among Emergency General Surgery Patients
Zogg CK, Jiang W, Ottesen TD, Shafi S, Schuster K, Becher R, Davis KA, Haider AH. Racial/Ethnic Disparities in Longer-term Outcomes Among Emergency General Surgery Patients. Annals Of Surgery 2018, 268: 968-979. PMID: 28742704, PMCID: PMC5783796, DOI: 10.1097/sla.0000000000002449.Peer-Reviewed Original ResearchConceptsEmergency general surgery patientsNon-Hispanic whitesGeneral surgery patientsLong-term outcomesNon-Hispanic blacksNon-Hispanic AsiansMinority patientsMajor morbidityUnplanned readmissionSurgery patientsOlder adultsRisk-adjusted Cox proportional hazards modelsEthnic disparitiesCox proportional hazards modelDiagnostic categoriesRacial/Ethnic DisparitiesUS population agesProportional hazards modelNHB patientsNonagenarian patientsNHW patientsBACKGROUND DATAHospital's percentageMortality differencesMedicare dataThe “mortality ascent”
Herrera-Escobar JP, Rios-Diaz AJ, Zogg CK, Wolf LL, Harlow A, Schneider EB, Cooper Z, Ordonez CA, Salim A, Haider AH. The “mortality ascent”. Journal Of Trauma And Acute Care Surgery 2018, 84: 139-145. PMID: 28930947, DOI: 10.1097/ta.0000000000001706.Peer-Reviewed Original ResearchConceptsUnstable trauma patientsLevel I TCsLevel II TCsHours postadmissionTrauma patientsLevel ILevel IIMortality riskHospital mortalityLog-binomial regression modelsNational Trauma Data BankComparable mortality riskHospital-level confoundersInjury Severity ScoreSystolic blood pressureAvailable treatment modalitiesTrauma Data BankSpecific risk factorsRisk-adjusted modelsBlood pressureHigher relative mortalityUnstable patientsBurn patientsSeverity scoreTreatment modalities
2017
The Need to Consider Longer-term Outcomes of Care
Zogg CK, Olufajo OA, Jiang W, Bystricky A, Scott JW, Shafi S, Havens JM, Salim A, Schoenfeld AJ, Haider AH. The Need to Consider Longer-term Outcomes of Care. Annals Of Surgery 2017, 266: 66-75. PMID: 28140382, DOI: 10.1097/sla.0000000000001932.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedBlack or African AmericanCaliforniaEmergency Service, HospitalHealthcare DisparitiesHispanic or LatinoHospital MortalityHumansIncomeInsurance CoverageInsurance, HealthLongitudinal StudiesMiddle AgedOutcome Assessment, Health CarePatient ReadmissionPostoperative ComplicationsProportional Hazards ModelsSurgical Procedures, OperativeSurvival AnalysisWhite PeopleYoung AdultConceptsLong-term outcomesNon-Hispanic blacksUnplanned readmissionMajor morbidityWhite patientsMinority patientsEthnic disparitiesEmergency general surgery patientsCalifornia State Inpatient DatabaseCox proportional hazards modelDiagnostic categoriesOlder adultsGeneral surgery patientsState Inpatient DatabasesProportional hazards modelRisk-adjusted differencesHispanic older adultsEGS patientsEGS volumeReadmission trendsSurgery patientsSurgical patientsHospital proportionInpatient DatabasePostacute phaseComparison of Epidemiology of the Injuries and Outcomes in Two First‐Level Trauma Centers in Colombia Using the Pan‐American Trauma Registry System
Ramachandran A, Ranjit A, Zogg CK, Herrera‐Escobar J, Appelson JR, Pino LF, Aboutanous MB, Haider AH, Ordonez CA. Comparison of Epidemiology of the Injuries and Outcomes in Two First‐Level Trauma Centers in Colombia Using the Pan‐American Trauma Registry System. World Journal Of Surgery 2017, 41: 2224-2230. PMID: 28417184, DOI: 10.1007/s00268-017-4013-8.Peer-Reviewed Original ResearchConceptsTrauma centerMortality outcomesRisk-adjusted logistic regression analysesTertiary care trauma centerPropensity scoreHospital Universitario del ValleMultivariable logistic regression modelLevel trauma centerTrauma-related mortalityPresence of hypotensionTrauma Registry SystemComparable mean ageMechanism of injuryOdds of deathComparison of EpidemiologyLogistic regression analysisLogistic regression modelsHospital mortalityPatient demographicsGCS scoreTrauma registryInjury epidemiologyMean ageInsurance statusInsurance type
2016
Race-based differences in duration of stay among universally insured coronary artery bypass graft patients in military versus civilian hospitals
Chowdhury R, Davis WA, Chaudhary MA, Jiang W, Zogg CK, Schoenfeld AJ, Jaklitsch MT, Kaneko T, Learn PA, Haider AH, Schneider EB. Race-based differences in duration of stay among universally insured coronary artery bypass graft patients in military versus civilian hospitals. Surgery 2016, 161: 1090-1099. PMID: 27932028, DOI: 10.1016/j.surg.2016.10.022.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBlack or African AmericanCohort StudiesConfidence IntervalsCoronary Artery BypassCoronary Artery DiseaseDatabases, FactualFemaleHealthcare DisparitiesHospital MortalityHospitals, MilitaryHospitals, PublicHumansLength of StayMaleMiddle AgedPrognosisRegression AnalysisRisk AssessmentSurvival AnalysisTreatment OutcomeUnited StatesUniversal Health InsuranceWhite PeopleConceptsCoronary artery bypass graftArtery bypass graftCoronary artery bypass graft patientsDuration of stayBypass graft patientsBypass graftRace-based differencesGraft patientsBlack patientsMilitary HospitalCivilian hospitalsHospital-level factorsEligible patientsWhite patientsMale patientsCivilian facilitiesWhite racePatientsStayTRICARE coverageNegative binomial regressionHospitalApparent mitigationGraftGreater durationPredictors of emergency ventral hernia repair: Targets to improve patient access and guide patient selection for elective repair
Wolf LL, Scott JW, Zogg CK, Havens JM, Schneider EB, Smink DS, Salim A, Haider AH. Predictors of emergency ventral hernia repair: Targets to improve patient access and guide patient selection for elective repair. Surgery 2016, 160: 1379-1391. PMID: 27542434, DOI: 10.1016/j.surg.2016.06.027.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedAged, 80 and overConfidence IntervalsDatabases, FactualElective Surgical ProceduresEmergenciesFemaleFollow-Up StudiesHealth Services AccessibilityHernia, VentralHerniorrhaphyHospital MortalityHumansInsurance CoverageLogistic ModelsMaleMiddle AgedOdds RatioPatient SelectionPredictive Value of TestsQuality ImprovementRetrospective StudiesRisk AssessmentSeverity of Illness IndexSex FactorsTime FactorsTreatment OutcomeConceptsVentral hernia repairEmergency ventral hernia repairHospital-level factorsHernia repairIndependent predictorsPatient selectionElective operationsWorse outcomesEmergency repairLonger hospital stayNationwide Inpatient SampleMultivariable logistic regressionUnited States populationRace/ethnicityHospital deathHospital staySecondary outcomesElective repairPrimary outcomePayer statusInpatient SamplePatient outcomesVentral herniasElective careGreater oddsUse of National Burden to Define Operative Emergency General Surgery
Scott JW, Olufajo OA, Brat GA, Rose JA, Zogg CK, Haider AH, Salim A, Havens JM. Use of National Burden to Define Operative Emergency General Surgery. JAMA Surgery 2016, 151: e160480-e160480. PMID: 27120712, DOI: 10.1001/jamasurg.2016.0480.Peer-Reviewed Original ResearchConceptsEmergency general surgeryEGS proceduresInpatient costsNational burdenGeneral surgeryClinical Modification procedure codesPrimary EGS diagnosesDay of admissionOverall mortality ratePeptic ulcer diseaseSmall bowel resectionNational Inpatient SampleNational quality benchmarksHospital mortalityMost admissionsSurgical admissionsSurgical mortalityComplication burdenComplication rateMajor complicationsPartial colectomyRetrospective reviewUlcer diseaseEGS diagnosesNinth RevisionAre Older Adults With Hip Fractures Disadvantaged in Level 1 Trauma Centers?
Metcalfe D, Olufajo OA, Zogg CK, Gates JD, Weaver MJ, Harris MB, Rios-Diaz AJ, Haider AH, Salim A. Are Older Adults With Hip Fractures Disadvantaged in Level 1 Trauma Centers? Medical Care 2016, 54: 616-622. PMID: 26974676, DOI: 10.1097/mlr.0000000000000535.Peer-Reviewed Original ResearchConceptsLevel 1 trauma centerHigh-level trauma centersTrauma centerNontrauma centersHip fractureOlder adultsVenous thromboembolismPatient groupLevel 2 trauma centerIsolated hip fractureRetrospective cohort studyWorse clinical outcomesLength of stayLarge regional hospitalInhospital mortalityUnderwent surgeryUnplanned readmissionCohort studySurgical treatmentClinical outcomesInterhospital transferInpatient stayRegional hospitalHigher oddsBetter outcomesHospital case volume and outcomes for proximal femoral fractures in the USA: an observational study
Metcalfe D, Salim A, Olufajo O, Gabbe B, Zogg C, Harris MB, Perry DC, Costa ML. Hospital case volume and outcomes for proximal femoral fractures in the USA: an observational study. BMJ Open 2016, 6: e010743. PMID: 27056592, PMCID: PMC4838676, DOI: 10.1136/bmjopen-2015-010743.Peer-Reviewed Original ResearchConceptsHigh-volume hospitalsHip fractureObservational studyIsolated hip fractureRate of pneumoniaHip fracture careHospital case volumeLow-volume hospitalsProximal femoral fracturesLength of stayPatient safety imperativeHospital mortalityVenous thromboembolismSecondary outcomesFracture careClinical outcomesFemoral fracturesAcute hospitalsPatient outcomesInclusion criteriaPressure ulcersCase volumeHospitalOlder adultsOutcomesInfluence of sub-specialty surgical care on outcomes for pediatric emergency general surgery patients in a low-middle income country
Shah AA, Shakoor A, Zogg CK, Oyetunji T, Ashfaq A, Garvey EM, Latif A, Riviello R, Qureshi FG, Mateen A, Haider AH, Zafar H. Influence of sub-specialty surgical care on outcomes for pediatric emergency general surgery patients in a low-middle income country. International Journal Of Surgery 2016, 29: 12-18. PMID: 26971828, DOI: 10.1016/j.ijsu.2016.03.007.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAsia, SoutheasternChildChild, PreschoolDeveloping CountriesEmergency Service, HospitalFemaleGeneral SurgeryHealth ResourcesHospital MortalityHumansLength of StayMaleOutcome Assessment, Health CarePakistanPediatric Emergency MedicinePostoperative ComplicationsRetrospective StudiesConceptsLength of stayPediatric patientsPediatric surgeryPediatric surgeonsEmergency general surgical conditionsHigher risk-adjusted oddsEmergency general surgery patientsBetter post-operative outcomesAverage LOSAdult general surgeonsAdult general surgeryGeneral surgery patientsGeneral surgical teamRisk-adjusted oddsGeneral surgical conditionsGeneral surgery teamPost-operative outcomesMultivariable regression analysisPediatric surgical specialtiesChildren/adolescentsResource-constrained settingsResource-limited settingsLow-middle income countriesMost patientsSurgery patients