2023
Early 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 ResearchConceptsVenous 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 review
2019
Regionalization of emergency general surgery operations: A simulation study.
Becher RD, Sukumar N, DeWane MP, Gill TM, Maung AA, Schuster KM, Stolar MJ, Davis KA. Regionalization of emergency general surgery operations: A simulation study. Journal Of Trauma And Acute Care Surgery 2019, 88: 366-371. PMID: 31804419, PMCID: PMC7472889, DOI: 10.1097/ta.0000000000002543.Peer-Reviewed Original ResearchConceptsEmergency general surgeryHigh-volume hospitalsEGS careEmergency general surgery operationsCalifornia inpatient databaseCommon EGS operationsRisk-adjusted deathsSignificant survival benefitLow-volume hospitalsUmbilical hernia repairSmall bowel resectionHigh-mortality hospitalsGeneral surgery operationsRegional trauma systemEGS operationsBowel resectionAdult patientsPrimary outcomeSurvival benefitInpatient DatabaseHernia repairTrauma systemLevel IVGeneral surgeryCare managementTop-tier emergency general surgery hospitals: Good at one operation, good at them all.
DeWane MP, Sukumar N, Stolar MJ, Gill TM, Maung AA, Schuster KM, Davis KA, Becher RD. Top-tier emergency general surgery hospitals: Good at one operation, good at them all. Journal Of Trauma And Acute Care Surgery 2019, 87: 289-296. PMID: 31349347, PMCID: PMC6771423, DOI: 10.1097/ta.0000000000002367.Peer-Reviewed Original ResearchConceptsRisk-adjusted mortalityEGS hospitalsHospital risk-adjusted mortalityOperation typeEGS operationsCalifornia State Inpatient DatabaseGeneral surgery hospitalsHospital-level factorsAcute care hospitalsState Inpatient DatabasesAmerican Hospital Association databasePoor-performing hospitalsSystems of careLow-risk operationAssessment of mortalityAdult patientsCare hospitalSurgery HospitalInpatient DatabaseHospital characteristicsMultinomial logistic regressionMortality rateHospitalLevel IIIZ-scoreThe 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 characteristicsEvaluation of Swallow Function Post-Extubation: Is It Necessary to Wait 24 Hours?
Leder SB, Warner HL, Suiter DM, Young NO, Bhattacharya B, Siner JM, Davis KA, Maerz LL, Rosenbaum SH, Marshall PS, Pisani MA, Siegel MD, Brennan JJ, Schuster KM. Evaluation of Swallow Function Post-Extubation: Is It Necessary to Wait 24 Hours? Annals Of Otology Rhinology & Laryngology 2019, 128: 619-624. PMID: 30841709, DOI: 10.1177/0003489419836115.Peer-Reviewed Original ResearchConceptsIntensive care unitSwallow evaluationDifferent intensive care unitsRe-intubation rateYale Swallow ProtocolMajority of patientsPost-extubation dysphagiaIntubation durationNosocomial pneumoniaPost extubationLonger hospitalizationCare unitProspective InvestigationSwallow ProtocolSwallowingHoursDysphagiaHospitalizationIntubationPneumoniaPatientsIncidenceEvaluationSymptomatic 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 ratesInsurance Status Biases Trauma-system Utilization and Appropriate Interfacility Transfer
Zogg CK, Schuster KM, Maung AA, Davis KA. Insurance Status Biases Trauma-system Utilization and Appropriate Interfacility Transfer. Annals Of Surgery 2018, 268: 681-689. PMID: 30004929, DOI: 10.1097/sla.0000000000002954.Peer-Reviewed Original ResearchConceptsNTC patientsMajor injuriesOlder adult trauma patientsNationwide Emergency Department SampleOptimal trauma careAdult trauma patientsEmergency department admissionsEmergency Department SampleTrauma center careTransfer of patientsComplex traumatic injuriesMultilevel logistic regressionTrauma patientsDepartment admissionsHigh morbidityTC careDirect admissionInsurance statusInterfacility transferUninsured patientsTrauma careTraumatic injuryOutcome measuresTrauma systemCenter careCan acute care surgeons perform while fatigued? An EAST multicenter study
Schuster KM, Hazelton JP, Rattigan D, Nguyen L, Kim D, Spence LH, Turay D, Luo-Owen X, Perez JM, Dayal S, Blatt M, Hill C, Bhattacharya B. Can acute care surgeons perform while fatigued? An EAST multicenter study. Journal Of Trauma And Acute Care Surgery 2018, 85: 476-484. PMID: 29787535, DOI: 10.1097/ta.0000000000001975.Peer-Reviewed Original ResearchConceptsAcute care surgeonsMajor morbidityPatient outcomesAcute care surgery serviceEAST multicenter studyPatient-level factorsEmergency casesFour-level ordinal scaleHours of sleepHierarchical logistic regression modelsImpact of fatigueLogistic regression modelsPatient factorsFemale patientsSurgery serviceMulticenter studyLevel IVImmediate operationPrognostic studiesSleep timePatient volumeSimilar outcomesMorbiditySurgeonsMortalityTransfer 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 decompensationTotal 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 imagingCholecystitisBilirubinCholelithiasisPatientsInterventionColicLevelsRelationship 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
Uncertainty Among Acute Care Surgery Providers Does Not Change with Experience.
Bhattacharya B, Maung A, Schuster K, Davis KA. Uncertainty Among Acute Care Surgery Providers Does Not Change with Experience. Connecticut Medicine 2017, 81: 133-139. PMID: 29772154.Peer-Reviewed Original Research
2016
Outcomes 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
Gun buyback programs
Violano P, Driscoll C, Chaudhary NK, Schuster KM, Davis KA, Borer E, Winters JK, Hirsh MP. Gun buyback programs. Journal Of Trauma And Acute Care Surgery 2014, 77: s46-s50. PMID: 25153055, DOI: 10.1097/ta.0000000000000319.Peer-Reviewed Original ResearchConceptsGun buyback programsAverage median household incomeForging of relationshipsLocal policeBuyback programsGun violenceLaw enforcementUnintentional firearm-related injuriesCriminal actsGun ownersMore firearmsSchool communityGun locksInterpersonal violenceInjury Free CoalitionChildren's accessViolenceFirearms trainingFirearmsUnited StatesHousehold incomeWeaponsMedian household incomeSurvey resultsFormal trainingThe 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 OUTCOMEPatientsPredictive factors for failure of nonoperative management in perforated appendicitis
Maxfield MW, Schuster KM, Bokhari J, McGillicuddy EA, Davis KA. Predictive factors for failure of nonoperative management in perforated appendicitis. Journal Of Trauma And Acute Care Surgery 2014, 76: 976-981. PMID: 24662860, DOI: 10.1097/ta.0000000000000187.Peer-Reviewed Original ResearchConceptsNonoperative managementAbdominal tendernessFailure groupIntensive care unit careUniversity tertiary care hospitalTertiary care hospitalLength of stayUnit careCare hospitalDefinitive treatmentLaboratory markersPerforated appendicitisNonsurgical treatmentClinical findingsPredictive factorsRadiographic findingsTomographic scanTherapeutic studiesAppendicitisEarly operationLevel IIIPatientsAbscessPhlegmonTachycardia
2013
Repositioning endotracheal tubes in the intensive care unit
Wang ML, Schuster KM, Bhattacharya B, Maung AA, Kaplan LJ, Davis KA. Repositioning endotracheal tubes in the intensive care unit. Journal Of Trauma And Acute Care Surgery 2013, 75: 146-149. PMID: 23940860, DOI: 10.1097/ta.0b013e31829849cd.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedChi-Square DistributionCohort StudiesCritical CareCritical IllnessFemaleFollow-Up StudiesHumansIntensive Care UnitsIntubation, IntratrachealLinear ModelsMaleMiddle AgedMonitoring, PhysiologicMultivariate AnalysisPatient PositioningProspective StudiesRadiography, ThoracicRetreatmentRisk AssessmentTracheaConceptsEndotracheal tubeSurgical intensive care unit patientsIntensive care unit patientsChest X-ray studyRoutine chest radiographCare unit patientsProspective observational studyIntensive care unitInterquartile rangeUnit patientsCare unitWithdrawal groupRespiratory therapistsChest radiographsObservational studyInclusion criteriaMedian withdrawalET withdrawalMean differencePatientsSuboptimal positioningInterventionIncisorsMedianWithdrawalRoutine Nasogastric Decompression in Small Bowel Obstruction: Is it Really Necessary?
Fonseca AL, Schuster KM, Maung AA, Kaplan LJ, Davis KA. Routine Nasogastric Decompression in Small Bowel Obstruction: Is it Really Necessary? The American Surgeon 2013, 79: 422-428. PMID: 23574854, DOI: 10.1177/000313481307900433.Peer-Reviewed Original ResearchConceptsSmall bowel obstructionNasogastric decompressionHospital lengthNG decompressionBowel obstructionRespiratory failureDiagnosis of SBOYale-New Haven HospitalNasogastric tube useRisk of pneumoniaRoutine nasogastric decompressionDevelopment of pneumoniaRetrospective chart reviewNew Haven HospitalBowel restIntravenous hydrationChart reviewAdult patientsTube useNGT placementPatientsStayOutcome variablesDecompressionNGT