2020
Urgent Care Centers Delay Emergent Surgical Care Based on Patient Insurance Status in The United States.
Hsiang WR, Wiznia D, Yousman L, Najem M, Mosier-Mills A, Jin G, Jain S, Khunte A, Davis KA, Forman HP, Schuster KM. Urgent Care Centers Delay Emergent Surgical Care Based on Patient Insurance Status in The United States. Annals Of Surgery 2020, 272: 548-553. PMID: 32932304, DOI: 10.1097/sla.0000000000004373.Peer-Reviewed Original ResearchMeSH KeywordsAmbulatory Care FacilitiesEmergency TreatmentHumansInsurance CoverageMedicaidSurgical Procedures, OperativeTime-to-TreatmentUnited StatesConceptsUrgent care centersMedicaid patientsCare centerInsurance typePrivate patientsEmergent surgical careEmergent surgical casesUrgent surgical conditionIncarcerated inguinal herniaEmergency department referralsPatient insurance statusED referralsInsurance statusReferral ratesInguinal herniaSurgical conditionsSurgical careSurgical casesPatientsPrivate insuranceCliniciansStandardized scriptMedicaidCareEmergent conditionsClosing 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 IV
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 managementHigh-performance acute care hospitals: Excelling across multiple emergency general surgery operations in the geriatric patient.
DeWane MP, Sukumar N, Stolar MJ, Gill TM, Maung AA, Schuster KM, Davis KA, Becher RD. High-performance acute care hospitals: Excelling across multiple emergency general surgery operations in the geriatric patient. Journal Of Trauma And Acute Care Surgery 2019, 87: 140-146. PMID: 31259872, PMCID: PMC7656193, DOI: 10.1097/ta.0000000000002273.Peer-Reviewed Original ResearchMeSH KeywordsAgedCaliforniaCluster AnalysisEmergenciesHospital MortalityHospitalsHumansSurgical Procedures, OperativeConceptsCommon EGS operationsEmergency general surgeryOlder patientsGeriatric patientsEmergency general surgery operationsEGS operationsCalifornia State Inpatient DatabaseGeneral surgery hospitalsPatients 65 yearsRisk-adjusted mortalitySurvival rates 1State Inpatient DatabasesGeneral surgery operationsClusters of hospitalsOperation typeHospital performanceEGS patientsSurgery HospitalInpatient DatabaseGroup of hospitalsGeriatric populationGeneral surgeryPatientsHospitalLevel IIITop-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-scoreAmerican Association for the Surgery of Trauma (AAST) emergency general surgery guidelines gap analysis
Schuster K, Davis K, Hernandez M, Holena D, Salim A, Crandall M. American Association for the Surgery of Trauma (AAST) emergency general surgery guidelines gap analysis. Journal Of Trauma And Acute Care Surgery 2019, Publish Ahead of Print: &na;. PMID: 30768554, DOI: 10.1097/ta.0000000000002226.Peer-Reviewed Original ResearchMeSH KeywordsEmergency TreatmentHumansNeeds AssessmentPractice Guidelines as TopicSocieties, MedicalSurgical Procedures, OperativeTraumatologyConceptsEmergency general surgeryEGS diseasesSmall bowel obstructionAcute care surgeryCommon disease statesAAST gradeAmerican AssociationBowel obstructionAcute cholecystitisTrauma gradeCare surgeryAcute pancreatitisAdditional researchGeneral surgeryDisease processPatient careSurgeryLiterature searchDiseaseDisease statesAdditional literature reviewLow-quality researchDiagnosisInitial gap analysisThorough assessmentHospital 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 increasePatientsEvaluating mortality outlier hospitals to improve the quality of care in emergency general surgery.
Becher RD, DeWane MP, Sukumar N, Stolar MJ, Gill TM, Maung AA, Schuster KM, Davis KA. Evaluating mortality outlier hospitals to improve the quality of care in emergency general surgery. Journal Of Trauma And Acute Care Surgery 2019, 87: 297-306. PMID: 30908450, PMCID: PMC6660354, DOI: 10.1097/ta.0000000000002271.Peer-Reviewed Original ResearchMeSH KeywordsCaliforniaEmergenciesFemaleHospital MortalityHospitalsHumansMaleMiddle AgedQuality ImprovementQuality Indicators, Health CareSurgical Procedures, OperativeConceptsStandardized mortality ratioOutlier hospitalsHospital variationMortality ratioStandardized mortalityEmergency general surgery operationsCalifornia State Inpatient DatabaseEGS operationsCommon EGS operationsSignificant hospital variationEmergency general surgeryHospital-level characteristicsHospital-level variablesSignificant excess mortalityGeneral surgery operationsState Inpatient DatabasesQuality improvement initiativesQuality of careHospital quality indicatorsNational Quality ForumEGS outcomesInpatient DatabaseExcess mortalityOnly hospitalEpidemiologic studies
2017
The capacity of ICD-10-CM/PCS to characterize surgical care
Utter GH, Schuster KM, Miller PR, Mowery NT, Agarwal SK, Winchell RJ, Crandall ML. The capacity of ICD-10-CM/PCS to characterize surgical care. Journal Of Trauma And Acute Care Surgery 2017, 83: 894-898. PMID: 28538626, DOI: 10.1097/ta.0000000000001592.Peer-Reviewed Original ResearchClinical CodingHumansInternational Classification of DiseasesSurgical Procedures, OperativeUnited States
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
2009
Emergency and Urgent Surgery
Schuster KM, Davis KA, Rosenbaum SH. Emergency and Urgent Surgery. Medical Clinics Of North America 2009, 93: 1131-1148. PMID: 19665625, DOI: 10.1016/j.mcna.2009.05.011.Peer-Reviewed Original ResearchConceptsAggressive resuscitative effortsEarly surgical consultationGeneral surgical emergenciesGeneral surgical conditionsEmergency surgical careHealth care providersAggressive resuscitationUrgent surgeryPostoperative periodSurgical emergencyIll patientsSurgical illnessSurgical consultationSurgical interventionResuscitative effortsSurgical conditionsSurgical careCare providersPatientsTherapeutic interventionsInterventionSelect subsetEmergencyOpen communicationSurgery