Robert Becher, MD, MS, FACS
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About
Research
Publications
2024
Immunotherapy Initiation at the End of Life in Patients With Metastatic Cancer in the US
Kerekes D, Frey A, Prsic E, Tran T, Clune J, Sznol M, Kluger H, Forman H, Becher R, Olino K, Khan S. Immunotherapy Initiation at the End of Life in Patients With Metastatic Cancer in the US. JAMA Oncology 2024, 10: 342-351. PMID: 38175659, PMCID: PMC10767643, DOI: 10.1001/jamaoncol.2023.6025.Peer-Reviewed Original ResearchNon-small cell lung cancerEnd of lifeMonth of deathImmunotherapy initiationCohort studyMAIN OUTCOMEStage IV non-small cell lung cancerCharlson-Deyo comorbidity indexHigh metastatic burdenInitiation of immunotherapyNational prescribing patternsRisk-adjusted patientsImmune checkpoint inhibitorsRetrospective cohort studyStage IV melanomaPercentage of patientsHigh-volume centersLocation of metastasesLow-volume centersOdds of deathCell lung cancerNational Clinical DatabaseLow-volume facilitiesDrug Administration approvalCheckpoint inhibitorsNational Estimates of Short- and Longer-Term Hospital Readmissions After Major Surgery Among Community-Living Older Adults
Wang Y, Leo-Summers L, Wyk B, Davis-Plourde K, Gill T, Becher R. National Estimates of Short- and Longer-Term Hospital Readmissions After Major Surgery Among Community-Living Older Adults. JAMA Network Open 2024, 7: e240028. PMID: 38416499, PMCID: PMC10902728, DOI: 10.1001/jamanetworkopen.2024.0028.Peer-Reviewed Original ResearchConceptsCenters for Medicare & Medicaid ServicesFee-for-serviceMedicare Advantage beneficiariesHospital readmissionUS residentsNational Health and Aging Trends Study dataCommunity-living older adultsProspective longitudinal cohort studyCommunity-living participantsRate of hospital readmissionLikelihood of hospital readmissionPopulation-based estimatesNationally representative estimatesSex-adjusted modelsCommunity-livingData linkageGeriatric conditionsMedicaid ServicesOlder personsOlder adultsMain OutcomesNational estimatesRepresentative estimatesData analysisCohort study
2023
Relationship Between Distressing Symptoms and Changes in Disability After Major Surgery Among Community-living Older Persons
Gill T, Han L, Feder S, Gahbauer E, Leo-Summers L, Becher R. Relationship Between Distressing Symptoms and Changes in Disability After Major Surgery Among Community-living Older Persons. Annals Of Surgery 2023, 279: 65-70. PMID: 37389893, PMCID: PMC10761592, DOI: 10.1097/sla.0000000000005984.Peer-Reviewed Original ResearchConceptsMajor surgeryDistressing symptomsElective surgeryFunctional outcomeOlder personsCommunity-living older personsMultiple distressing symptomsSocioeconomic disadvantageCommunity-living personsTiming of surgerySerious health eventsNumber of disabilitiesSurgerySignificant associationSymptomsHealth eventsRate ratioPotential targetDisabilityUnit increaseDeleterious effectsOutcomesPersonsMultimorbidityAdmission
2022
Population-Based Estimates of 1-Year Mortality After Major Surgery Among Community-Living Older US Adults
Gill TM, Vander Wyk B, Leo-Summers L, Murphy TE, Becher RD. Population-Based Estimates of 1-Year Mortality After Major Surgery Among Community-Living Older US Adults. JAMA Surgery 2022, 157: e225155. PMID: 36260323, PMCID: PMC9582971, DOI: 10.1001/jamasurg.2022.5155.Peer-Reviewed Original ResearchConceptsPopulation-based estimatesMajor surgeryMean survival timeOlder US adultsProbable dementiaUS adultsSurvival timeSex-adjusted hazard ratioProspective longitudinal cohort studyCommunity-living older adultsLongitudinal cohort studyPotential prognostic valueService Medicare beneficiariesNon-Hispanic blacksNon-Hispanic whitesAging Trends StudyGeriatric characteristicsCohort studyGeriatric surgeryHazard ratioNonelective surgeryElective surgeryGeriatric conditionsPrognostic valueMean ageThe effect of the COVID-19 pandemic on community violence in Connecticut
O'Neill KM, Dodington J, Gawel M, Borrup K, Shapiro DS, Gates J, Gregg S, Becher RD. The effect of the COVID-19 pandemic on community violence in Connecticut. The American Journal Of Surgery 2022, 225: 775-780. PMID: 36253316, PMCID: PMC9540704, DOI: 10.1016/j.amjsurg.2022.10.004.Peer-Reviewed Original ResearchConceptsCommunity violenceCOVID-19 pandemicTrauma registry dataViolence-related traumaLarge-scale morbiditySystemic healthPatient presentationRegistry dataPre-COVID periodTraumaLinear regression modelsCOVID periodNegative healthRegression modelsPandemicHealthCOVID pandemicMorbidityInjuryMortalityLatinx communitiesSocial inequitiesFactors Associated With Days Away From Home in the Year After Major Surgery Among Community-living Older Persons
Gill TM, Becher RD, Murphy TE, Gahbauer EA, Leo-Summers L, Han L. Factors Associated With Days Away From Home in the Year After Major Surgery Among Community-living Older Persons. Annals Of Surgery 2022, 278: e13-e19. PMID: 35837967, PMCID: PMC9840715, DOI: 10.1097/sla.0000000000005528.Peer-Reviewed Original ResearchConceptsHealth care facilitiesMajor surgeryAge 85 yearsCare facilitiesOlder personsRisk factorsNumber of daysLower peak expiratory flowCommunity-living older personsShort Physical Performance BatteryIndependent risk factorCommunity-living personsPhysical Performance BatteryPeak expiratory flowCandidate risk factorsQuality of lifeHospital dischargeMultivariable analysisExpiratory flowMedian numberPerformance BatteryMusculoskeletal surgerySurgeryMean differenceHospitalGeriatric vulnerability and the burden of disability after major surgery
Gill TM, Murphy TE, Gahbauer EA, Leo‐Summers L, Becher RD. Geriatric vulnerability and the burden of disability after major surgery. Journal Of The American Geriatrics Society 2022, 70: 1471-1480. PMID: 35199332, PMCID: PMC9106872, DOI: 10.1111/jgs.17693.Peer-Reviewed Original ResearchConceptsBurden of disabilityMajor surgeryGeriatric vulnerabilitiesHospital dischargeElective surgeryFunctional outcomeLong-term functional outcomeStrong epidemiologic evidenceCommunity-living personsPoor functional outcomeNon-elective surgeryProspective longitudinal studyAdditional vulnerability factorVulnerability factorsMultivariable analysisEpidemiologic evidenceSurgery increasesBlack raceDisability burdenFemale sexMore disabilityAge 85Hispanic ethnicitySurgeryOlder personsEvaluation of Firearm-related Reinjury in Connecticut: An Opportunity for Gun Violence Prevention
O'Neill KM, Jean RA, Dodington J, Davis K, Becher RD. Evaluation of Firearm-related Reinjury in Connecticut: An Opportunity for Gun Violence Prevention. Journal Of Surgical Research 2022, 274: 23-30. PMID: 35121547, DOI: 10.1016/j.jss.2021.12.009.Peer-Reviewed Original ResearchConceptsFirearm-related injuriesFirearm injuriesYale New Haven Health SystemMedical record dataChief Medical ExaminerCohort studyTrauma patientsGun violence preventionConnecticut OfficePatient controlsPatientsInjuryHealth systemRelevant covariatesPrevention effortsRecord dataViolence prevention effortsReinjuryMedical examinersMortalityFirearm violenceRiskViolence preventionHomicide mortalityYears
2021
The Incidence and Cumulative Risk of Major Surgery in Older Persons in the United States
Becher RD, Vander Wyk B, Leo-Summers L, Desai MM, Gill TM. The Incidence and Cumulative Risk of Major Surgery in Older Persons in the United States. Annals Of Surgery 2021, 277: 87-92. PMID: 34261884, PMCID: PMC8758792, DOI: 10.1097/sla.0000000000005077.Peer-Reviewed Original ResearchConceptsMajor surgeryOlder personsCumulative riskNational HealthCommunity-living older personsHigh-quality surgical careNon-frail groupPopulation-based incidenceService Medicare beneficiariesMedicaid Services dataCumulative risk estimatesProspective longitudinal studyUnited States agesAging Trends StudyGeriatric characteristicsRepresentative incidenceFrail groupAdjusted incidenceGeriatric populationProbable dementiaSurgical carePersons 85Medicare beneficiariesSurgeryVulnerable subgroupsNational trends in emergency department closures, mergers, and utilization, 2005-2015
Venkatesh AK, Janke A, Rothenberg C, Chan E, Becher RD. National trends in emergency department closures, mergers, and utilization, 2005-2015. PLOS ONE 2021, 16: e0251729. PMID: 34015007, PMCID: PMC8136839, DOI: 10.1371/journal.pone.0251729.Peer-Reviewed Original ResearchConceptsHospital-based EDsEmergency department closureED visitsHospital admissionHospital bedsED closureYearly ED visitsLarge health systemAmerican Hospital Association Annual SurveyInpatient bed capacityPrimary outcomeSecondary outcomesMore patientsEmergency departmentRelative increaseInpatient bedsPatient volumeRural areasHealth systemAdmissionVisitsNational trendsBed capacityEDObservational analysis
Clinical Care
Overview
Clinical Specialties
General Surgery, Trauma & Surgical Critical Care; Colorectal Surgery; Minimally Invasive Surgery
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Board Certifications
Surgical Critical Care Surgery
- Certification Organization
- AB of Surgery
- Original Certification Date
- 2021
General Surgery
- Certification Organization
- AB of Surgery
- Original Certification Date
- 1972
Yale Medicine News
Links & Media
News
- April 03, 2024
Understanding the Risks of Surgery in Older Adults
- March 01, 2024Source: HCPLive
Seniors Have Increased Hospital Readmission Risk Within 180 Days of Major Surgery
- February 28, 2024Source: YaleNews
Risk of Hospital Readmission After Surgery Is High for Older Americans
- January 04, 2024
Immunotherapy for Metastatic Cancer on the Rise, Even Near End of Life