2023
Changes in Older Adult Trauma Quality When Evaluated Using Longer-Term Outcomes vs In-Hospital Mortality
Zogg C, Cooper Z, Peduzzi P, Falvey J, Castillo-Angeles M, Kodadek L, Staudenmayer K, Davis K, Tinetti M, Lichtman J. Changes in Older Adult Trauma Quality When Evaluated Using Longer-Term Outcomes vs In-Hospital Mortality. JAMA Surgery 2023, 158: e234856. PMID: 37792354, PMCID: PMC10551815, DOI: 10.1001/jamasurg.2023.4856.Peer-Reviewed Original ResearchConceptsHospital-level factorsTraumatic brain injurySevere traumatic brain injuryHospital mortalityTrauma QualityOlder adultsHip fractureComposite scoreHigher risk-adjusted oddsLevel 1 trauma centerIn-Hospital MortalityRisk-adjusted oddsLong-term outcomesMultivariable logistic regressionNontrauma centersTrauma patientsTerm outcomesTrauma centerPrimary diagnosisBrain injuryTrauma systemMAIN OUTCOMEMedicare feeService claimsForms of traumaEmergency general surgery verification: Quality improvement and the case for optimal resources and process standards
Coleman J, Davis K, Savage S, Staudenmayer K, Coimbra R. Emergency general surgery verification: Quality improvement and the case for optimal resources and process standards. Journal Of Trauma And Acute Care Surgery 2023, 96: e1-e4. PMID: 37678150, DOI: 10.1097/ta.0000000000004135.Peer-Reviewed Original ResearchMeSH KeywordsEmergenciesGeneral SurgeryHospitalsHumansPostoperative ComplicationsQuality ImprovementRegistriesRetrospective StudiesSurgical Procedures, OperativeConceptsEmergency general surgeryEmergency surgical interventionDay of surgeryAcute care surgeryPublic health burdenQuality Improvement ProgramPostoperative complicationsCare surgeryHospital admissionIll patientsSurgical interventionFormal quality improvement programHealth burdenGeneral surgeryPatient careCare deliverySurgeryPrograms/servicesField of traumaOutcomes researchPatientsAdmissionHospitalNational databankPractice standardsRoutine post-operative labs and healthcare system burden in acute appendicitis
Sznol J, Becher R, Maung A, Bhattacharya B, Davis K, Schuster K. Routine post-operative labs and healthcare system burden in acute appendicitis. The American Journal Of Surgery 2023, 226: 571-577. PMID: 37291012, DOI: 10.1016/j.amjsurg.2023.06.005.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAppendectomyAppendicitisComorbidityDelivery of Health CareHealth Care CostsHumansRetrospective StudiesConceptsHealthcare system burdenSystem burdenHealth care costsAppendicitis managementIncreased LOSUncomplicated AAAcute appendicitisRetrospective cohortClinical courseClinical variablesPatient populationMinimal comorbiditiesMultivariable modelingHealthcare costsCare costsPatientsLaboratory utilizationNational Health Expenditure AccountsLab utilizationLaboratory testingBurdenLaboratory testsAppendicitisComorbiditiesCohortPalliative Care in a Pandemic: A Multicenter Cohort of Critically Ill Patients with Coronavirus Disease 2019
Kodadek L, Moore M, Miller S, Schneider E, Ahuja V, Maerz L, Davis K. Palliative Care in a Pandemic: A Multicenter Cohort of Critically Ill Patients with Coronavirus Disease 2019. Surgical Infections 2023, 24: 190-198. PMID: 36757283, PMCID: PMC10081705, DOI: 10.1089/sur.2022.377.Peer-Reviewed Original ResearchMeSH KeywordsAdultCOVID-19Critical IllnessHumansIntensive Care UnitsPalliative CarePandemicsRetrospective StudiesSARS-CoV-2ConceptsIntensive care unitPalliative careIll patientsCoronavirus disease 2019Life careClinical characteristicsMechanical ventilationDisease 2019Acute respiratory syndrome coronavirus 2 infectionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectionSyndrome coronavirus 2 infectionCoronavirus 2 infectionPalliative care consultationPalliative care servicesCOVID-19Outcomes of interestHospital lengthAdult patientsComorbid diseasesDisease courseMulticenter cohortCare unitCare consultationsVaccination dataPatients
2020
Geographic Variation in the Utilization of and Mortality After Emergency General Surgery Operations in the Northeastern and Southeastern United States
Becher RD, Jin L, Warren JL, Gill TM, DeWane MP, Davis KA, Zhang Y. Geographic Variation in the Utilization of and Mortality After Emergency General Surgery Operations in the Northeastern and Southeastern United States. Annals Of Surgery 2020, 275: 340-347. PMID: 32516232, PMCID: PMC7726051, DOI: 10.1097/sla.0000000000003939.Peer-Reviewed Original ResearchConceptsHospital service areasSubsequent mortalityEmergency general surgery careEmergency general surgery operationsEGS operationsCommon EGS operationsAge-standardized ratesGeneral surgery careState Inpatient DatabasesGeneral surgery operationsRandom-effects modelWide geographic variationHospital mortalityInpatient DatabaseSurgery careKruskal-Wallis testMortality rateUnwarranted variationMortalityStandardized ratesLinear random effects modelSurgery operationsUnited StatesGeographic variationCareThe effect of anticoagulation on outcomes after liver and spleen injuries: A research consortium of New England centers for trauma (ReCONECT) study
Bhattacharya B, Askari R, Davis KA, Dorfman J, Eid AI, Elsharkawy AE, Kasotakis G, Mackey S, Odom S, Okafor BU, Rosenblatt M, Ruditsky A, Velmahos G, Maung AA. The effect of anticoagulation on outcomes after liver and spleen injuries: A research consortium of New England centers for trauma (ReCONECT) study. Injury 2020, 51: 1994-1998. PMID: 32482426, DOI: 10.1016/j.injury.2020.05.002.Peer-Reviewed Original ResearchMeSH KeywordsAnticoagulantsHumansInjury Severity ScoreLiverMiddle AgedNew EnglandRetrospective StudiesSpleenTrauma CentersWounds, NonpenetratingConceptsNon-ACS patientsEffect of anticoagulationNon-operative managementSpleen injurySplenic injuryLiver injuryInitial non-operative managementSignificant differencesUse of anticoagulationBlood product transfusionMulticenter retrospective studyAC drugsMore PRBCsInjury gradeProduct transfusionCommon indicationAC patientsAtrial fibrillationRetrospective studyAnticoagulationSolid organsPatientsInjuryStudy periodLiverHospital 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
Contemporary management of spontaneous retroperitoneal and rectus sheath hematomas
Warren MH, Bhattacharya B, Maung AA, Davis KA. Contemporary management of spontaneous retroperitoneal and rectus sheath hematomas. The American Journal Of Surgery 2019, 219: 707-710. PMID: 31109633, DOI: 10.1016/j.amjsurg.2019.05.002.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAngiographyAnticoagulantsBlood Component TransfusionEmbolization, TherapeuticFemaleHematomaHumansInternational Normalized RatioLength of StayMaleMiddle AgedPlatelet Aggregation InhibitorsProthrombin TimeRectal DiseasesRetroperitoneal SpaceRetrospective StudiesShock, HemorrhagicTomography, X-Ray ComputedConceptsSheath hematomaSurgical interventionBlood product transfusionOptimal treatment strategySpontaneous retroperitonealIntravenous heparinProduct transfusionAdult patientsMedian ageAntiplatelet agentsHemorrhagic shockDisease progressionBlood productsTreatment strategiesCT scanHematomaOutcome dataPatientsOne-year periodContemporary managementSpecific agentsAngioembolizationRetroperitonealInterventionAgentsHospital 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 increasePatientsSymptomatic 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 ratesTotal 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 imagingCholecystitisBilirubinCholelithiasisPatientsInterventionColicLevelsValidation of a new American Association for the Surgery of Trauma (AAST) anatomic severity grading system for acute cholecystitis
Vera K, Pei KY, Schuster KM, Davis KA. Validation of a new American Association for the Surgery of Trauma (AAST) anatomic severity grading system for acute cholecystitis. Journal Of Trauma And Acute Care Surgery 2018, 84: 650-654. PMID: 29271871, DOI: 10.1097/ta.0000000000001762.Peer-Reviewed Original ResearchConceptsLength of stayAcute cholecystitisICU useGrade 2Anatomic gradingAdverse eventsGrade 1Longer LOSAnatomic grading systemGrade 1 diseaseEmergency general surgeryGrade 3 patientsRetrospective cohort studyIncidence of complicationsMajority of patientsTertiary medical centerLow-grade diseaseSurgery of TraumaRisk-adjusted outcomesGood inter-rater reliabilityAAST gradeAmerican AssociationCholecystitis severityCohort studyConsecutive patientsA simple predictor of post-operative complications after open surgical adhesiolysis for small bowel obstruction
Asuzu D, Pei KY, Davis KA. A simple predictor of post-operative complications after open surgical adhesiolysis for small bowel obstruction. The American Journal Of Surgery 2018, 216: 67-72. PMID: 29548529, DOI: 10.1016/j.amjsurg.2018.02.031.Peer-Reviewed Original ResearchConceptsPost-operative complicationsSmall bowel obstructionBowel obstructionOpen lysisSurgical managementSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseAdhesive small bowel obstructionQuality Improvement Program databaseImprovement Program databaseAvailable clinical parametersPrior sepsisAnesthesiologists classificationClinical parametersSurgical adhesiolysisFunctional statusProgram databaseAmerican CollegeComplicationsObstructionLogistic regressionPreoperative modelCharacteristic curveAmerican SocietyFASComparison 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 diseaseExternal Validation of University of Wisconsin's Clinical Criteria for Obtaining Maxillofacial Computed Tomography in Trauma
Harrington AW, Pei KY, Assi R, Davis KA. External Validation of University of Wisconsin's Clinical Criteria for Obtaining Maxillofacial Computed Tomography in Trauma. Journal Of Craniofacial Surgery 2018, 29: e167-e170. PMID: 29309356, DOI: 10.1097/scs.0000000000004240.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedEcchymosisFacial BonesFacial InjuriesFemaleGlasgow Coma ScaleHospitals, UniversityHumansMaleMalocclusionMiddle AgedPhysical ExaminationPractice Guidelines as TopicPredictive Value of TestsRetrospective StudiesSkull FracturesTomography, X-Ray ComputedTooth LossTrauma CentersWisconsinConceptsLevel 1 trauma centerTrauma centerFacial fracturesClinical criteriaPredictive valueAdditional cross-sectional imagingModern practice patternsPhysical examination criteriaCross-sectional imagingNegative predictive valueMaxillofacial computed tomographyPositive predictive valueElectronic medical recordsRetrospective case studyMultisystem traumaPhysical examinationMaxillofacial fracturesBoard-certified radiologistsMedical recordsPractice patternsComputed tomographyFacial bonesConfidence intervalsInternal validation studyExamination criteriaSurgeons overestimate postoperative complications and death when compared with the National Surgical Quality Improvement Project risk calculator
Pei KY, Healy J, Davis KA. Surgeons overestimate postoperative complications and death when compared with the National Surgical Quality Improvement Project risk calculator. Journal Of Surgical Research 2018, 225: 95-100. PMID: 29605041, DOI: 10.1016/j.jss.2018.01.008.Peer-Reviewed Original ResearchConceptsComplex surgical patientsGeneral surgery residentsSurgical patientsRisk calculatorNational Surgical Quality Improvement ProjectSurgical Quality Improvement ProjectSurgery residentsSurgical site infectionOverall response rateSurgical Risk CalculatorPrediction of morbidityQuality improvement projectRisk-adjusted modelsCardiac complicationsPostoperative complicationsPostoperative morbiditySite infectionSurgical riskComplex patientsAmerican CollegeClinical scenariosMorbidityResponse rateComplicationsPatientsRelationship 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 useProphylactic Ureteral Stent Placement vs No Ureteral Stent Placement During Open Colectomy
Merola J, Arnold B, Luks V, Ibarra C, Resio B, Davis KA, Pei KY. Prophylactic Ureteral Stent Placement vs No Ureteral Stent Placement During Open Colectomy. JAMA Surgery 2018, 153: 87-90. PMID: 28973647, PMCID: PMC5833617, DOI: 10.1001/jamasurg.2017.3477.Peer-Reviewed Original Research
2017
Natural history of splenic vascular abnormalities after blunt injury
Zarzaur BL, Dunn JA, Leininger B, Lauerman M, Shanmuganathan K, Kaups K, Zamary K, Hartwell JL, Bhakta A, Myers J, Gordy S, Todd SR, Claridge JA, Teicher E, Sperry J, Privette A, Allawi A, Burlew CC, Maung AA, Davis KA, Cogbill T, Bonne S, Livingston DH, Coimbra R, Kozar RA. Natural history of splenic vascular abnormalities after blunt injury. Journal Of Trauma And Acute Care Surgery 2017, 83: 999-1005. PMID: 28570347, DOI: 10.1097/ta.0000000000001597.Peer-Reviewed Original ResearchConceptsBlunt splenic injurySplenic vascular injuryVascular injuryVascular abnormalitiesSplenic injuryTomography scanNatural historyRisks of splenectomyOutcomes of patientsComputed tomography scanNonoperative failureAdult patientsBlunt injuryEarly splenectomyUnderwent splenectomyInjury characteristicsMultivariable analysisTrauma centerTrauma radiologistSplenectomyHigh riskPrognostic studiesPatientsAppropriate managementLevel III