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 trauma
2020
Spirometry not pain level predicts outcomes in geriatric patients with isolated rib fractures.
Schuster KM, Sanghvi M, O'Connor R, Becher R, Maung AA, Davis KA. Spirometry not pain level predicts outcomes in geriatric patients with isolated rib fractures. Journal Of Trauma And Acute Care Surgery 2020, 89: 947-954. PMID: 32467465, DOI: 10.1097/ta.0000000000002795.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overEmergency Service, HospitalFemaleHand StrengthHospitals, RehabilitationHumansIntensive Care UnitsLength of StayMalePainPain ManagementPain MeasurementPatient DischargePatient TransferPredictive Value of TestsProspective StudiesRib FracturesSpirometryTrauma CentersTreatment OutcomeConceptsLength of stayIsolated rib fracturesNegative inspiratory forceUnplanned ICU admissionRib fracturesPain levelsDay 1ICU admissionInspiratory forceGrip strengthMedian LOSHospital day 1Expiratory volume 1Complete spirometryPain controlDischarge dispositionPulmonary functionEarly dischargeGeriatric patientsVital capacityMean ageSpirometry measuresPulmonary capacityLevel IVFEV1Mapping the increasing interest in acute care surgery-Who, why and which fellowship?
Gayed BN, Zarzaur BL, Livingston DH, Chiu WC, Davis KA, Tisherman SA, Alam HB, Spain DA. Mapping the increasing interest in acute care surgery-Who, why and which fellowship? Journal Of Trauma And Acute Care Surgery 2020, 88: 629-635. PMID: 32320176, DOI: 10.1097/ta.0000000000002585.Peer-Reviewed Original ResearchConceptsAcute care surgerySurgery of TraumaPractice patternsCare surgeryFellowship typeClinical interestSurgical critical careFellowship yearDifferent fellowshipPrimary clinical interestAmerican AssociationFisher's exactCritical careLevel IVPearson χFellowship program directorsTrauma surgeryResponse rateSurgeryOperative experienceFellowship pathwaysTrauma trainingMost fellowsRecent traineesFellowship choicesHospital 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
High-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 ResearchConceptsCommon 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-scoreContemporary 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 increasePatientsThe Economic Footprint of Acute Care Surgery in the United States
Knowlton LM, Minei J, Tennakoon L, Davis KA, Doucet J, Bernard A, Haider A, Scherer L, Spain DA, Staudenmayer KL. The Economic Footprint of Acute Care Surgery in the United States. Journal Of Trauma And Acute Care Surgery 2019, Publish Ahead of Print: &na;. PMID: 30589750, PMCID: PMC6433481, DOI: 10.1097/ta.0000000000002181.Peer-Reviewed Original ResearchConceptsAcute care surgeryEmergency general surgeryACS patientsClinical Modification diagnosisInpatient populationInternational ClassificationAdult ACS patientsNon-surgical patientsHealth care utilizationHigher mean costSurgical critical careNonoperative conditionsACS diagnosisAdult patientsPatient characteristicsCare surgeryCare utilizationAdult admissionsEGS conditionsInpatient costsInpatient hospitalizationCritical careGeneral surgeryMean costPatientsEvaluation 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 SampleChanges in Discharge to Rehabilitation: Potential Unintended Consequences of Medicare Total Hip Arthroplasty/Total Knee Arthroplasty Bundled Payments, Should They Be Implemented on a Nationwide Scale?
Zogg CK, Falvey JR, Dimick JB, Haider AH, Davis KA, Grauer JN. Changes in Discharge to Rehabilitation: Potential Unintended Consequences of Medicare Total Hip Arthroplasty/Total Knee Arthroplasty Bundled Payments, Should They Be Implemented on a Nationwide Scale? The Journal Of Arthroplasty 2019, 34: 1058-1065.e4. PMID: 30878508, PMCID: PMC6884960, DOI: 10.1016/j.arth.2019.01.068.Peer-Reviewed Original ResearchMeSH KeywordsAgedArthroplasty, Replacement, HipArthroplasty, Replacement, KneeComputer SimulationDecision TreesElective Surgical ProceduresHumansMedicareMiddle AgedMonte Carlo MethodPatient DischargePatient Protection and Affordable Care ActPatient ReadmissionQuality of LifeRehabilitationReimbursement MechanismsSkilled Nursing FacilitiesUnited StatesConceptsExtent of therapyHealth-related qualityType of rehabilitationFunctional recoveryPatients' health-related qualitySkilled nursing facility useElective total hipPrimary TKA patientsOutcomes of patientsPatient-centered outcomesPatients' functional recoveryInpatient rehabilitation facilityNursing facility useEpisode of careAverage functional outcomeBundled payment programsDischarge dispositionTKA patientsUnplanned readmissionTotal hipFunctional outcomeAffordable Care ActOutcome measuresRehabilitation facilityBundled Payments
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 dataInsurance 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 careTransfer 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 imagingCholecystitisBilirubinCholelithiasisPatientsInterventionColicLevelsVenous Thromboembolism-Related Readmission in Emergency General Surgery Patients: A Role for Prophylaxis on Discharge?
DeWane MP, Davis KA, Schuster KM, Maung AA, Becher RD. Venous Thromboembolism-Related Readmission in Emergency General Surgery Patients: A Role for Prophylaxis on Discharge? Journal Of The American College Of Surgeons 2018, 226: 1072-1077.e3. PMID: 29574180, DOI: 10.1016/j.jamcollsurg.2018.03.021.Peer-Reviewed Original ResearchConceptsVenous thromboembolismEmergency general surgery operationsPost-discharge venous thromboembolismEmergency general surgery patientsMultivariable logistic regression modelingCommon EGS operationsGeneral surgery patientsRate of readmissionUrinary tract infectionSurgeons NSQIP databaseHigh-risk groupGeneral surgery operationsLogistic regression modelingEGS operationsProphylactic anticoagulationVTE formationVTE prophylaxisVTE ratesEGS patientsPostoperative sepsisNSQIP databaseProlonged lengthSurgery patientsTract infectionsPredictive factorsRisk of Surgical Site Infection (SSI) following Colorectal Resection Is Higher in Patients With Disseminated Cancer: An NCCN Member Cohort Study
Kamboj M, Childers T, Sugalski J, Antonelli D, Bingener-Casey J, Cannon J, Cluff K, Davis KA, Dellinger EP, Dowdy SC, Duncan K, Fedderson J, Glasgow R, Hall B, Hirsch M, Hutter M, Kimbro L, Kuvshinoff B, Makary M, Morris M, Nehring S, Ramamoorthy S, Scott R, Sovel M, Strong V, Webster A, Wick E, Aguilar JG, Carlson R, Sepkowitz K. Risk of Surgical Site Infection (SSI) following Colorectal Resection Is Higher in Patients With Disseminated Cancer: An NCCN Member Cohort Study. Infection Control And Hospital Epidemiology 2018, 39: 555-562. PMID: 29553001, PMCID: PMC6707075, DOI: 10.1017/ice.2018.40.Peer-Reviewed Original ResearchConceptsSurgical site infectionDisseminated cancerHealthcare-associated infectionsSSI ratesColorectal surgeryASA scoreSite infectionSSI riskColorectal proceduresRate of SSIRisk of SSIDevelopment of SSICommon healthcare-associated infectionsChronic obstructive pulmonary diseaseInfect Control Hosp EpidemiolBackgroundSurgical site infectionCurrent Procedural Technology codesPooled SSI rateNational Comprehensive Cancer Network (NCCN) member institutionsObstructive pulmonary diseaseClinical Modification codesLonger durationPotential risk factorsRisk-adjusted outcomesSurgical quality improvementA 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 disease