2021
Frailty is a stronger predictor than age for postoperative morbidity in Crohn’s disease
Wolf JH, Hassab T, D'Adamo CR, Svoboda S, Demos J, Ahuja V, Katlic M. Frailty is a stronger predictor than age for postoperative morbidity in Crohn’s disease. Surgery 2021, 170: 1061-1065. PMID: 34059345, DOI: 10.1016/j.surg.2021.04.030.Peer-Reviewed Original ResearchConceptsSimplified Frailty IndexNational Surgical Quality Improvement ProgramFrailty indexCrohn's diseaseBowel resectionPostoperative morbiditySurgical Quality Improvement ProgramLogistic regression modelingStrongest predictorQuality Improvement ProgramAggregate morbidityNSQIP definitionsPreoperative frailtyImmunosuppressive therapyPostoperative outcomesSurgical candidacyChronic natureMorbidityFunctional assessmentFrailtyResectionDiseaseOlder individualsPotential predictorsPatients
2020
Frailty is a better predictor than age for outcomes in geriatric patients with rectal cancer undergoing proctectomy
Miller SM, Wolf J, Katlic M, D'Adamo CR, Coleman J, Ahuja V. Frailty is a better predictor than age for outcomes in geriatric patients with rectal cancer undergoing proctectomy. Surgery 2020, 168: 504-508. PMID: 32665144, DOI: 10.1016/j.surg.2020.05.027.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsAgedAged, 80 and overClinical Decision-MakingFeasibility StudiesFemaleFrail ElderlyFrailtyGeriatric AssessmentHospital MortalityHumansLogistic ModelsMaleMiddle AgedPostoperative ComplicationsProctectomyRectal NeoplasmsRetrospective StudiesRisk AssessmentRisk FactorsTreatment OutcomeYoung AdultConceptsRectal cancerOlder ageFrailty indexNational Quality Improvement Program databaseQuality Improvement Program databaseNational quality improvement programImprovement Program databasePoor postoperative outcomesPredictor of morbidityPrimary rectal cancerAdverse surgical outcomesQuality Improvement ProgramFrail patientsOlder patientsPatient agePostoperative outcomesGeriatric patientsGreater morbiditySurgical optionsSurgical outcomesRisk factorsProgram databaseMorbidityPatientsProctectomyRacial disparities in surgical outcomes for benign thyroid disease
Maduka RC, Gibson CE, Chiu AS, Jean RA, Wills-Johnson N, Azar SA, Oliveira K, Ahuja V. Racial disparities in surgical outcomes for benign thyroid disease. The American Journal Of Surgery 2020, 220: 1219-1224. PMID: 32669203, DOI: 10.1016/j.amjsurg.2020.06.054.Peer-Reviewed Original ResearchConceptsBenign thyroid diseaseThyroid diseaseRLN injuryNeck hematomaPostoperative complicationsWhite patientsSurgical outcomesRacial disparitiesRecurrent laryngeal nerve injuryLaryngeal nerve injurySignificant postoperative complicationsMalignant thyroid diseaseSignificant hypocalcemiaNerve injuryPostoperative outcomesPatient factorsSurgical treatmentBlack patientsAsian patientsBenign diseaseThyroid surgeryHigh incidenceGreater oddsPatientsMultivariate analysisThe Unintended Consequences of Nonoperative Management of Acute Appendicitis
Oliveira K, Jean RA, Gonsai R, Maduka RC, Gibson CE, Chiu AS, Ahuja V. The Unintended Consequences of Nonoperative Management of Acute Appendicitis. Journal Of Surgical Research 2020, 255: 436-441. PMID: 32619858, DOI: 10.1016/j.jss.2020.05.018.Peer-Reviewed Original ResearchConceptsNonoperative managementAcute appendicitisNational Readmission DatabaseOdds of readmissionCause readmission rateRisk of readmissionTraditional operative approachMultivariable linear regressionMore comorbiditiesIndex hospitalizationReadmission ratesSurgical managementAdult admissionsOperative approachPatient burdenAppendicitisPatientsSix monthsAppendectomyReadmissionSignificant increaseMost casesLinear regressionManagementComorbiditiesPreoperative Nutritional Status Predicts Major Morbidity After Primary Rectal Cancer Resection
Wolf JH, Ahuja V, D'Adamo CR, Coleman J, Katlic M, Blumberg D. Preoperative Nutritional Status Predicts Major Morbidity After Primary Rectal Cancer Resection. Journal Of Surgical Research 2020, 255: 325-331. PMID: 32593891, DOI: 10.1016/j.jss.2020.05.081.Peer-Reviewed Original ResearchConceptsOrgan space infectionRectal cancer resectionSurgical outcomesRectal cancerRenal failureCancer resectionAdverse outcomesMultivariate regression modelPrimary rectal cancer resectionPreoperative nutritional statusQuality Initiative ProgramCurrent Procedural Terminology codesTime of surgeryRectal cancer surgeryBody mass indexPrimary rectal cancerAdverse surgical outcomesState of malnutritionEffects of malnutritionProcedural Terminology codesChi-square testHigh rateStudent's t-testDiseases 9/10Major morbidity
2019
Operative Mortality Prediction for Primary Rectal Cancer: Age Matters
Li Z, Coleman J, D'Adamo CR, Wolf J, Katlic M, Ahuja N, Blumberg D, Ahuja V. Operative Mortality Prediction for Primary Rectal Cancer: Age Matters. Journal Of The American College Of Surgeons 2019, 228: 627-633. PMID: 30630082, DOI: 10.1016/j.jamcollsurg.2018.12.014.Peer-Reviewed Original ResearchConceptsPrimary rectal cancerRectal cancerLogistic regression modelsActual mortalityOlder patientsRisk calculatorAmerican CollegeCovariate-adjusted logistic regression modelsCurrent risk calculatorsICD-9/10 codesColorectal cancer increasesSurgeons NSQIP databaseYears age groupAge categoriesMortality risk estimatesOperative mortalityNSQIP databaseRegression modelsPrognostic valueFunctional statusCancer increasesCare discussionsMortality predictionCPT codesAge groups
2017
The Changing Epidemiology of Diverticulitis in the United States
Teetor T, Palachick B, Grim R, Bell T, Martin J, Blumberg D, Khan K, Ahuja V. The Changing Epidemiology of Diverticulitis in the United States. The American Surgeon 2017, 83: 134-136. PMID: 28424119, DOI: 10.1177/000313481708300411.Peer-Reviewed Original Research
2016
Locally advanced primary recto-sigmoid cancers: Improved survival with multivisceral resection
Laurence G, Ahuja V, Bell T, Grim R, Ahuja N. Locally advanced primary recto-sigmoid cancers: Improved survival with multivisceral resection. The American Journal Of Surgery 2016, 214: 432-436. PMID: 28082009, DOI: 10.1016/j.amjsurg.2016.12.018.Peer-Reviewed Original ResearchConceptsMultivisceral resectionAdvanced colorectal cancerColorectal cancerCancer patientsYear survivalNon-metastatic colorectal cancerRadiation treatmentRecto-sigmoid cancerFive-year survivalSignificant associated morbidityKaplan-Meier analysisExtensive surgical proceduresGreatest survival advantageEligible patientsAssociated morbiditySelect patientsMeier analysisStandard surgeryRadical operationSEER dataAdjacent organsSurgical proceduresSurvival advantagePatientsSurgical specialists
2015
Critical Outcomes in Nonrobotic vs Robotic-Assisted Cardiac Surgery
Yanagawa F, Perez M, Bell T, Grim R, Martin J, Ahuja V. Critical Outcomes in Nonrobotic vs Robotic-Assisted Cardiac Surgery. JAMA Surgery 2015, 150: 771-777. PMID: 26083734, DOI: 10.1001/jamasurg.2015.1098.Peer-Reviewed Original ResearchConceptsLength of stayMedian LOSCardiac surgical proceduresNonrobotic surgeryRobotic-assisted surgeryCardiac surgerySurgical proceduresRobotic-assisted cardiac surgeryPropensity scoreLower LOSNationwide Inpatient SampleRobotic-assisted casesHigher median costCardiac operationsInpatient SampleCardiac patientsOpen techniqueMAIN OUTCOMECardiac casesMedian costHealthcare costsSurgeryLower mortalityComplicationsUtilization Project
2014
Changing Demographics in Laparoscopic Cholecystectomy Performed in the United States: Hospitalizations from 1998 to 2010
Tucker JJ, Grim R, Bell T, Martin J, Ahuja V. Changing Demographics in Laparoscopic Cholecystectomy Performed in the United States: Hospitalizations from 1998 to 2010. The American Surgeon 2014, 80: 652-658. PMID: 24987895, DOI: 10.1177/000313481408000718.Peer-Reviewed Original ResearchConceptsLaparoscopic cholecystectomyDisease burdenUtilization Project Nationwide Inpatient Sample databaseLarge hospital bed sizeAge groupsNationwide Inpatient Sample databasePrevalence of obesityYoung patient populationYears of ageHospital bed sizePeople ages 15Patients 15Younger patientsObese populationMedian lengthPatient populationHospital costsCommunity hospitalObese youthMedian costClinical experienceEconomic burdenObesityAge 15Sample databaseUnnecessary Head Computed Tomography Scans: A Level 1 Trauma Teaching Experience
Parma C, Carney D, Grim R, Bell T, Shoff K, Ahuja V. Unnecessary Head Computed Tomography Scans: A Level 1 Trauma Teaching Experience. The American Surgeon 2014, 80: 664-668. PMID: 24987897, DOI: 10.1177/000313481408000720.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCraniocerebral TraumaFemaleGuideline AdherenceHospital CostsHospitals, CommunityHospitals, TeachingHumansInjury Severity ScoreMaleMiddle AgedPatient SafetyPennsylvaniaPractice Guidelines as TopicQuality ImprovementRegistriesRetrospective StudiesTomography, X-Ray ComputedTrauma CentersUnnecessary ProceduresYoung AdultConceptsHead CT scanCT scanHead injuryHigher Injury Severity ScoreCanadian CT Head RuleMild traumatic brain injuryMinor head injuryProportion of patientsInjury Severity ScoreGlasgow Coma ScaleLength of stayLoss of consciousnessTraumatic brain injuryQuality patient careVentilator daysComa ScaleNeurologic complaintsTrauma registryVehicular injuriesSeverity scoreUnivariate analysisBrain injuryTomography scanInclusion criteriaAge 41
2013
Use, Cost, Complications, and Mortality of Robotic versus Nonrobotic General Surgery Procedures Based on a Nationwide Database
Salman M, Bell T, Martin J, Bhuva K, Grim R, Ahuja V. Use, Cost, Complications, and Mortality of Robotic versus Nonrobotic General Surgery Procedures Based on a Nationwide Database. The American Surgeon 2013, 79: 553-560. PMID: 23711262, DOI: 10.1177/000313481307900613.Peer-Reviewed Original ResearchConceptsLysis of adhesionsLength of stayNonrobotic surgeryGeneral surgeryRobotic casesRobotic surgeryOpen surgeryUtilization Project Nationwide Inpatient Sample dataNationwide Inpatient Sample dataGeneral surgery proceduresRobotic general surgeryHospital bed sizeLower mortality rateCurrent Procedural TerminologyRobotic-assisted proceduresCharlson scoreHigher complicationsNationwide databaseProcedure typeRobotic cholecystectomyHospital regionHealthcare costsSurgeryMortality rateSurgery procedures
2012
Predicting Risk of Death in General Surgery Patients on the Basis of Preoperative Variables Using American College of Surgeons National Surgical Quality Improvement Program Data
Vaid S, Bell T, Grim R, Ahuja V. Predicting Risk of Death in General Surgery Patients on the Basis of Preoperative Variables Using American College of Surgeons National Surgical Quality Improvement Program Data. The Permanente Journal 2012, 16: 10-17. PMID: 23251111, PMCID: PMC3523928, DOI: 10.7812/tpp/12-019.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overDatabases, FactualDecision Support TechniquesFemaleGeneral SurgeryHospital MortalityHumansLogistic ModelsMaleMiddle AgedPostoperative ComplicationsPractice Guidelines as TopicPreoperative PeriodReproducibility of ResultsRisk AssessmentRisk FactorsSocieties, MedicalTreatment OutcomeUnited StatesYoung AdultConceptsPreoperative variablesMortality predictorsAmerican CollegeACS NSQIP Participant Use Data FilesNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement Program dataSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program dataNSQIP Participant Use Data FilesParticipant Use Data FileQuality Improvement Program dataQuality Improvement Program databaseLogistic regressionGeneral surgery patientsCurrent Procedural Terminology codesPoor functional statusImprovement Program databaseRisk of deathProcedural Terminology codesLaparoscopic colorectalOperative survivalSurgery patientsSteroid usePancreas surgeryDead patientsCost Analysis of Laparoscopic versus Open Colectomy in Patients with Colon Cancer: Results from a Large Nationwide Population Database
Vaid S, Tucker J, Bell T, Grim R, Ahuja V. Cost Analysis of Laparoscopic versus Open Colectomy in Patients with Colon Cancer: Results from a Large Nationwide Population Database. The American Surgeon 2012, 78: 635-641. PMID: 22643256, DOI: 10.1177/000313481207800614.Peer-Reviewed Original ResearchConceptsLaparoscopic colectomyOpen colectomyColon cancerUtilization Project National Inpatient Sample databaseNational Inpatient Sample databaseElective laparoscopic colectomyNationwide population databasePredictors of costsLower mortality rateLower total chargesMann-Whitney testCharlson scoreLaparoscopic approachMean ageUnadjusted analysesUrban hospitalMortality ratePatientsColectomyHospital sizeTeaching statusCancerSample databaseReliable optionPopulation database
2011
Changing Epidemiology of Acute Appendicitis in the United States: Study Period 1993–2008
Buckius MT, McGrath B, Monk J, Grim R, Bell T, Ahuja V. Changing Epidemiology of Acute Appendicitis in the United States: Study Period 1993–2008. Journal Of Surgical Research 2011, 175: 185-190. PMID: 22099604, DOI: 10.1016/j.jss.2011.07.017.Peer-Reviewed Original ResearchLaparoscopic Cholecystectomy Is Safe but Underused in the Elderly
Tucker JJ, Yanagawa F, Grim R, Bell T, Ahuja V. Laparoscopic Cholecystectomy Is Safe but Underused in the Elderly. The American Surgeon 2011, 77: 1014-1020. PMID: 21944516, DOI: 10.1177/000313481107700820.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedCase-Control StudiesCholecystectomyCholecystectomy, LaparoscopicConfidence IntervalsFemaleFollow-Up StudiesGallbladder DiseasesGeriatric AssessmentHumansLogistic ModelsMaleMiddle AgedPostoperative ComplicationsPredictive Value of TestsPreoperative CareRisk AssessmentSafety ManagementTreatment OutcomeConceptsLength of stayOpen cholecystectomyLaparoscopic cholecystectomyElderly patientsSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseLonger LOSLogistic regressionImprovement Program databaseEarly operative interventionLow complication rateMultivariate logistic regressionNonelderly patientsOperative interventionComplication rateIndependent predictorsLC surgeryPatient groupGallbladder diseaseHigh comorbidityProgram databaseAmerican CollegeEmergent casesSafe optionApplication of a Tertiary Referral Scoring System to Predict Nonreversal of Hartmann's Procedure for Diverticulitis in a Community Hospital
Vaid S, Wallet J, Litt J, Bell T, Grim R, Ahuja V. Application of a Tertiary Referral Scoring System to Predict Nonreversal of Hartmann's Procedure for Diverticulitis in a Community Hospital. The American Surgeon 2011, 77: 814-819. PMID: 21944340, DOI: 10.1177/000313481107700712.Peer-Reviewed Original ResearchConceptsHartmann's procedureScoring systemHartmann's reversalLogistic regressionCommunity hospital settingHigher mean ageOnly predictive variableHigher scoresAcute diverticulitisAnesthesiologists (ASA) scorePreoperative transfusionPulmonary comorbiditiesMean ageHospital databaseCleveland ClinicCommunity hospitalHospital settingPatientsNonreversal groupDiverticulitisAmerican SocietyScoresPredictive variablesSurgeonsAge