2024
A novel preoperative score to predict severe acute cholecystitis
Kuhlenschmidt K, Taveras L, Schuster K, Kaafarani H, El Hechi M, Puri R, Crandall M, Schroeppel T, Cripps M. A novel preoperative score to predict severe acute cholecystitis. Journal Of Trauma And Acute Care Surgery 2024, 96: 870-875. PMID: 38523119, DOI: 10.1097/ta.0000000000004308.Peer-Reviewed Original ResearchAcute cholecystitisPreoperative scoresLogistic regression modelsGrading scaleAmerican Association for the SurgerySevere acute cholecystitisStepwise logistic regression modelSurgical decision makingPrognostic Level IIIMulticenter databaseMulticenter trialMulticenter validationCholecystitisCounseling patientsHigh-gradeLevel IIIC-statisticPatientsRegression modelsCholecystectomyMulticenterScoresSacPositive correlationGrade
2023
Routine 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 ResearchConceptsHealthcare system burdenSystem burdenHealth care costsAppendicitis managementIncreased LOSUncomplicated AAAcute appendicitisRetrospective cohortClinical courseClinical variablesPatient populationMinimal comorbiditiesMultivariable modelingHealthcare costsCare costsPatientsLaboratory utilizationNational Health Expenditure AccountsLab utilizationLaboratory testingBurdenLaboratory testsAppendicitisComorbiditiesCohortCurrent use of the National Surgical Quality Improvement Program surgical risk calculator in academic surgery: a mixed-methods study
Miller S, Azar S, Farrelly J, Salzman G, Broderick M, Sanders K, Anto V, Patel N, Cordova A, Schuster K, Jones T, Kodadek L, Gross C, Morton J, Rosenthal R, Becher R. Current use of the National Surgical Quality Improvement Program surgical risk calculator in academic surgery: a mixed-methods study. Surgery In Practice And Science 2023, 13: 100173. PMID: 37502700, PMCID: PMC10373440, DOI: 10.1016/j.sipas.2023.100173.Peer-Reviewed Original ResearchNSQIP Surgical Risk CalculatorSurgical Risk CalculatorNonelective casesRisk calculatorNational Surgical Quality Improvement Program Surgical Risk CalculatorHigh-risk patientsGeneral clinical practiceSpecific clinical scenariosCross-sectional studyElectronic health recordsFrail patientsPrimary outcomeHalf of respondentsPreoperative assessmentContemporary surgical practiceClinical practiceClinical scenariosSurgical practicePast monthPatientsSurgeonsTraining statusSurrogate consentPotential interventionsHealth recordsAlcohol withdrawal syndrome in trauma patients: a study using the Trauma Quality Program Participant User File
Jones T, Bhattacharya B, Schuster K, Becher R, Kodadek L, Davis K, Maung A. Alcohol withdrawal syndrome in trauma patients: a study using the Trauma Quality Program Participant User File. Trauma Surgery & Acute Care Open 2023, 8: e001047. PMID: 37188153, PMCID: PMC10175962, DOI: 10.1136/tsaco-2022-001047.Peer-Reviewed Original ResearchAlcohol withdrawal syndromeAlcohol use disorderPositive blood alcohol concentrationHistory of AUDBlood alcohol concentrationParticipant User FileAdult patientsTrauma patientsWithdrawal syndromeAbbreviated Injury Scale headHigh-risk patient populationInjury scale headAdult trauma patientsPositive toxicology screenMultivariable logistic regressionRetrospective reviewRetrospective studyToxicology screenPatient populationTricyclic antidepressantsMAIN OUTCOMEAmerican CollegePatientsUse disordersUncommon occurrenceImaging acute cholecystitis, one test is enough
Schuster K, Schroeppel T, O'Connor R, Enniss T, Cripps M, Cullinane D, Kaafarani H, Crandall M, Puri R, Tominaga G. Imaging acute cholecystitis, one test is enough. The American Journal Of Surgery 2023, 226: 99-103. PMID: 36882336, DOI: 10.1016/j.amjsurg.2023.02.018.Peer-Reviewed Original ResearchConceptsCommon bile duct diameterBile duct diameterAcute cholecystitisIntra-class correlation coefficientDuct diameterRight upper quadrant painUpper quadrant painSigns of inflammationSingle imaging studyChi-square testQuadrant painPericholecystic fluidWall thicknessMulticenter studyPatientsImaging studiesCholecystitisAbnormal valuesGold standardAdequate informationPainInflammationAdmissionStudyDiagnosisManagement and Outcome of High-Grade Hepatic and Splenic Injuries
Presser E, Sznol J, Schuster K. Management and Outcome of High-Grade Hepatic and Splenic Injuries. Current Surgery Reports 2023, 11: 55-63. DOI: 10.1007/s40137-023-00344-1.Peer-Reviewed Original ResearchSplenic injuryOperative interventionUnstable patientsTrauma grade IVHigh-grade injuriesModality of choiceTransient respondersActive bleedingGrade injuriesSerial examsStable patientsSignificant morbidityPermissive hypotensionEndovascular interventionPrehospital interventionsRadiological studiesTrauma bayBlood productsGrade IVPatientsSecondary surveyInjuryExact indicationsClass IIIActive signs
2022
Occult traumatic pneumothorax: Is routine follow up chest X-ray necessary?
Bhattacharya B, O'Connor R, Becher R, Schuster K, Davis K, Maung A. Occult traumatic pneumothorax: Is routine follow up chest X-ray necessary? Surgery In Practice And Science 2022, 9: 100073. DOI: 10.1016/j.sipas.2022.100073.Peer-Reviewed Original ResearchChest X-rayRoutine chest X-rayInjury Severity ScoreClinical managementInitial trauma evaluationUrban trauma centerComputerized tomography scanPaucity of evidenceOccult pneumothoracesPneumothorax progressionAdult patientsTrauma centerClinical evolutionClinical symptomsInjury scoreMean ageTrauma evaluationSeverity scoreTomography scanPatientsInterventionPneumothoracesSymptomsAgeX-ray
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 ResearchConceptsUrgent 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 conditionsDoes Emergency General Surgery (EGS) Hospital Volume Contribute to Improved Outcomes?
DeWane M, Becher R, Schuster K. Does Emergency General Surgery (EGS) Hospital Volume Contribute to Improved Outcomes? Current Surgery Reports 2020, 8: 17. DOI: 10.1007/s40137-020-00262-6.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsImproved outcomesHospital-based outcomesHigh-volume centersRecent FindingsRecent evidenceEGS volumeHospital mortalitySurgeon volumePatient mortalityVolume centersHigh-risk operationsSurgery volumeReviewThis reviewOutcomesEGS operationsMortalitySpecific factorsPatientsCase complexityObserved improvement
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 IIIHospital 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 increasePatientsEvaluation 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 ProtocolSwallowingHoursDysphagiaHospitalizationIntubationPneumoniaPatientsIncidenceEvaluation
2018
Definition of Emergency General Surgery (EGS) and Its Burden on the Society
Gale S, Schuster K, Crandall M, Shafi S. Definition of Emergency General Surgery (EGS) and Its Burden on the Society. 2018, 1-11. DOI: 10.1007/978-3-319-96286-3_1.Peer-Reviewed Original ResearchTotal 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 imagingCholecystitisBilirubinCholelithiasisPatientsInterventionColicLevelsWhen should screening of pediatric trauma patients for adult behaviors start?
Maung AA, Becher RD, Schuster KM, Davis KA. When should screening of pediatric trauma patients for adult behaviors start? Trauma Surgery & Acute Care Open 2018, 3: e000181. PMID: 29766143, PMCID: PMC5905833, DOI: 10.1136/tsaco-2018-000181.Peer-Reviewed Original ResearchPediatric trauma patientsMechanism of injuryTrauma patientsPediatric trauma centerInjury Severity ScoreIncidence of sportsCare of patientsPositive toxicology testsElectronic medical recordsMost patientsPatient ageRetrospective reviewTrauma centerBicycle injuriesSeverity scoreMedical recordsLevel IVGunshot injuriesPatientsInjuryYounger ageLogistic regressionSubstance abuseAge-related variationsToxicology tests
2015
Motor Vehicle Collision Patient with Simultaneous Duodenal Transection and Thoracic Aorta Injury: A Case Report and Review of the Literature
Chen C, Schuster K, Bhattacharya B. Motor Vehicle Collision Patient with Simultaneous Duodenal Transection and Thoracic Aorta Injury: A Case Report and Review of the Literature. Case Reports In Surgery 2015, 2015: 519836. PMID: 25688322, PMCID: PMC4321849, DOI: 10.1155/2015/519836.Peer-Reviewed Original ResearchAorta injuryHigh-speed motor vehicle collisionMotor vehicle collision (MVC) patientsThoracic aorta injuryMotor vehicle collisionsBlunt polytraumaDuodenal transectionLess morbidityCase reportSuch injuriesSurgical teamFull recoveryComplex management decisionsInjuryPatientsVehicle collisionsPolytraumaMorbidityTransectionMortalityTrauma
2014
The Use of Magnetic Resonance Imaging in the Diagnosis of Suspected Appendicitis in Pregnancy : Shortened Length of Stay Without Increase in Hospital Charges
Fonseca AL, Schuster KM, Kaplan LJ, Maung AA, Lui FY, Davis KA. The Use of Magnetic Resonance Imaging in the Diagnosis of Suspected Appendicitis in Pregnancy : Shortened Length of Stay Without Increase in Hospital Charges. JAMA Surgery 2014, 149: 687-693. PMID: 24871698, DOI: 10.1001/jamasurg.2013.4658.Peer-Reviewed Original ResearchConceptsMR imaging groupHospital chargesNontherapeutic explorationsPregnant patientsImaging groupFetal outcomesShorter LOSEmergency departmentUniversity tertiary referral centerMean hospital chargesTertiary referral centerLength of stayMagnetic resonancePathology-confirmed appendicitisAbdominal painOperative interventionReferral centerClinical outcomesGestational ageMultivariable analysisRetrospective reviewFetal lossAppendicitisMAIN OUTCOMEPatientsPredictive factors for failure of nonoperative management in perforated appendicitis
Maxfield MW, Schuster KM, Bokhari J, McGillicuddy EA, Davis KA. Predictive factors for failure of nonoperative management in perforated appendicitis. Journal Of Trauma And Acute Care Surgery 2014, 76: 976-981. PMID: 24662860, DOI: 10.1097/ta.0000000000000187.Peer-Reviewed Original ResearchConceptsNonoperative managementAbdominal tendernessFailure groupIntensive care unit careUniversity tertiary care hospitalTertiary care hospitalLength of stayUnit careCare hospitalDefinitive treatmentLaboratory markersPerforated appendicitisNonsurgical treatmentClinical findingsPredictive factorsRadiographic findingsTomographic scanTherapeutic studiesAppendicitisEarly operationLevel IIIPatientsAbscessPhlegmonTachycardia
2013
Repositioning endotracheal tubes in the intensive care unit
Wang ML, Schuster KM, Bhattacharya B, Maung AA, Kaplan LJ, Davis KA. Repositioning endotracheal tubes in the intensive care unit. Journal Of Trauma And Acute Care Surgery 2013, 75: 146-149. PMID: 23940860, DOI: 10.1097/ta.0b013e31829849cd.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedChi-Square DistributionCohort StudiesCritical CareCritical IllnessFemaleFollow-Up StudiesHumansIntensive Care UnitsIntubation, IntratrachealLinear ModelsMaleMiddle AgedMonitoring, PhysiologicMultivariate AnalysisPatient PositioningProspective StudiesRadiography, ThoracicRetreatmentRisk AssessmentTracheaConceptsEndotracheal tubeSurgical intensive care unit patientsIntensive care unit patientsChest X-ray studyRoutine chest radiographCare unit patientsProspective observational studyIntensive care unitInterquartile rangeUnit patientsCare unitWithdrawal groupRespiratory therapistsChest radiographsObservational studyInclusion criteriaMedian withdrawalET withdrawalMean differencePatientsSuboptimal positioningInterventionIncisorsMedianWithdrawalRoutine Nasogastric Decompression in Small Bowel Obstruction: Is it Really Necessary?
Fonseca AL, Schuster KM, Maung AA, Kaplan LJ, Davis KA. Routine Nasogastric Decompression in Small Bowel Obstruction: Is it Really Necessary? The American Surgeon 2013, 79: 422-428. PMID: 23574854, DOI: 10.1177/000313481307900433.Peer-Reviewed Original ResearchConceptsSmall bowel obstructionNasogastric decompressionHospital lengthNG decompressionBowel obstructionRespiratory failureDiagnosis of SBOYale-New Haven HospitalNasogastric tube useRisk of pneumoniaRoutine nasogastric decompressionDevelopment of pneumoniaRetrospective chart reviewNew Haven HospitalBowel restIntravenous hydrationChart reviewAdult patientsTube useNGT placementPatientsStayOutcome variablesDecompressionNGT