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 ResearchMeSH KeywordsAgedCaliforniaCluster AnalysisEmergenciesHospital MortalityHospitalsHumansSurgical Procedures, OperativeConceptsCommon 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-scoreHospital 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 increasePatientsEvaluating mortality outlier hospitals to improve the quality of care in emergency general surgery.
Becher RD, DeWane MP, Sukumar N, Stolar MJ, Gill TM, Maung AA, Schuster KM, Davis KA. Evaluating mortality outlier hospitals to improve the quality of care in emergency general surgery. Journal Of Trauma And Acute Care Surgery 2019, 87: 297-306. PMID: 30908450, PMCID: PMC6660354, DOI: 10.1097/ta.0000000000002271.Peer-Reviewed Original ResearchConceptsStandardized mortality ratioOutlier hospitalsHospital variationMortality ratioStandardized mortalityEmergency general surgery operationsCalifornia State Inpatient DatabaseEGS operationsCommon EGS operationsSignificant hospital variationEmergency general surgeryHospital-level characteristicsHospital-level variablesSignificant excess mortalityGeneral surgery operationsState Inpatient DatabasesQuality improvement initiativesQuality of careHospital quality indicatorsNational Quality ForumEGS outcomesInpatient DatabaseExcess mortalityOnly hospitalEpidemiologic studies
2017
Ongoing Evolution of Emergency General Surgery as a Surgical Subspecialty
Becher RD, Davis KA, Rotondo MF, Coimbra R. Ongoing Evolution of Emergency General Surgery as a Surgical Subspecialty. Journal Of The American College Of Surgeons 2017, 226: 194-200. PMID: 29111417, DOI: 10.1016/j.jamcollsurg.2017.10.014.Commentaries, Editorials and Letters
2012
Systemic inflammation worsens outcomes in emergency surgical patients
Becher RD, Hoth JJ, Miller PR, Meredith JW, Chang MC. Systemic inflammation worsens outcomes in emergency surgical patients. Journal Of Trauma And Acute Care Surgery 2012, 72: 1140-1149. PMID: 22673238, DOI: 10.1097/ta.0b013e3182516a97.Peer-Reviewed Original ResearchMeSH KeywordsAgedDigestive System Surgical ProceduresDisease ProgressionEmergenciesFollow-Up StudiesHumansMiddle AgedMorbidityOutcome Assessment, Health CarePostoperative ComplicationsRetrospective StudiesRisk FactorsSeverity of Illness IndexSurvival RateSystemic Inflammatory Response SyndromeUnited StatesConceptsSystemic inflammatory response syndromeSevere sepsis/septic shockSepsis/septic shockPreoperative systemic inflammationEmergency surgical patientsSystemic inflammatory responseThirty-day survivalSystemic inflammationInflammatory responsePostoperative outcomesSurgical patientsSeptic shockEmergent colon surgeryEmergency general surgeryInflammatory response syndromeTimely surgical interventionAcute care surgeonsKaplan-Meier methodRisk of morbidityDamage control operationPreoperative inflammationColorectal operationsPostoperative complicationsHazard ratioSepsis patients