A5012429269- Trauma and Emergency Care Studies
- Healthcare Policy and Management
- Cardiac, Anesthesia and Surgical Outcomes
- Emergency and Acute Care Studies
- Hip and Femur Fractures
- Abdominal Trauma and Injuries
- Appendicitis Diagnosis and Management
- Pelvic and Acetabular Injuries
- Anesthesia and Pain Management
- Trauma Management and Diagnosis
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Cardiac Arrest and Resuscitation
- Palliative Care and End-of-Life Issues
- Airway Management and Intubation Techniques
- COVID-19 and healthcare impacts
- Healthcare Quality and Management
- Patient Dignity and Privacy
- Esophageal Cancer Research and Treatment
- Global Health Workforce Issues
- Ethics in medical practice
- Healthcare cost, quality, practices
- Medical Malpractice and Liability Issues
- Venous Thromboembolism Diagnosis and Management
- Primary Care and Health Outcomes
- Healthcare Operations and Scheduling Optimization
University of Utah
2018-2025
American Association for the Surgery of Trauma
2021
Memorial Hospital
2020
Massachusetts General Hospital
2020
Johns Hopkins University
2020
University of Maryland, Baltimore
2020
Valley Hospital
2020
Eastern Maine Medical Center
2020
Memorial Hospital
2020
Memorial Hospital
2020
Abstract Background To increase bed capacity and resources, hospitals have postponed elective surgeries, although the financial impact of this decision is unknown. We sought to report surgical case distribution, associated gross hospital revenue regional intensive care unit (ICU) as cases are cancelled then resumed under simulated trends COVID-19 incidence. Methods A retrospective, cohort analysis was performed using insurance claims from 161 million enrollees MarketScan database January 1,...
Importance Hospitals with emergency surgical services provide essential care for a wide range of time-sensitive diseases. Commonly used measures spatial access, such as distance or travel time, have been shown to underestimate disparities compared more comprehensive metrics. Objective To examine population-level differences in access hospitals capability across the US using enhanced 2-step floating catchment (E2SFCA) methods. Design, Setting, and Participants A cross-sectional study 2015...
BACKGROUND The Emergency Surgery Score (ESS) was recently developed and retrospectively validated as an accurate mortality risk calculator for emergency general surgery. We sought to prospectively validate ESS, specifically in the high-risk nontrauma laparotomy (EL) patient. METHODS This is Eastern Association of Trauma multicenter prospective observational study. Between April 2018 June 2019, 19 centers enrolled all adults (aged >18 years) undergoing EL. Preoperative, intraoperative,...
Hospitals show wide variation in outcomes and systems of care. It is unclear whether hospital complexity-the range services technologies provided-affects what direction. We sought to determine complexity was associated with inpatient surgical mortality.Using national Medicare data, we identified all fee-for-service inpatients who underwent 1 5 common high-risk procedures 2008-2009 measured by the number unique primary diagnoses admitted each over 2-year period. calculated 30-day...
Socioeconomic disadvantage is associated with worse outcomes after elective surgery, but the effect on emergency general surgery (EGS) remains unclear. We examined association of socioeconomic and EGS procedures investigated whether admission to hospitals comprehensive clinical social resources mitigated this effect.
BACKGROUND Preinjury antithrombotic (AT) use is associated with worse outcomes for geriatric (65 years or older) patients traumatic brain injury (TBI). Previous studies have found that of AT outside established guidelines widespread in TBI patients. METHODS In this single-center retrospective cross-sectional study, we examined inappropriate among presenting intracranial hemorrhage. We reviewed records 65 older preinjury who presented to a Level 1 trauma center hemorrhage between 2016 and...
BACKGROUND Evidence increasingly supports sigmoidectomy with primary anastomosis (SPA) and diverting loop ileostomy over Hartmann's procedure for perforated diverticulitis in stable patients. Prompt reversal (DLIR) is often preferred by patients; however, optimal timing after index surgery remains unclear. The objective of this study to examine the association DLIR clinical outcomes costs. METHODS Retrospective analysis was performed using National Readmissions Database (2010–2020) all...
<h3>Importance</h3> Care fragmentation at time of readmission after emergency general surgery (EGS) is associated with high mortality; however, the factors underlying this finding remain unclear. <h3>Objective</h3> To identify patient and hospital increased mortality among patients EGS readmitted within 30 days discharge to a nonindex hospital. <h3>Design, Setting, Participants</h3> Retrospective cohort study using 2014 Healthcare Cost Utilization Project Nationwide Readmissions Database....
Single-center data demonstrates that regional analgesia (RA) techniques are associated with reduced risk of delirium in older patients multiple rib fractures. We hypothesized a similar effect between RA and would be identified larger cohort from level I trauma centers.Retrospective seven centers were collected for intensive care unit (ICU) 65 years or ≥3 fractures January 2012 to December 2016. Those head and/or spine injury Abbreviated Injury Scale (AIS) score ≥ 3 history dementia excluded....
Federal efforts about public reporting and quality improvement programs for hospitals have focused primarily on a small number of medical conditions. Whether performance these conditions accurately predicts the broader hospital care is unknown.To determine whether mortality rates publicly reported are correlated with hospitals' overall performance.Using national Medicare data, we compared at 2322 US acute 30-day risk-adjusted mortality, aggregated across 3 (acute myocardial infarction,...
BACKGROUND Current evaluation of rib fractures focuses almost exclusively on flail chest with little attention bicortically displaced fractures. Chest trauma that is severe enough to cause leads worse outcomes. An association between and pulmonary outcomes would potentially change patient care in the setting trauma. We tested hypothesis were an important clinical marker for patients nonflail METHODS This nine-center American Association Surgery Trauma multi-institutional study analyzed...
The majority of high grade renal trauma can be managed conservatively. However, nephrectomy is still common for acute management. We hypothesized that when controlling multiple injury severity measures, would associated with increased mortality.We identified patients from the National Trauma Data Bank® 2007-2016. Exclusion criteria were age <18 years, severe head and death within 4 hours admission. performed conditional logistic regression analysis to determine if was independently...
Emergency general surgery (EGS) encompasses a spectrum of time-sensitive and resource-intensive conditions, which require adequate timely access to surgical care. Developing metrics accurately quantify spatial care is critical for this field. We sought evaluate the ability ratio (SPAR), incorporates travel time, hospital capacity, population demand in its measure EGS delineate disparities.We constructed geographic information science platform EGS-capable hospitals California mapped location,...
Although oral anticoagulant use has been implicated in worse outcomes for patients with a traumatic brain injury (TBI), prior studies have mostly examined the of vitamin K antagonists (VKAs). In an era increasing direct anticoagulants (DOACs) lieu VKAs, authors compared survival TBI on different types premorbid anticoagulation medications those not anticoagulation.The retrospectively reviewed records 1186 adult who presented at level I trauma center intracranial hemorrhage after blunt...
BACKGROUND This study updates the American Association for Surgery of Trauma (AAST) Organ Injury Scale (OIS) renal trauma using evidence-based criteria bleeding control intervention. METHODS was a secondary analysis multicenter retrospective including patients with high-grade from seven level 1 centers 2013 to 2018. All eligible were assigned new grades based on revised criteria. The primary outcome used measure injury severity intervention bleeding. Secondary outcomes included urinary...
Optimal venous thromboembolism (VTE) enoxaparin prophylaxis dosing remains elusive. Weight-based (WB) safely increases anti-factor Xa levels without the need for routine monitoring but it is unclear if leads to lower VTE risk. We hypothesized that WB would decrease risk compared with standard fixed (SFD).
Importance There is growing interest in developing coordinated regional systems for nontraumatic surgical emergencies; however, our understanding of existing emergency general surgery (EGS) care communities limited. Objective To apply network analysis methods to delineate EGS regions and compare the performance this method with Dartmouth Health Referral Regions (HRRs). Design, Setting, Participants This cross-sectional study was conducted using 2019 California New York state department...
Abstract Background To increase bed capacity and resources, hospitals have postponed elective surgeries, although the financial impact of this decision is unknown. We sought to report surgical case distribution, associated gross hospital earnings regional intensive care unit (ICU) as cases are cancelled then resumed under simulated trends COVID-19 incidence. Methods A retrospective, cohort analysis was performed using insurance claims from 161 million enrollees MarketScan database January 1,...