A5060045309- Cardiac, Anesthesia and Surgical Outcomes
- Transplantation: Methods and Outcomes
- Health disparities and outcomes
- Hemodynamic Monitoring and Therapy
- Renal Transplantation Outcomes and Treatments
- Health Systems, Economic Evaluations, Quality of Life
- Anesthesia and Pain Management
- Anesthesia and Sedative Agents
- Inflammatory Biomarkers in Disease Prognosis
- Organ Transplantation Techniques and Outcomes
- Blood transfusion and management
- Climate Change and Health Impacts
- Health, Environment, Cognitive Aging
- Food Security and Health in Diverse Populations
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- COVID-19 Clinical Research Studies
- Obstructive Sleep Apnea Research
- Adipokines, Inflammation, and Metabolic Diseases
- Thermal Regulation in Medicine
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Spine and Intervertebral Disc Pathology
- Aortic aneurysm repair treatments
- Acute Ischemic Stroke Management
- Pain Management and Opioid Use
- Sepsis Diagnosis and Treatment
Cleveland Clinic Lerner College of Medicine
2017-2025
Case Western Reserve University
2015-2025
Cleveland Clinic
2015-2024
MetroHealth Medical Center
2015-2020
University Hospitals of Cleveland
2020
Outcomes Research Consortium
2009-2017
Northwestern University
2012-2016
Quantitative BioSciences
2008-2016
Population Health Research Institute
2016
Juravinski Hospital
2016
The incidence, severity, and duration of postoperative oxygen desaturation in the general surgical population are poorly characterized. We therefore used continuous pulse oximetry to quantify arterial saturation (SpO2) a cross-section patients having noncardiac surgery.Oxygen saturation, blinded clinicians, was recorded at 1-minute intervals >45 years old for up 48 hours after surgery 1250 from Cleveland Clinic Main Campus 250 Juravinski Hospital. determined (1) cumulative minutes raw...
Recently, van Walraven developed a weighted summary score (VW) based on the 30 comorbidities from Elixhauser comorbidity system. One of comorbidities, cardiac arrhythmia, is currently excluded as indicator in administrative datasets such Nationwide Inpatient Sample (NIS), prompting us to examine validity VW and its use NIS.Using data 2009 Maryland State Database, we derived scores predict in-hospital mortality full (30) reduced (29) set compared model performance these other summaries NIS...
Core temperature patterns in patients warmed with forced air remain poorly characterized. Also unknown is the extent to which transient and mild intraoperative hypothermia contributes adverse outcomes broad populations.We evaluated esophageal (core) temperatures 58,814 adults having surgery lasting >60 min who were air. Independent associations between hypothermic exposure transfusion requirement duration of hospitalization evaluated.In every percentile subgroup, core decreased during first...
The authors tested the primary hypothesis that perioperative IV lidocaine administration during spine surgery (and in postanesthesia care unit for no more than 8 h) decreases pain and/or opioid requirements initial 48 postoperative hours. Secondary outcomes included major complications, nausea and vomiting, duration of hospitalization, quality life.One hundred sixteen adults having complex were randomly assigned to (2 mg·kg·h) or placebo unit. Pain was evaluated with a verbal response scale....
<h3>Importance</h3> Immune dysregulation can increase the risk of infection, malignant neoplasms, and cardiovascular disease, but improved methods are needed to identify quantify immunologic hazard in general population. <h3>Objective</h3> To determine whether lymphopenia is associated with reduced survival outpatients. <h3>Design, Setting, Participants</h3> This retrospective cohort study National Health Nutrition Examination Survey (NHANES) included participants enrolled from January 1,...
Inequality in health outcomes relation to Americans' socioeconomic position is rising.First, evaluate the spatial relationship between neighborhood disadvantage and major atherosclerotic cardiovascular disease (ASCVD)-related events; second, relative extent which physiologic risk account for neighborhood-level variation ASCVD event rates.Observational cohort analysis of geocoded longitudinal electronic records.A single academic center surrounding neighborhoods northeastern Ohio.109 793...
Importance Inequitable access to transplant in the US is well recognized, yet nature and extent of upstream disparities care prior are unknown. Objective To understand patterns referral for lung by race, ethnicity, neighborhood-level socioeconomic status. Design, Setting, Participants This retrospective cohort study included adults aged 18 80 years with obstructive restrictive disease from a single large-volume center Cleveland, Ohio, who were diagnosed between January 1, 2006, May 11, 2023....
Many commonly used anesthetic agents produce a dose-dependent amplitude reduction and latency prolongation of evoked responses, which may impair diagnosis intraoperative spinal cord injury. Dexmedetomidine is increasingly as an adjunct for general anesthesia. Therefore, the authors tested hypothesis that dexmedetomidine does not have clinically important effect on somatosensory transcranial motor responses.Thirty-seven patients were enrolled underwent surgery with instrumentation during...
Background Optimal risk adjustment is a requisite precondition for monitoring quality of care and interpreting public reports hospital outcomes. Current risk-adjustment measures have been criticized including baseline variables that are difficult to obtain inadequately adjusting high-risk patients. The authors sought develop highly predictive models 30-day mortality morbidity based only on small number preoperative characteristics. They included the Procedural Terminology code corresponding...
Anemia has been associated with increased postoperative morbidity and mortality. We used the American College of Surgeons National Surgical Quality Improvement Program database to retrospectively assess relationship between preoperative anemia 30-day mortality in noncardiac surgical patients, careful distinguish confounding variables from mediator variables.Each patient was matched one without using propensity matching on potentially baseline variables. Logistic regression evaluate...
Objectives: Sacroiliac joint pain is a common cause of low back (LBP). Cooled radiofrequency ablation (c-RFA) the lateral branches was recently introduced with hypothesis that it creates larger lesions to overcome anatomic variability and achieve better outcomes as compared traditional approach (t-RFA). The objective this comparative study determine if c-RFA superior over t-RFA in providing longer relief. Methods: Data on 88 patients were retrospectively collected between January 2006 June...
Whether intraoperative use of hydroxyethyl starch impairs kidney function remains unknown. The authors thus tested the primary hypothesis that Hextend promotes renal injury in surgical patients. Secondarily, evaluated dose-outcome relationship, in-hospital and 90-day mortality, whether relationship between colloid acute (AKI) depends on baseline risk for AKI.The data 44,176 adults without preexisting failure who had inpatient noncardiac surgery from 2005 to 2012. Patients given a combination...
<h3>Background and Objectives:</h3> Temporal lobe epilepsy (TLE) is the most common adult form of associated with high risk for cognitive deficits depressed mood. However, little known about role environmental factors on cognition mood in TLE. This cross-sectional study examined relationship between neighborhood deprivation neuropsychological function adults <h3>Methods:</h3> Neuropsychological data were obtained from a clinical registry patients TLE included measures intelligence,...
This expert review seeks to highlight implicit bias in health care, transplant medicine, and pediatric heart transplantation focus attention on the role these biases may play racial/ethnic socioeconomic disparities noted transplantation. breaks down decision making process points at which affect outcomes discuss how science of human help understand complex processes.
Objective. Intradiscal biacuplasty (IDB) is a novel bipolar cooled radiofrequency system for the treatment of degenerative disk disease. We present results pilot trial with 6-month follow-up.
Lumbar spinal stenosis (LSS) may result from degenerative changes of the spine, which lead to neural ischemia, neurogenic claudication, and a significant decrease in quality life. Treatments for LSS range conservative management including epidural steroid injections (ESI) laminectomy surgery. vary greatly cost success. ESI is least costly treatment be successful early stages but often must repeated frequently. Laminectomy surgery more has higher complication rates. Minimally invasive lumbar...
Using a multi-institutional EMR registry, we extracted housing status and evaluated the presence of several important comorbidities in order to describe demographics comorbidity burden persons experiencing homelessness northeast Ohio compare this non-homeless individuals varying socioeconomic position. Of 1,974,766 patients identified 15,920 (0.8%) as homeless, 351,279 (17.8%) top quintile area deprivation index (ADI), 1,607,567 (81.4%) lower four quintiles deprivation. The was highest...