A5028630773- Nerve Injury and Rehabilitation
- Orthopedic Surgery and Rehabilitation
- Peripheral Nerve Disorders
- Anesthesia and Pain Management
- Spinal Cord Injury Research
- Pain Management and Opioid Use
- Musculoskeletal pain and rehabilitation
- Reconstructive Surgery and Microvascular Techniques
- Pain Management and Treatment
- Dupuytren's Contracture and Treatments
- Cardiac, Anesthesia and Surgical Outcomes
- Opioid Use Disorder Treatment
- Shoulder Injury and Treatment
- Pain Mechanisms and Treatments
- Burn Injury Management and Outcomes
- Culinary Culture and Tourism
- Myofascial pain diagnosis and treatment
- Surgical Sutures and Adhesives
- Cardiovascular Issues in Pregnancy
- Spinal Dysraphism and Malformations
- Nail Diseases and Treatments
- Sport and Mega-Event Impacts
- Hip and Femur Fractures
- Medical Malpractice and Liability Issues
- Pharmaceutical studies and practices
Stanford University
2016-2025
VA Palo Alto Health Care System
2016-2025
Stanford Medicine
2010-2025
Palo Alto Veterans Institute for Research
2011-2024
United States Department of Veterans Affairs
2013-2024
Palo Alto University
2007-2022
Stanford Health Care
2015-2022
Center for Innovation
2022
Veterans Health Administration
2019
Santa Clara Valley Medical Center
2019
<h3>Importance</h3> Patients with frailty have higher risk for postoperative mortality and complications; however, most research has focused on small groups of high-risk procedures. The associations among frailty, operative stress, are poorly understood. <h3>Objective</h3> To assess the association between at varying levels stress as measured by Operative Stress Score, a novel measure created this study. <h3>Design, Setting, Participants</h3> This retrospective cohort study included veterans...
<h3>Importance</h3> Guidelines recommend using gabapentin to decrease postoperative pain and opioid use, but significant variation exists in clinical practice. <h3>Objective</h3> To determine the effect of perioperative on remote time resolution cessation. <h3>Design, Setting, Participants</h3> A randomized, double-blind, placebo-controlled trial was conducted at a single-center, tertiary referral teaching hospital. total 1805 patients aged 18 75 years scheduled for surgery (thoracotomy,...
BackgroundIdentification of a safe and effective medical therapy for abdominal aortic aneurysm (AAA) disease remains significant unmet need. Recent small cohort studies indicate that metformin, the world's most commonly prescribed oral hypoglycemic agent, may limit AAA enlargement. We sought to validate these preliminary observations in larger cohort.MethodsAll patients with asymptomatic managed Veterans Affairs Health Care System between 2003 2013 were identified by International...
<h3>Importance</h3> Acute postoperative pain is associated with the development of persistent postsurgical pain, but it unclear which aspect most estimable. <h3>Objective</h3> To identify patient clusters based on acute trajectories, preoperative psychosocial characteristics high-risk cluster, and best predictor remote outcomes. <h3>Design, Setting, Participants</h3> A secondary analysis Stanford Accelerated Recovery Trial randomized, double-blind clinical trial was conducted at a...
There is growing evidence that thrombotic and inflammatory pathways contribute to the severity of COVID-19. Common medications such as aspirin, mitigate these pathways, may decrease COVID-19 mortality. This retrospective assessment was designed quantify correlation between pre-diagnosis aspirin mortality for positive patients in our care. Data from Veterans Health Administration national electronic health record database utilized evaluation. across country with a first polymerase chain...
Abstract Infectious threats, like the COVID-19 pandemic, hinder maintenance of a productive and healthy workforce. If subtle physiological changes precede overt illness, then proactive isolation testing can reduce labor force impacts. This study hypothesized that an early infection warning service based on wearable monitoring predictive models created with machine learning could be developed deployed. We prototype tool, first deployed June 23, 2020, delivered continuously updated scores risk...
Background: Major joint replacement surgical procedures are common, elective with a care episode that includes both inpatient readmissions and postoperative emergency department (ED) visits. Inpatient well studied; however, to our knowledge, little is known about ED visits following these procedures. We sought characterize 30-day major procedure. Methods: used administrative records from California, Florida, New York, 2010 through 2012, identify adults undergoing total knee hip arthroplasty....
Breast reconstruction improves quality-of-life of breast cancer patients. Different reconstructive options exist, yet commentary in the plastic surgery literature suggests that financial constraints are limiting access to autologous (AR). This study follows national trends and identifies factors associated with choices. Data were obtained from Nationwide Inpatient Sample 1998 2008. Patients categorized as having either implant or ARs. Bivariate multivariate regression analysis identified...
Widely-prescribed prodrug opioids (e.g., hydrocodone) require conversion by liver enzyme CYP-2D6 to exert their analgesic effects. The most commonly prescribed antidepressant, selective serotonin reuptake inhibitors (SSRIs), inhibits activity and therefore may reduce the effectiveness of opioids. We used a machine learning approach identify patients combination SSRIs postoperatively examine effect this on postoperative pain control. Using EHR data from an academic medical center, we...
Electronic health records (EHRs) were implemented to improve quality of care and patient outcomes. This study assessed the relationship between EHR-adoption We performed an observational using State Inpatient Databases linked American Hospital Association survey, 2011. Surgical medical patients from 6 large, diverse states included. univariate analyses developed hierarchical regression models relating level EHR utilization mortality, readmission rates, complications. evaluated effect...
The sudden emergence of COVID-19 has brought significant challenges to the care Veterans. An improved ability predict a patient's clinical course would facilitate optimal decisions, resource allocation, family counseling, and strategies for safely easing distancing restrictions. Care Assessment Need (CAN) score is an existing risk assessment tool within Veterans Health Administration (VA), produces from 0 99, with higher correlating greater risk. model was originally designed nonacute...
The purpose of this study was to assess length stay (LOS), complication rates, costs, and charges cleft palate repair by various hospital types. We hypothesized that pediatric hospitals would have shorter LOS, fewer complications, lower costs charges.Patients were identified ICD-9-CM code for (27.62) using databases from the Agency Health Research Quality Healthcare Cost Utilization Project Kids' Inpatient Database 1997, 2000, 2003, 2006. Patient characteristics (age, race, gender, insurer,...
Addressing the opioid epidemic is a national priority. We analyzed trends in inpatient and emergency department (ED) discharges for abuse, dependence, poisoning using Healthcare Cost Utilization Project data. Inpatient ED discharge rates increased overall across study period, but decline was observed prescription opioid–related beginning 2010, while sharp increase heroin-related began 2008.