Gastrointestinal complications following cardiac surgery: A national analysis.

Background: Gastrointestinal complications occur in ∼1 of 20 patients undergoing cardiac surgery and are associated with adverse consequences, although contemporary analyses are lacking.

Methods: All elective adult (≥18) hospitalizations entailing coronary artery bypass grafting, valve procedures, or a combination thereof were identified in the 2016-2021 Nationwide Readmission Database. Institutions were stratified by annual hospital cardiac surgery volume, with the highest quartile defined as high-volume hospitals.

Impact of Transcatheter Aortic Valve Replacement Volume on Outcomes in Patients with End Stage Renal Disease.

Background: Patients with end-stage renal disease (ESRD) are at increased risk for calcific aortic stenosis. Given limited data on the efficacy of transcatheter aortic valve replacement (TAVR) in this population, the present study examined acute mortality, complications, and 30-day nonelective readmissions in a national cohort of patients with ESRD.

Methods: The 2016-2021 National Readmissions Database was queried to identify all TAVR admissions (≥18years).

Association of hematological malignancies with clinical and financial outcomes following transcatheter aortic valve replacement.

Background: While Transcatheter Aortic Valve Replacement (TAVR) is increasingly performed in patients with severe aortic stenosis, the impact of Hematologic Malignancies (HM) on associated outcomes, remains unclear. The authors The authors used a contemporary national database to investigate whether HM is associated with adverse clinical and financial outcomes following elective TAVR.

Materials And Methods: The authors The authors identified all adult (≥ 18-years) hospitalizations for elective TAVR in the 2016-2021 Nationwide Readmissions Database.

Contemporary Operative Trends and Outcomes of Laparoscopic and Robotic Heller Myotomy Using a Large National Database.

BackgroundRobotic-assisted Heller myotomy (RAHM) is increasingly utilized for the surgical treatment of achalasia. While prior studies have suggested potential technical advantages of RAHM over laparoscopic Heller myotomy (LHM), the economic implications remain less well-defined. This study aimed to compare hospitalization costs and clinical outcomes between RAHM and LHM using a nationally representative cohort.

Inter-hospital variation in transfusion practices for severe trauma.

Background: Ideal blood transfusion practices have evolved over the last decade, with updated recommendations for the plasma:red blood cell (RBC) ratio. A ≥ 1:1 ratio of plasma:RBC has been associated with improved survival. The objective of the current study was to evaluate interhospital variation in plasma:RBC ratio and the associated inpatient mortality.

Outcomes and costs in splenectomy after failed splenic arterial embolization for blunt splenic injury.

Background: Splenic injury (BSI) is present in nearly 45 % of abdominal blunt trauma cases in the US and splenic artery embolization (SAE) has been increasingly utilized to manage BSI in recent years. However, SAE failure necessitating delayed splenectomy remains a critical concern with significant implications for patient outcomes and healthcare resource utilization.

Methods: We conducted a retrospective cohort study utilizing the 2016-2021 Nationwide Readmissions Database.

Association of psychosocial risk factors on outcomes of patients undergoing emergency general surgery Accepted at Academic Surgical Congress.

Introduction: Psychosocial risk factors, including depression and developmental disorders, have increasingly been shown to adversely impact postoperative outcomes. Despite their high prevalence, psychosocial risk factors and their associated outcomes after emergency general surgery remain ill-defined. In the present work, we characterized the association of psychosocial risk factors with mortality, postoperative complications, hospitalization costs, and 30-day readmissions after emergency general surgery.

Increasing Utilization of Palliative Care is Associated With Reduced Health Care Costs in Operative Trauma: A National Analysis.

IntroductionPalliative care (PC) has been shown to improve comfort for surgical patients nearing the end of life. Although single-institution studies suggest PC to be a cost-effective strategy, the contemporary national trends in costs and utilization of this modality remain unknown.MethodsAdult patients (≥18 years) who did not survive following hospitalization for surgical management of traumatic injury were tabulated in the 2016 to 2020 Nationwide Readmissions Database.

Transcatheter compared with surgical mitral valve intervention in patients with end-stage renal disease.

Introduction: Patients with end-stage renal disease are at increased risk for developing mitral valve calcification and dysfunction. The present study evaluated clinical and financial outcomes of transcatheter compared with surgical mitral valve replacement/repair in patients with end-stage renal disease using a national cohort.

Methods: This was a retrospective analysis of all adult patients with end-stage renal disease receiving isolated surgical mitral valve replacement/repair or transcatheter mitral valve replacement/repair in the Nationwide Readmissions Database (2016-2021).

Association of hospital for-profit status with clinical and financial outcomes following emergency general surgery.

Background: The impact of for-profit (FP) hospital ownership on healthcare outcomes has garnered increasing attention in recent years with limited work linking FP status with lower quality of care and higher costs. However, outcomes emergency general surgery (EGS) at FP hospitals remains unknown.

Methods: All non-elective adult (≥18 years) hospitalizations entailing EGS (appendectomy, cholecystectomy, laparotomy, large bowel resection, perforated ulcer repair, or small bowel resection), within 2 days of admission, were tabulated from the 2016 to 2021 National Inpatient Sample.

Association of dementia with adverse outcomes after emergent hernia repair.

Background: As the prevalence of dementia within an aging population increases, its impact on surgical outcomes, particularly in emergent settings, is a growing concern. We aimed to evaluate the association between dementia and outcomes after emergent hernia repair.

Methods: A retrospective analysis was performed of patients (≥65 years) undergoing nonelective hernia repair using the Nationwide Readmissions Database from 2016 to 2021.

National trends in utilization and outcomes of elective open and minimally invasive colostomy reversal: A NSQIP analysis.

Background: Minimally invasive approach for reversal of Hartmann's procedure remains understudied. This study examined the outcomes associated with open and minimally invasive approaches for colostomy reversal in a national cohort.

Methods: The 2012-2022 American College of Surgeons National Surgical Quality Improvement Program participant use file data was queried to identify all adult (≥18 years) patients undergoing elective open or minimally invasive colostomy takedown.

Association of body mass index and outcomes in surgical and transcatheter aortic valve replacement.

Background: The association between body mass index (BMI) and outcomes in surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR) is not well understood. This study assessed the nuanced relationship between BMI and clinical outcomes in a nationally representative cohort undergoing aortic valve replacement.

Methods: Adult (≥18 years) admissions for elective SAVR or TAVR from the 2016-2021 National Inpatient Sample were analyzed.

Cost-Volume Relationship in Rectal Cancer Resection Across the United States.

BackgroundWhile greater institutional experience with high-risk rectal cancer operations has previously been associated with improved clinical outcomes, the impact on costs remains unclear. The present work aimed to characterize the relationship between hospital proctectomy volume and hospitalization costs.MethodsThe 2016-2021 Nationwide Readmissions Database was queried to identify all adults undergoing elective rectal cancer resection.

National Outcomes of Venoarterial Extracorporeal Life Support in Patients with Chronic Kidney Disease.

Background: Despite the increasing use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) as advanced circulatory support for acute cardiac and circulatory failure, its high morbidity and mortality have necessitated the identification of risk factors. The prevalence of chronic kidney disease (CKD) in VA-ECMO patients remains unclear, and its relationship with outcomes is not well established.

Methods: A retrospective analysis was conducted on patients (≥18 years) undergoing VA-ECMO using the 2019-2021 Nationwide Readmissions Database.

Association of frailty with clinical and financial outcomes of hospitalization for non-operative trauma.

Background: With advances in imaging and interventional techniques, traumatic injuries are increasingly managed non-operatively. However, the impact of frailty on outcomes of non-operatively managed traumatic injuries remains generally unexplored. Using a national cohort, we characterized the association of frailty with clinical and financial outcomes of non-operative trauma hospitalizations.

Association of hospital volume with outcomes for reoperative coronary artery bypass grafting.

Introduction: Outcomes following reoperative coronary artery bypass graft surgery are widely underexplored. Evaluating a contemporary national cohort, we assessed acute clinical and financial sequelae following reoperative coronary artery bypass graft surgery at the patient and hospital levels.

Methods: The 2016-2021 Nationwide Readmissions Database was queried to identify all adult (≥18 years) hospitalizations for elective isolated coronary artery bypass graft surgery.

Race based disparities in clinical and financial outcomes associated with major elective and emergent surgery.

Background: Racial health disparities are responsible for ∼$50 billion in excess annual healthcare expenditures, driven in part by unequal access to preventive services. We thus studied cost differences in abdominal aortic aneurysm repair (AAA), coronary artery bypass graft (CABG), and colon resection for malignancy (COL), as the elective status of these procedures suggest greater access to preventive care and screening.

Methods: All adult hospitalizations for AAA, CABG, and COL were identified using the 2011-2020 National Inpatient Sample.

Outcomes Following Colectomy at For-Profit Hospitals: A National Analysis.

BackgroundOne of the most commonly performed operations in the US, colectomy remains associated with a substantial incidence of postoperative complications. While there is increasing recognition that hospital for-profit financial structure may be linked with variation in morbidity, the impact of care at for-profit (FP) hospitals on outcomes following colectomy remains to be elucidated.MethodsAll adults undergoing elective/emergent colectomy for diverticular disease, inflammatory bowel disease, benign colonic neoplasms, or colon cancer, ≤2days of admission, were tabulated from the Nationwide Readmissions Database.

Decade-long variation in the development of complications after cardiac surgery across the United States.

Background: Interhospital variation in complications after cardiac surgery may reflect differences in quality across centers. Although these differences have been observed for years, changes in variation over time have not been quantified. In the present study, we assessed trends in center-level variation of major adverse events after cardiac surgery and associations with hospital volume.

Patient- and Institution-Level Factors Associated With Intraoperative Cardiac Arrest During Major Noncardiac Surgery.

Background: Intraoperative cardiac arrest (IOCA) is a rare but catastrophic event with significant morbidity, mortality, and health care costs. This study aimed to characterize the frequency, risk factors, and outcomes of IOCA.

Methods: Adults undergoing noncardiac surgery were identified in the 2016 to 2021 National Inpatient Sample.

Association of Tracheostomy Timing With Outcomes Following Traumatic Cervical Spinal Cord Injury.

BackgroundPatients with cervical spinal cord injury (CSCI) often require tracheostomy due to a prolonged ventilator dependence. However, optimal time for tracheostomy remains controversial.MethodsAll adult patients (≥18 years) with CSCI who underwent tracheostomy were identified in the 2018-2021 Trauma Quality Improvement Program database.

Great Debates: The Wave of the Future vs Tried and True: Integrated Training in Surgery vs General Surgery Training Followed by Fellowship.

Surgical training in the United States is undergoing a significant transformation, with a shift from the traditional model-general surgery followed by specialized fellowships-to integrated residency programs that offer early specialization. This shift has sparked debate over the impact on surgical competency, training efficiency, and outcomes. Proponents of integrated training highlight benefits such as earlier specialization, increased procedural volume, enhanced technical skills, and improved mentorship and research opportunities.

Association of Coronary Revascularization Modality and Timing With Outcomes of Acute Coronary Syndrome in Kidney Transplant Recipients.

Coronary artery disease (CAD) remains a leading cause of morbidity and mortality among renal transplant (RTx) recipients, with non-ST-segment-elevation acute coronary syndrome (NSTE-ACS) representing a disproportionately high burden. However, the optimal revascularization strategy for NSTE-ACS in RTx recipients remains unclear. This retrospective study analyzed the 2016 to 2021 Nationwide Readmissions Database.

Race, Insurance, and Sex-Based Disparities in Access to High-Volume Centers for Pancreatectomy.

Background: With a large body of literature demonstrating positive volume-outcome relationships for most major operations, minimum volume requirements have been suggested for concentration of cases to high-volume centers (HVCs). However, data are limited regarding disparities in access to these hospitals for pancreatectomy patients.

Methods: The 2005-2018 National Inpatient Sample (NIS) was queried for all elective adult hospitalizations for pancreatectomy.