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).

Variation in mechanical circulatory support use for acute myocardial infarction cardiogenic shock.

Background: Cardiogenic shock (CS) is a leading cause of mortality following acute myocardial infarction (AMI). Some patients may require intra-aortic balloon pump (IABP) or percutaneous ventricular assist device (PVAD) placement; however, there is a paucity of standardised algorithms to guide the deployment of each device. The present study evaluated interhospital variation in the use of IABP and PVAD for AMI CS and identified institutional factors associated with hospital-level device preference.

Impact of gastrointestinal complications on readmission and resource use after kidney transplantation.

Background: Gastrointestinal complications are a major cause of morbidity following kidney transplantation and may be attributable to the need for immunosuppression. Given the lack of contemporary data on this topic, we characterized the incidence and association of gastrointestinal complications with index outcomes and readmission in a national cohort of kidney transplantation recipients.

Methods: All adults undergoing kidney transplantation in the 2016-2021 Nationwide Readmissions Database were identified.

Patterns and Consequences of Care Fragmentation in Post-Surgical Management of Upper Gastrointestinal and Hepatopancreatobiliary Cancers.

Background: Upper gastrointestinal (UGI) and hepatopancreatobiliary (HPB) oncologic operations are frequently performed at major referral centers. Postoperatively, many patients face care fragmentation (CF), which has been previously linked to inferior outcomes. This analysis examines clinical and financial outcomes of CF following UGI and HPB cancer operations.

Association of cognitive impairment with utilization and acute outcomes of aortic valve replacement.

Background: An increasing number of older adults are diagnosed with severe aortic stenosis and offered surgical or transcatheter aortic valve replacement. Given that the increase in cognitive impairment among geriatric patients has been estimated up to approximately 30%, we examined the independent association of cognitive impairment with postoperative outcomes.

Methods: All hospitalizations involving surgical aortic valve replacement or transcatheter aortic valve replacement for aortic stenosis among older adults (≥65 years) were identified from the 2016-2021 Nationwide Readmissions Database.

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.

Sex-based disparities in acute outcomes of endovascular abdominal aortic aneurysm repair.

Introduction: Although endovascular aneurysm repair is widely adopted for the treatment of abdominal aortic aneurysms, several factors, including female sex, traditionally have been thought to confer inferior outcomes. In the absence of contemporary analyses, we characterized in-hospital outcomes of endovascular aneurysm repair in a national cohort of patients with abdominal aortic aneurysm and examined the evolution of sex-based disparities over the past decade.

Methods: The 2010-2021 Nationwide Readmissions Database was queried to identify all adult (≥18 years) patients with a diagnosis of unruptured abdominal aortic aneurysms undergoing elective endovascular aneurysm repair.

Persistent racial disparities in the use of high-volume esophagectomy centers in the United States.

Background: Although the volume-outcome relationship in esophagectomy has been established, disparities in the use of high-volume esophagectomy centers persist. The present study examined the representation of various racial groups undergoing esophagectomy at high-volume hospitals and explored the associated clinical and financial outcomes.

Methods: All elective adult (≥18 years) hospitalizations entailing esophagectomy were identified in the 2012-2021 National Inpatient Sample.

Acute Cardiogenic Shock Secondary to Left Main Occlusion in a Patient with Behçet Disease.

Coronary artery involvement in Behçet disease (BD) is exceedingly rare and is associated with significant risk of short-term and long-term mortality. We describe a rare case of ST-segment elevation myocardial infarction and cardiogenic shock due to suspected coronary vasculitis in a patient with BD successfully treated with mechanical circulatory support.

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.

Transcarotid Artery Revascularization Versus Carotid Endarterectomy With and Without High-Risk Criteria: A National Target Trial.

Objective: We sought to evaluate outcomes associated with transcarotid artery revascularization with flow reversal(TCAR) versus carotid endarterectomy(CEA) for carotid artery stenosis(CAS), emulating a randomized controlled trial.

Summary Background Data: The introduction of TCAR has revolutionized management of CAS. While this approach has been demonstrated to yield reduced morbidity relative to transfemoral carotid artery stenting, a comparison of outcomes with gold-standard CEA remains lacking.

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).

Retained foreign bodies after major operations: Trends, risk factors, and associated outcomes.

Background: Retained foreign bodies are rare complications of surgical practice that are associated with adverse events and increased health care costs. While previous work has reported on the incidence of retained foreign bodies, updated national data evaluating contemporary trends as well as risk factors and associated outcomes remain limited.

Methods: The 2018-2022 National Inpatient Sample was used to identify all hospitalizations entailing major cardiac, gastrointestinal, genitourinary, neurosurgical, orthopedic, thoracic, and vascular operations.

Center-Level Variation in the Development of Acute Kidney Injury Following Cardiac Operation.

Background: Acute kidney injury (AKI) is a frequent complication following cardiac surgery. However, factors associated with AKI remain poorly understood. In this national study, we evaluated centre-level variation in the incidence of AKI after elective cardiac surgery.

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 center-level operative volume and acute outcomes following robotic-assisted colectomy for colorectal cancer.

Background: The adoption of robotic-assisted colectomy (RAC) remains limited due to high costs. There is a paucity of data regarding the impact of institutional robotic experience on costs in patients undergoing RAC for colorectal cancer.

Methods: All adult patients undergoing RAC for colorectal cancer were identified using the 2016-2020 Nationwide Readmissions Database.

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.