Publications by authors named "Spencer R Goble"
Background: Gastrostomy tubes have not been shown to improve long-term outcomes in patients with dementia, yet the risk of short-term complications have not been well characterized in this population.
Methods: This is a cross-sectional retrospective assessment of the National Inpatient Sample from 2016 to 2022. We compared outcomes in patients with dementia and those without dementia.
Background: The impact of homelessness on clinical outcomes and health care utilization among hospitalized cirrhosis patients has not been well-characterized.
Methods: We conducted a cross-sectional study using the National Inpatient Sample (2016 to 2021) to analyze hospitalizations of adults with cirrhosis, comparing outcomes between those with and without homelessness. Demographic, clinical, and hospital-level characteristics were assessed, along with outcomes such as mortality and AMA discharges.
IntroductionEnd-of-life care for liver transplant recipients is often characterized by high utilization of invasive procedures, prolonged hospital stays, and elevated health care costs. Despite evidence demonstrating that palliative care can reduce aggressive interventions, improve patient-centered outcomes, and lower costs, its integration into transplant care remains inconsistent.MethodsA retrospective analysis was conducted using the National Inpatient Sample database (2016-2021).
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- The study examined the use of physical restraints on patients with hepatic encephalopathy, particularly focusing on racial and socioeconomic disparities in their application.
- Findings revealed that restraint use occurred in 2.4% of hospitalizations, with Black patients more likely to be restrained compared to White patients, while income level did not significantly impact restraint use.
- Additionally, the results showed that restraints were linked to higher mortality in patients without other invasive cares, whereas they reduced mortality in cases with invasive procedures, highlighting the need for careful evaluation of restraint necessity.
End-of-life in Hepatocellular Carcinoma: How Palliative Care and Social Factors Impact Care and Cost.
J Clin Gastroenterol
September 2025
Article Synopsis
- - The study examined how palliative care, race, and socioeconomic status affect the use of invasive procedures in patients with hepatocellular carcinoma (HCC), using data from hospitalizations between 2016 and 2019.
- - Results showed that 18.1% of HCC hospitalizations involved palliative care, which was linked to fewer invasive procedures in terminal cases, while Black and Hispanic patients were more likely to undergo aggressive treatments compared to white patients.
- - Palliative care not only led to less aggressive end-of-life care but also resulted in lower hospitalization costs for both terminal and nonterminal cases, highlighting its importance in managing HCC patients.
Article Synopsis
- - Traumatic pancreaticobiliary injuries are tough to diagnose and manage, and a study analyzed 25 trauma cases where patients underwent endoscopic retrograde cholangiopancreatography (ERCP) to address these injuries.
- - Among the 25 patients, 48% had pancreatic injuries, another 48% had biliary injuries, and the median age was 28, with most injuries stemming from blunt trauma (56%).
- - ERCP proved effective, as all biliary leaks were resolved in patients who had repeat ERCPs, while 57% of pancreatic duct leaks were resolved in those who also had follow-up procedures, although one patient did develop complications.
Background Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are gaining popularity in the management of diabetes mellitus and obesity. It has been suggested that this class of medications causes delayed gastric emptying which raised concerns about the potential for aspiration of gastric contents in patients undergoing sedation. This led to a statement by the American Society of Anesthesiologists about their preoperative use.
View Article and Find Full Text PDFBackground: Prior assessments of critical care outcomes in patients with cirrhosis have shown conflicting results. We aimed to provide nationwide generalizable results of critical care outcomes in patients with decompensated cirrhosis.
Methods: This is a retrospective study using the National Inpatient Sample from 2016 to 2019.
Introduction: Currently available data regarding the impact of liver transplantation on the outcomes of patients hospitalized with COVID-19 is conflicting. This study aims to compare the outcomes and resource utilization between patients with and without a history of liver transplant hospitalized with COVID-19.
Methods And Materials: This is a retrospective study using the National Inpatient Sample.
The Effect of Pass/Fail Exam Grading on Exam Performance in a Pediatric Clerkship.
J Med Educ Curric Dev
November 2023
Objective: Clerkship grades are a component of determining a residency candidate's competitiveness. In 2017, the University of Minnesota Medical School's pediatric clerkship transitioned its standardized multiple-choice exam, the Aquifer Pediatrics Examination, to pass/fail with eligibility for honors being determined by clinical performance, not exam performance. We assessed the effect this change had on Aquifer exam performance and evaluated for correlation between Aquifer exam performance and clinical evaluation scores in order to gather insight into the validity of each type of assessment with respect to one another.
View Article and Find Full Text PDFRevaccination for Hepatitis B in Previous Nonresponders Following Hepatitis C Eradication.
J Infect Dis
February 2024
Background: Patients with chronic hepatitis C virus (HCV) do not respond to hepatitis B virus (HBV) vaccination as efficiently as the general population. We assessed if revaccination after HCV treatment resulted in improved response.
Methods: Previous HBV vaccine nonresponders were prospectively recruited for revaccination after HCV eradication.
Introduction and Objectives Statin use for primary prevention of coronary artery disease (CAD) has historically been limited in patients with chronic liver disease due to concerns for increased adverse events with statin use in this population. We aimed to quantify the underutilization of statins among individuals with a history of HCV infection in a community health system to understand the clinical implications of statin underutilization in a diverse, generalizable population of patients infected with HCV. Materials and Methods We performed a single-center retrospective study of individuals with a history of HCV infection aged 40-75 years from 2019-2021.
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