Impact of Social Vulnerability and Allostatic Load on Postoperative Outcomes.

Background: We sought to investigate the association between allostatic load (AL), social vulnerability, and postoperative outcomes following hepatopancreatobiliary (HPB) cancer surgery.

Methods: Individuals who underwent HPB surgery were identified using the Epic Cosmos database. AL was calculated based on 10 biomarkers across four physiological systems: cardiovascular, metabolic, renal, and immune.

Stronger together: Impact of social capital on gastrointestinal cancer surgery outcomes among older adults.

Introduction: We sought to investigate the association between social capital and postoperative outcomes among patients undergoing gastrointestinal cancer surgery.

Methods: Medicare Standard Analytic Files were queried to identify individuals who underwent gastrointestinal cancer surgery between 2007 and 2019. Patient residential addresses at the county level were linked with social capital data.

Cancer screening adherence among e-cigarette users in the United States.

Introduction: Tobacco use patterns have dramatically shifted, with electronic cigarettes (e-cigarettes) rapidly increasing in popularity despite uncertainty about their health impacts. This study examines adherence to preventive cancer screening guidelines among cigarette smokers, e-cigarette users, and non-smokers, addressing a critical gap in understanding how tobacco use influences engagement in preventive healthcare.

Methods: A total of 445132 adult respondents were queried from the 2022 Behavioral Risk Factor Surveillance System data.

Nationwide Trends and Perioperative Outcomes of Alcohol Withdrawal Syndrome After Major Operation.

Introduction: Alcohol withdrawal syndrome (AWS) is a potentially life-threatening condition that may complicate the postoperative course of surgical patients. This study aimed to define the incidence, identify risk factors, and evaluate the impact of AWS among patients undergoing major surgery.

Methods: The National Inpatient Sample (2016-2019) was used to identify adult patients (≥18 years) who underwent major surgical procedures.

An easy-to-use online calculator to identify patients least likely to benefit from surgical resection of intrahepatic cholangiocarcinoma.

Background And Objective: Although it is the primary curative-intent treatment option for intrahepatic cholangiocarcinoma, liver resection can be associated with high postoperative morbidity and mortality. As such, a high-risk resection may not be warranted when the oncological benefits are minimal. In the current study, we sought to develop 2 preoperative models to predict 90-day mortality and overall survival after liver resection for intrahepatic cholangiocarcinoma.

Patterns of Cannabis Use Among Cancer Survivors: Insights From the Behavioral Risk Factor Surveillance System.

Purpose: Cannabis has been legalized across multiple states over the past decade; however, its use among cancer survivors remains understudied. Therefore, we sought to define factors associated with cannabis use among cancer survivors.

Materials And Methods: This study used the Behavioral Risk Factor Surveillance System to identify cancer survivors across 23 states that completed the optional cannabis module in 2021.

Impact of Neighborhood Socioeconomic Trajectories on Gastrointestinal Cancer Care: A SEER-Medicare Analysis.

Background: Historical discriminatory policies, such as residential redlining, along with current socioeconomic status, may impact gastrointestinal (GI) cancer care. We sought to investigate how evolving neighborhood characteristics impact the diagnosis and treatment of GI cancer.

Patients And Methods: Individuals who were diagnosed with GI cancer were identified using the Surveillance Epidemiology and End Results (SEER)-Medicare linked database.

Racial/ethnic and socioeconomic disparities in cancer mortality hotspots: A multi-state geospatial analysis.

Introduction: We sought to identify county-level cancer mortality hotspots for breast, colorectal, lung, and prostate cancers, as well as evaluate contributions of structural factors underlying racial/ethnic disparities, and social vulnerability index (SVI).

Methods: This ecological analysis included states selected to represent high (i.e.

Employment Disruption and Financial Burden Associated with Gastrointestinal Cancers.

Background: Understanding the extent of employment disruption and the financial strain faced by individuals with GI cancer is crucial to develop targeted support services. We sought to investigate employment disruption and financial burden among patients with gastrointestinal cancer (GI) diagnosis.

Methods: Patients diagnosed with GI cancer were identified using the MarketScan database.

Association of Discharge Against Medical Advice with Surgical Outcomes and Healthcare Cost.

Background: Patients who leave the hospital prematurely often remain in a compromised clinical state, which may increase the risk of complications. Discharge against medical advice (DAMA) has been associated with increased morbidity, fragmented care, and higher healthcare costs, but its impact on major surgical populations remains understudied. We sought to evaluate trends, risk factors, and postoperative outcomes among surgical patients who were DAMA.

Impact of Private Equity Acquisition of Hospitals on Surgical Outcomes.

Objective: To characterize outcomes of patients undergoing a major surgical procedure at private equity-acquired (PEA) versus non-acquired centers.

Summary Background Data: Private-equity acquisitions of health centers can be followed by policy changes aimed at maximizing profit over quality of care.

Methods: Patients who underwent a major surgical procedure between 2016-2021 were identified using 100% Medicare Standard Analytic Files.

The Impact of Antidepressants on Surgical Outcomes Among Patients With Abdominal Cancer and Comorbid Depression.

Objective: Depression is commonly linked to cancer and may negatively impact patient outcomes; however, the influence of antidepressants on surgical outcomes remains unclear. We sought to evaluate the role of antidepressants among patients with gastrointestinal cancer and comorbid depression undergoing surgical resection.

Methods: Patients diagnosed with hepatobiliary, pancreatic, and colorectal cancers (2008-2019) were identified within SEER-Medicare.

The Hidden Burden: Impact of Allostatic Load on Colorectal Cancer Surgery Outcomes.

Background: Allostatic load (AL) is a composite measure of the physiological damage caused by socioenvironmental stressors. We sought to investigate the association between AL, social vulnerability index (SVI), and postoperative outcomes following colorectal cancer (CRC) surgery.

Patients And Methods: Individuals who underwent surgery for CRC between 2022 and 2024 were identified using the Epic Cosmos database.

Lymphocyte-C-Reactive Protein Ratio: Impact on Prognosis of Patients Following Resection of Primary Liver Cancer.

Objective: We sought to characterize the prognostic value of lymphocyte-C-reactive protein ratio (LCR) among patients undergoing liver resection (LR) for hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC).

Methods: Patients who underwent curative-intent LR for HCC and ICC between 2000 and 2023 were identified from a multiinstitutional database. The prognostic value of nine different inflammatory markers were evaluated relative to short- (i.

Impact of postdischarge low-molecular-weight heparin after gastrointestinal cancer surgery.

Background: The real-world effectiveness of low-molecular-weight heparin (LMWH) to prevent venous thromboembolism (VTE) among patients undergoing cancer surgery remains uncertain. We sought to examine postdischarge prescription patterns and outcomes associated with LMWH use among patients who underwent surgery for gastrointestinal (GI) cancer.

Methods: Individuals who underwent GI cancer resection between 2013 and 2020 were identified from the IBM MarketScan database.

Surgical outcomes among individuals experiencing homelessness with gastrointestinal cancer.

Background: The number of people experiencing homelessness has increased drastically in recent years, and cancer remains a leading cause of death among this population. Therefore, the current study aimed to investigate the receipt of gastrointestinal (GI) cancer treatment and outcomes among people experiencing homelessness.

Methods: Patients diagnosed with GI cancer were identified using the National Inpatient Sample database (2016-2019).

Surgical Desirability of Outcomes Ranking: Implications of Racial and Economic Privilege on Days at Home after Major Operation.

Background: Racial and economic privilege can impact postoperative outcomes. We sought to assess the association of socioeconomic privilege with surgical outcomes using a composite measure called Desirability of Outcome Ranking (DOOR) and days at home within 90 days (DAH-90).

Methods: Medicare claims data were used to identify patients who underwent a range of complex surgical procedures between 2016 and 2021.

Prevalence and trends of cancer-related daily life limitations among gastrointestinal cancer survivors.

Purpose: The number of gastrointestinal (GI) cancer survivors has increased substantially due to improvements in early detection and treatment, yet long-term functional patient outcomes remain poorly characterized. We sought to quantify the burden of activity limitations (AL) and functional limitations (FL) among GI cancer survivors compared with non-GI cancer survivors and the general U.S.

Textbook outcome in liver surgery after staged versus simultaneous resection for synchronous colorectal liver metastases.

Background: We sought to define the likelihood of textbook outcome in liver surgery (TOLS) among patients undergoing simultaneous versus staged resection for sCRLM.

Methods: Patients with sCRLM who underwent curative-intent resection between 2000-2022 were identified from an international multi-institutional database. TOLS was defined by the absence of intraoperative grade ≥2 events, R1 resection margin, post-hepatectomy liver failure, bile leakage, major postoperative complications, in-hospital/90-day mortality, and 90-day readmission.

New persistent opioid use among patients with behavioral health disorders following major surgery.

Background: Patients with substance use or mental health disorders may have differential responses to pain after surgery, which may result in higher opioid use. We sought to characterize the association of behavioral health disorders with new persistent opioid use after a major surgical procedure.

Methods: Patients who underwent a major surgical procedure between 2013 and 2020 were identified using the IBM-MarketScan database.

Identification of a gene signature and prediction of overall survival of patients with stage IV colorectal cancer using a novel machine learning approach.

Objective: We sought to characterize unique gene signature patterns associated with worse overall survival (OS) among patients with stage IV colorectal cancer (CRC) using a machine learning (ML) approach.

Methods: Data from the AACR GENIE registry were analyzed for genetic variations (somatic mutations, structural variants and copy number alterations) among patients with CRC. Adult patients (≥18 years) with histologically confirmed stage IV CRC who underwent next-generation sequencing were included.

Exocrine pancreatic insufficiency after partial pancreatectomy: impact on primary healthcare utilization and expenditures.

Introduction: We sought to characterize the impact of exocrine pancreatic insufficiency (EPI) on primary healthcare utilization and expenditures following partial pancreatectomy (PP).

Methods: Patients who underwent PP between 2004 and 2019 were identified using SEER-Medicare. Patients who developed EPI within 6 months following surgery were included in the EPI cohort and were followed for 1-year post-surgery.

Recurrence patterns and prediction of survival after recurrence for gallbladder cancer.

Background: Gallbladder cancer (GBC) is associated with a poor prognosis. Recurrence patterns and their effect on survival remain ill-defined. This study aimed to analyze recurrence patterns and develop a machine learning (ML) model to predict survival after recurrence (SAR) of GBC.

Impact of intraoperative blood loss on postoperative morbidity after liver resection for primary and secondary liver cancer.

Background: We sought to determine the association between intraoperative blood loss (IBL) and postoperative morbidity among patients undergoing surgery for liver cancer.

Methods: Patients undergoing surgery for primary and secondary liver cancer were identified from a multi-institutional database. Adjusted blood loss (aBL) was calculated by normalizing IBL to body weight; the comprehensive complication index (CCI) was used to evaluate postoperative complications.

Predictive model for very early recurrence of patients with perihilar cholangiocarcinoma: a machine learning approach.

Background: Although offering the best chance of potential cure for patients with localized perihilar cholangiocarcinoma (pCCA), resection has been associated with high morbidity and sometimes poor long-term outcomes due to recurrence. We sought to develop a predictive model to identify individuals at high risk for very early recurrence (VER) after curative-intent surgery for pCCA.

Methods: Patients who underwent curative-intent surgery for pCCA between 2000-2023 were identified from a multi-institutional database.