The Experts below are selected from a list of 70143 Experts worldwide ranked by ideXlab platform

Elizabeth B Habermann - One of the best experts on this subject based on the ideXlab platform.

  • assessing the performance of national surgical quality improvement Program surgical risk calculator in elective spine surgery insights from patients undergoing single level posterior lumbar fusion
    World Neurosurgery, 2019
    Co-Authors: Arjun S Sebastian, Elizabeth B Habermann, Anshit Goyal, Mohammed Ali Alvi, Waseem Wahood, Mohamed Elminawy, Mohamad Bydon
    Abstract:

    Introduction The American College of Surgeons–National Surgical Quality Improvement Program Surgical Risk Calculator is a tool developed to use 21 individual patient characteristics to make predictions for occurrence of 13 general and 2 procedure-specific outcomes. The goal of this study was to evaluate the performance of the Surgical Risk Calculator in predicting outcomes in patients receiving posterior lumbar fusion. Methods American College of Surgeons–National Surgical Quality Improvement Program Participant Use File for 2015 was queried for patients with age ≥18 years undergoing single-level posterior lumbar fusion (PLF) surgery. Individual patient characteristics were entered into the online risk calculator interface to retrieve the predicted estimated risk for perioperative outcomes and complications. Following this, predictive performance was analyzed by computing Brier score, c-statistic, and sensitivity values for all observed outcomes. Results A total of 2808 patients undergoing single-level PLF were included in the analysis. Overall, a very low incidence of 30-day postoperative complications was observed with the procedure (0.9%–6.3%). Poor predictive performance was found for all outcomes, including readmissions (c-statistic = 0.63; sensitivity = 15.28%; Brier score = 0.048) and returns to operating room (c-statistic = 0.56; sensitivity = 21.05%; Brier score = 0.032). The best performance was observed for venous thromboembolism (c-statistic=0.66: Brier score = 0.008), although sensitivity was poor (3.85%) on account of low incidence. Predictive performance for length of stay revealed good agreement between observed and predicted values with the exception of prolonged predicted hospital stays (>3.5 days). Conclusions This study assesses the performance of the risk calculator for a homogenous population of patients undergoing a single-level PLF. Although the calculator did not fare well in predicting most outcomes, results need to be interpreted in the context of the low incidence rate of such outcomes.

  • risk factors for 30 day unplanned readmission and major perioperative complications after spine fusion surgery in adults a review of the national surgical quality improvement Program database
    Spine, 2016
    Co-Authors: Elizabeth B Habermann, Kristine Thomsen, Todd A Milbrandt, Ahmad Nassr, Noelle A Larson
    Abstract:

    STUDY DESIGN Retrospective review of a prospective cohort. OBJECTIVE The aim of the study was to determine the patient characteristics and surgical procedure factors related to increased rates of 30-day unplanned readmission and major perioperative complications after spinal fusion surgery, and the association between unplanned readmission and major complications. SUMMARY OF BACKGROUND DATA Reducing unplanned readmissions can reduce the cost of healthcare. Payers are implementing penalties for 30-day readmissions after discharge. There is limited data regarding the current rates and risk factors for unplanned readmission and major complications related to spinal fusion surgery. METHODS Spine fusion patients were identified using the 2012 and 2013 American College of Surgeons National Surgical Quality Improvement Program Participant User File. Rates of readmissions within 30 days after spine fusion surgery were calculated using the person-years method. Cox proportional hazards models were used to assess the independent associations of spine surgical procedure types, diagnoses, patient profiles, and major perioperative complications with unplanned related readmissions. Independent risk factors for major complications were assessed by multivariable logistic regression. RESULTS Of the 18,602 identified patients, there was a 5.2% overall major perioperative complication rate. There was a rate of 4.4% per 30 person-days for unplanned readmissions related to index surgery. Independent risk factors for both readmissions and major perioperative complications included combined anterior and posterior surgery, diagnosis of solitary tumor, older age, and higher American Society of Anesthesiologists class. Patients with deep/organ surgical site infection carried higher risk of having unplanned readmission, followed by pulmonary embolism, acute renal failure, and stroke/cerebral vascular accident with neurological deficit. CONCLUSION This study provides benchmark rates of 30-day readmission based on diagnosis and procedure codes from a high-quality database for adult spinal fusion patients and showed increased rates of 30-day unplanned readmission and major perioperative complications for patients with specific risk factors. Targeted preoperative planning on modifiable risk factors with proportional reimbursement may promote higher-quality healthcare. LEVEL OF EVIDENCE 3.

  • predictors of surgical site infection following craniotomy for intracranial neoplasms an analysis of prospectively collected data in the american college of surgeons national surgical quality improvement Program database
    World Neurosurgery, 2016
    Co-Authors: Brandon A Mccutcheon, Elizabeth B Habermann, Daniel S Ubl, Maya A Babu, Patrick R Maloney, Meghan E Murphy, Panagiotis Kerezoudis, Mohamad Bydon, Ian F Parney
    Abstract:

    Objective To determine the rate of surgical site infection (SSI) after resection of an intracranial neoplasm using the American College of Surgeons National Surgical Quality Improvement Program data set and to identify potential risk factors associated with SSI. Methods The National Surgical Quality Improvement Program Participant Use Data File was queried during the period 2006–2013 for patients who underwent a resection for an intracranial neoplasm. Multivariable logistic regression analysis was used to identify risk factors associated with SSI. Results Inclusion criteria were met by 12,021 patients. SSI occurred at a rate of 2.04%. SSI was significantly associated with increased rates of return to the operating room (56.1% vs. 4.0%, P 30 days (5.3% vs. 1.3%, P 4 hours (OR = 1.891, 95% CI = 1.298–2.756) were associated with an increased odds of SSI. Among cases with available chemotherapy data ( n  = 3504), recent chemotherapy (OR = 3.007, 95% CI = 1.460–6.196) was associated with an increased odds of SSI. Conclusions This study identified patient risk factors that may assist clinical decision making regarding patient risk stratification, timing of surgery, and preoperative antibiotic prophylaxis for patients with an intracranial neoplasm undergoing craniotomy.

Akshay Sood - One of the best experts on this subject based on the ideXlab platform.

  • adverse event rates timing of complications and the impact of specialty on outcomes following adrenal surgery an analysis of 30 day outcome data from the american college of surgeons national surgical quality improvement Program acs nsqip
    Urology, 2016
    Co-Authors: Akshay Sood, Kaustav Majumder, Naveen Kachroo, Jesse D Sammon, Firas Abdollah, Marianne Schmid, Linda Hsu, Wooju Jeong
    Abstract:

    Objective To report on 30-day adverse event rates and timing of complications following adrenal surgery; further, to investigate the impact of specialty (general surgery vs urology) on these outcomes using a large prospective multi-institutional data registry. Materials and Methods Within the American College of Surgeons National Surgical Quality Improvement Program (2005-2012), patients undergoing adrenalectomy were identified (CPT-codes: 60540, 60545, 60650). Outcomes evaluated included complications, blood transfusion, length of stay, reintervention, readmission, and mortality. Complications were further evaluated in relation to discharge status (pre-/postdischarge). Multivariable regression models assessed association between specialty and 30-day morbidity/mortality. Results During the study period, 4844 patients underwent adrenalectomy (95.7% general surgery). The overall complication rate was 7.5% (n = 363); 43.2% of the complications occurred postdischarge with a substantial proportion of major complications, including cardiac, pulmonary, renal, neurologic, septic, and deep venous thrombosis/pulmonary embolism also occurring postdischarge (29.9%). The overall blood transfusion, reintervention, readmission, and mortality rates were 3.9%, 2.0%, 6.4%, and 0.6%, respectively. In adjusted analyses, specialty did not have an effect on any of the outcomes ( P  >  .05 all). Conclusion One in 13 patients suffers a complication postadrenalectomy. Approximately 40% of these complications occur postdischarge, primarily within the first 2 weeks of surgery. Accurate knowledge regarding 30-day adverse event rates and timing of complications that this study provides may facilitate improved patient-physician communication and encourage early patient follow-up in this critical window. Lastly, specialty does not seem to affect outcomes in American College of Surgeons National Surgical Quality Improvement Program Participant hospitals.

Mohamad Bydon - One of the best experts on this subject based on the ideXlab platform.

  • assessing the performance of national surgical quality improvement Program surgical risk calculator in elective spine surgery insights from patients undergoing single level posterior lumbar fusion
    World Neurosurgery, 2019
    Co-Authors: Arjun S Sebastian, Elizabeth B Habermann, Anshit Goyal, Mohammed Ali Alvi, Waseem Wahood, Mohamed Elminawy, Mohamad Bydon
    Abstract:

    Introduction The American College of Surgeons–National Surgical Quality Improvement Program Surgical Risk Calculator is a tool developed to use 21 individual patient characteristics to make predictions for occurrence of 13 general and 2 procedure-specific outcomes. The goal of this study was to evaluate the performance of the Surgical Risk Calculator in predicting outcomes in patients receiving posterior lumbar fusion. Methods American College of Surgeons–National Surgical Quality Improvement Program Participant Use File for 2015 was queried for patients with age ≥18 years undergoing single-level posterior lumbar fusion (PLF) surgery. Individual patient characteristics were entered into the online risk calculator interface to retrieve the predicted estimated risk for perioperative outcomes and complications. Following this, predictive performance was analyzed by computing Brier score, c-statistic, and sensitivity values for all observed outcomes. Results A total of 2808 patients undergoing single-level PLF were included in the analysis. Overall, a very low incidence of 30-day postoperative complications was observed with the procedure (0.9%–6.3%). Poor predictive performance was found for all outcomes, including readmissions (c-statistic = 0.63; sensitivity = 15.28%; Brier score = 0.048) and returns to operating room (c-statistic = 0.56; sensitivity = 21.05%; Brier score = 0.032). The best performance was observed for venous thromboembolism (c-statistic=0.66: Brier score = 0.008), although sensitivity was poor (3.85%) on account of low incidence. Predictive performance for length of stay revealed good agreement between observed and predicted values with the exception of prolonged predicted hospital stays (>3.5 days). Conclusions This study assesses the performance of the risk calculator for a homogenous population of patients undergoing a single-level PLF. Although the calculator did not fare well in predicting most outcomes, results need to be interpreted in the context of the low incidence rate of such outcomes.

  • predictors of surgical site infection following craniotomy for intracranial neoplasms an analysis of prospectively collected data in the american college of surgeons national surgical quality improvement Program database
    World Neurosurgery, 2016
    Co-Authors: Brandon A Mccutcheon, Elizabeth B Habermann, Daniel S Ubl, Maya A Babu, Patrick R Maloney, Meghan E Murphy, Panagiotis Kerezoudis, Mohamad Bydon, Ian F Parney
    Abstract:

    Objective To determine the rate of surgical site infection (SSI) after resection of an intracranial neoplasm using the American College of Surgeons National Surgical Quality Improvement Program data set and to identify potential risk factors associated with SSI. Methods The National Surgical Quality Improvement Program Participant Use Data File was queried during the period 2006–2013 for patients who underwent a resection for an intracranial neoplasm. Multivariable logistic regression analysis was used to identify risk factors associated with SSI. Results Inclusion criteria were met by 12,021 patients. SSI occurred at a rate of 2.04%. SSI was significantly associated with increased rates of return to the operating room (56.1% vs. 4.0%, P 30 days (5.3% vs. 1.3%, P 4 hours (OR = 1.891, 95% CI = 1.298–2.756) were associated with an increased odds of SSI. Among cases with available chemotherapy data ( n  = 3504), recent chemotherapy (OR = 3.007, 95% CI = 1.460–6.196) was associated with an increased odds of SSI. Conclusions This study identified patient risk factors that may assist clinical decision making regarding patient risk stratification, timing of surgery, and preoperative antibiotic prophylaxis for patients with an intracranial neoplasm undergoing craniotomy.

Wooju Jeong - One of the best experts on this subject based on the ideXlab platform.

  • adverse event rates timing of complications and the impact of specialty on outcomes following adrenal surgery an analysis of 30 day outcome data from the american college of surgeons national surgical quality improvement Program acs nsqip
    Urology, 2016
    Co-Authors: Akshay Sood, Kaustav Majumder, Naveen Kachroo, Jesse D Sammon, Firas Abdollah, Marianne Schmid, Linda Hsu, Wooju Jeong
    Abstract:

    Objective To report on 30-day adverse event rates and timing of complications following adrenal surgery; further, to investigate the impact of specialty (general surgery vs urology) on these outcomes using a large prospective multi-institutional data registry. Materials and Methods Within the American College of Surgeons National Surgical Quality Improvement Program (2005-2012), patients undergoing adrenalectomy were identified (CPT-codes: 60540, 60545, 60650). Outcomes evaluated included complications, blood transfusion, length of stay, reintervention, readmission, and mortality. Complications were further evaluated in relation to discharge status (pre-/postdischarge). Multivariable regression models assessed association between specialty and 30-day morbidity/mortality. Results During the study period, 4844 patients underwent adrenalectomy (95.7% general surgery). The overall complication rate was 7.5% (n = 363); 43.2% of the complications occurred postdischarge with a substantial proportion of major complications, including cardiac, pulmonary, renal, neurologic, septic, and deep venous thrombosis/pulmonary embolism also occurring postdischarge (29.9%). The overall blood transfusion, reintervention, readmission, and mortality rates were 3.9%, 2.0%, 6.4%, and 0.6%, respectively. In adjusted analyses, specialty did not have an effect on any of the outcomes ( P  >  .05 all). Conclusion One in 13 patients suffers a complication postadrenalectomy. Approximately 40% of these complications occur postdischarge, primarily within the first 2 weeks of surgery. Accurate knowledge regarding 30-day adverse event rates and timing of complications that this study provides may facilitate improved patient-physician communication and encourage early patient follow-up in this critical window. Lastly, specialty does not seem to affect outcomes in American College of Surgeons National Surgical Quality Improvement Program Participant hospitals.

Jesse D Sammon - One of the best experts on this subject based on the ideXlab platform.

  • adverse event rates timing of complications and the impact of specialty on outcomes following adrenal surgery an analysis of 30 day outcome data from the american college of surgeons national surgical quality improvement Program acs nsqip
    Urology, 2016
    Co-Authors: Akshay Sood, Kaustav Majumder, Naveen Kachroo, Jesse D Sammon, Firas Abdollah, Marianne Schmid, Linda Hsu, Wooju Jeong
    Abstract:

    Objective To report on 30-day adverse event rates and timing of complications following adrenal surgery; further, to investigate the impact of specialty (general surgery vs urology) on these outcomes using a large prospective multi-institutional data registry. Materials and Methods Within the American College of Surgeons National Surgical Quality Improvement Program (2005-2012), patients undergoing adrenalectomy were identified (CPT-codes: 60540, 60545, 60650). Outcomes evaluated included complications, blood transfusion, length of stay, reintervention, readmission, and mortality. Complications were further evaluated in relation to discharge status (pre-/postdischarge). Multivariable regression models assessed association between specialty and 30-day morbidity/mortality. Results During the study period, 4844 patients underwent adrenalectomy (95.7% general surgery). The overall complication rate was 7.5% (n = 363); 43.2% of the complications occurred postdischarge with a substantial proportion of major complications, including cardiac, pulmonary, renal, neurologic, septic, and deep venous thrombosis/pulmonary embolism also occurring postdischarge (29.9%). The overall blood transfusion, reintervention, readmission, and mortality rates were 3.9%, 2.0%, 6.4%, and 0.6%, respectively. In adjusted analyses, specialty did not have an effect on any of the outcomes ( P  >  .05 all). Conclusion One in 13 patients suffers a complication postadrenalectomy. Approximately 40% of these complications occur postdischarge, primarily within the first 2 weeks of surgery. Accurate knowledge regarding 30-day adverse event rates and timing of complications that this study provides may facilitate improved patient-physician communication and encourage early patient follow-up in this critical window. Lastly, specialty does not seem to affect outcomes in American College of Surgeons National Surgical Quality Improvement Program Participant hospitals.