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2. Expanding the scope of quality measurement in surgery to include nonoperative care

Author

Wandling, Michael W, Ko, Clifford Y, Bankey, Paul E, Cribari, Chris, Cryer, H Gill, Diaz, Jose J, Duane, Therese M, Hameed, S Morad, Hutter, Matthew M, Metzler, Michael H, Regner, Justin L, Reilly, Patrick M, Reines, H David, Sperry, Jason L, Staudenmayer, Kristan L, Utter, Garth H, Crandall, Marie L, Bilimoria, Karl Y, and Nathens, Avery B

Subjects
Patient Safety, 8.1 Organisation and delivery of services, Health and social care services research, Management of diseases and conditions, 7.3 Management and decision making, Appendicitis, Benchmarking, Cholecystitis, Emergency Medicine, Female, General Surgery, Humans, Intestinal Obstruction, Intestine, Small, Male, Pilot Projects, Quality Improvement, Emergency general surgery, surgical quality assessment, nonoperative management, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Nursing, Emergency & Critical Care Medicine
Abstract

Patients managed non-operatively have been excluded from risk-adjusted benchmarking programs, including the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP). Consequently, optimal performance evaluation is not possible for specialties like emergency general surgery (EGS) where non-operative management is common. We developed a multi-institutional EGS clinical data registry within ACS NSQIP that includes patients managed non-operatively to evaluate variability in non-operative care across hospitals and identify gaps in performance assessment that occur when only operative cases are considered.Using ACS NSQIP infrastructure and methodology, surgical consultations for acute appendicitis, acute cholecystitis, and small bowel obstruction (SBO) were sampled at 13 hospitals that volunteered to participate in the EGS clinical data registry. Standard NSQIP variables and 16 EGS-specific variables were abstracted with 30-day follow-up. To determine the influence of complications in non-operative patients, rates of adverse outcomes were identified and hospitals were ranked by performance with and then without including non-operative cases.2,091 patients with EGS diagnoses were included, 46.6% with appendicitis, 24.3% with cholecystitis, and 29.1% with SBO. The overall rate of non-operative management was 27.4%, 6.6% for appendicitis, 16.5% for cholecystitis, and 69.9% for SBO. Despite comprising only 27.4% of patients in the EGS Pilot, non-operative management accounted for 67.7% of deaths, 34.3% of serious morbidities, and 41.8% of hospital readmissions. After adjusting for patient characteristics and hospital diagnosis mix, addition of non-operative management to hospital performance assessment resulted in 12 of 13 hospitals changing performance rank, with 4 hospitals changing by 3 or more positions.This study identifies a gap in performance evaluation when non-operative patients are excluded from surgical quality assessment and demonstrates the feasibility of incorporating non-operative care into existing surgical quality initiatives. Broadening the scope of hospital performance assessment to include non-operative management creates an opportunity to improve the care of all surgical patients, not just those who have an operation.III, Prognostic and Epidemiological.

Published
2017

10. Pesticide Environmental Fate

Author

Warner Phelps, Kim Winton, William R. Effland, K. Winton, William R. Effland, Nelson C. Thurman, Raju Gangaraju, Ian Nicholson, David Kroetsch, Mary Nett, Paul Hendley, S. A. Cryer, P. N. Coody, J. White, S. A. Cryer, H. E. Dixon-White, C. K. Robb, P. N. Coody, J. White, S. A. Cryer, S. A. Cryer, P.

Published
2002

19. 51

Author

Siletz, Anaar, primary, Kelly-Scumpia, Kindra, additional, Scumpia, Phillip, additional, Ragkousis, Vasileios, additional, Shirazi, Roksana, additional, Sanaiha, Yas, additional, Benharash, Peyman, additional, Shemin, Richard, additional, Laks, Hillel, additional, Hunter, Curtis, additional, Kwon, Murray, additional, Do, Tran, additional, Mimila, Naomi, additional, Crager, Sara, additional, Williams, Kevin, additional, Bensinger, Steven, additional, Cryer, H. Gill, additional, and Smale, Stephen, additional

Published
2019
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27. Expanding the Scope of Quality Measurement in Surgery to Include Non-Operative Care: Results from the ACS NSQIP Emergency General Surgery Pilot

Author

Wandling, Michael W., Ko, Clifford Y., Bankey, Paul E., Cribari, Chris, Cryer, H. Gill, Diaz, Jose J., Duane, Therese M., Hameed, S. Morad, Hutter, Matthew M., Metzler, Michael H., Regner, Justin L., Reilly, Patrick M., Reines, H. David, Sperry, Jason L., Staudenmayer, Kristan L., Utter, Garth H., Crandall, Marie L., Bilimoria, Karl Y., and Nathens, Avery B.

Subjects
Male, Clinical Sciences, 8.1 Organisation and delivery of services, Pilot Projects, Nursing, Cardiorespiratory Medicine and Haematology, Small, Article, 7.3 Management and decision making, Intestine, Small, Cholecystitis, Humans, Emergency general surgery, Appendicitis, Quality Improvement, Emergency & Critical Care Medicine, Intestine, Benchmarking, surgical quality assessment, General Surgery, nonoperative management, Emergency Medicine, Female, Patient Safety, Management of diseases and conditions, Intestinal Obstruction, Health and social care services research
Abstract

Patients managed nonoperatively have been excluded from risk-adjusted benchmarking programs, including the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP). Consequently, optimal performance evaluation is not possible for specialties like emergency general surgery (EGS) where nonoperative management is common. We developed a multi-institutional EGS clinical data registry within ACS NSQIP that includes patients managed nonoperatively to evaluate variability in nonoperative care across hospitals and identify gaps in performance assessment that occur when only operative cases are considered.Using ACS NSQIP infrastructure and methodology, surgical consultations for acute appendicitis, acute cholecystitis, and small bowel obstruction (SBO) were sampled at 13 hospitals that volunteered to participate in the EGS clinical data registry. Standard NSQIP variables and 16 EGS-specific variables were abstracted with 30-day follow-up. To determine the influence of complications in nonoperative patients, rates of adverse outcomes were identified, and hospitals were ranked by performance with and then without including nonoperative cases.Two thousand ninety-one patients with EGS diagnoses were included, 46.6% with appendicitis, 24.3% with cholecystitis, and 29.1% with SBO. The overall rate of nonoperative management was 27.4%, 6.6% for appendicitis, 16.5% for cholecystitis, and 69.9% for SBO. Despite comprising only 27.4% of patients in the EGS pilot, nonoperative management accounted for 67.7% of deaths, 34.3% of serious morbidities, and 41.8% of hospital readmissions. After adjusting for patient characteristics and hospital diagnosis mix, addition of nonoperative management to hospital performance assessment resulted in 12 of 13 hospitals changing performance rank, with four hospitals changing by three or more positions.This study identifies a gap in performance evaluation when nonoperative patients are excluded from surgical quality assessment and demonstrates the feasibility of incorporating nonoperative care into existing surgical quality initiatives. Broadening the scope of hospital performance assessment to include nonoperative management creates an opportunity to improve the care of all surgical patients, not just those who have an operation.Care management, level IV; Epidemiologic, level III.

Published
2017

28. Expanding the Scope of Quality Measurement in Surgery to Include Non-Operative Care: Results from the ACS NSQIP Emergency General Surgery Pilot.

Author

Wandling, Michael W, Wandling, Michael W, Ko, Clifford Y, Bankey, Paul E, Cribari, Chris, Cryer, H Gill, Diaz, Jose J, Duane, Therese M, Hameed, S Morad, Hutter, Matthew M, Metzler, Michael H, Regner, Justin L, Reilly, Patrick M, Reines, H David, Sperry, Jason L, Staudenmayer, Kristan L, Utter, Garth H, Crandall, Marie L, Bilimoria, Karl Y, Nathens, Avery B, Wandling, Michael W, Wandling, Michael W, Ko, Clifford Y, Bankey, Paul E, Cribari, Chris, Cryer, H Gill, Diaz, Jose J, Duane, Therese M, Hameed, S Morad, Hutter, Matthew M, Metzler, Michael H, Regner, Justin L, Reilly, Patrick M, Reines, H David, Sperry, Jason L, Staudenmayer, Kristan L, Utter, Garth H, Crandall, Marie L, Bilimoria, Karl Y, and Nathens, Avery B

Abstract

Patients managed non-operatively have been excluded from risk-adjusted benchmarking programs, including the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP). Consequently, optimal performance evaluation is not possible for specialties like emergency general surgery (EGS) where non-operative management is common. We developed a multi-institutional EGS clinical data registry within ACS NSQIP that includes patients managed non-operatively to evaluate variability in non-operative care across hospitals and identify gaps in performance assessment that occur when only operative cases are considered.Using ACS NSQIP infrastructure and methodology, surgical consultations for acute appendicitis, acute cholecystitis, and small bowel obstruction (SBO) were sampled at 13 hospitals that volunteered to participate in the EGS clinical data registry. Standard NSQIP variables and 16 EGS-specific variables were abstracted with 30-day follow-up. To determine the influence of complications in non-operative patients, rates of adverse outcomes were identified and hospitals were ranked by performance with and then without including non-operative cases.2,091 patients with EGS diagnoses were included, 46.6% with appendicitis, 24.3% with cholecystitis, and 29.1% with SBO. The overall rate of non-operative management was 27.4%, 6.6% for appendicitis, 16.5% for cholecystitis, and 69.9% for SBO. Despite comprising only 27.4% of patients in the EGS Pilot, non-operative management accounted for 67.7% of deaths, 34.3% of serious morbidities, and 41.8% of hospital readmissions. After adjusting for patient characteristics and hospital diagnosis mix, addition of non-operative management to hospital performance assessment resulted in 12 of 13 hospitals changing performance rank, with 4 hospitals changing by 3 or more positions.This study identifies a gap in performance evaluation when non-operative patients are excluded from surgical quality assessment and demonst

Published
2017

29. Reappraisal of pancreatic and duodenal injury management based on injury severity

Author

Flynn, William J., Jr., Cryer, H. Gill, and Richardson, J. David

Subjects
Pancreas -- Injuries, Wounds and injuries -- Care and treatment, Duodenum -- Injuries, Health
Abstract

There is no agreement on the best method of treatment for injury to the pancreas (a nodular gland, lying across the abdomen behind the stomach, that secretes various substances, including digestive enzymes, insulin and glucagon) and duodenum (first portion of the small intestine). Treatment for duodenal injuries can vary greatly among different institutions. There is less controversy over treatment of distal pancreatic injuries, but treatment of proximal pancreatic ductal injury and combined duodenal-pancreatic injury remains controversial. A study was undertaken to evaluate the effectiveness of treatment protocols that were based on severity of injury. There were 81 patients with pancreatic, duodenal or pancreatoduodenal injuries; 65 survived initial injury. Penetrating injury (gunshot or stab wounds) occurred in 48 patients, and blunt trauma as a result of motor vehicle accidents or falls occurred in 33 patients. There were 23 patients with duodenal injury, 47 with pancreatic injury, 11 with combined injury. Method of treatment was determined by grade of severity of injury. Twenty-one patients had injury to the pancreas but not the ducts and were treated by drainage. Eighteen patients who had pancreatic ductal injury were treated by resection (cutting out of a significant portion) of the pancreas; seven of these patients (39 percent) developed abscesses. This finding suggests that pancreatic wound predisposes the patient to abscesses in the abdominal region. There were no late deaths in either group. Duodenal injuries that involved less than 40 percent of its circumference were treated by simple closure; tube decompression was reserved for injuries greater than 40 percent of circumference. There were no late deaths. There were four early deaths among the 11 patients with combined injuries. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1990

33. Revising Recommendations and Outcome Measurements after Complex Open Abdominal Wall Reconstruction.

Author

DIAMOND, SHAWN, CRYER, H. GILL, and Gill Cryer, H

Subjects
*ABDOMINAL surgery, *HERNIA surgery, *CHI-squared test, *COMPARATIVE studies, *DERMIS, *LONGITUDINAL method, *MEDICAL protocols, *MULTIVARIATE analysis, *PROBABILITY theory, *REOPERATION, *SURGICAL complications, *T-test (Statistics), *TIME, *DISEASE relapse, *SURGICAL equipment, *LOGISTIC regression analysis, *BODY mass index, *DISEASE incidence, *RETROSPECTIVE studies, *DESCRIPTIVE statistics, *ABDOMINOPLASTY, *ODDS ratio
Abstract

Grading systems developed by the Ventral Hernia Working Group (VHWG) for complex open abdominal wall reconstruction rely on limited outcomes: surgical site occurrence (SSO) and hernia recurrence. This does not account for the longitudinal restoration of a functional abdominal wall and the ability to correct complications. We performed a single-site, retrospective review of consecutive complex open abdominal wall reconstruction interventions with 24-month minimum follow-up to establish reoperation rates and compare long-term results to the VHWG. About 125 midline hernia repairs (>200 cm(2)) were studied. All had loss of functional domain and 47-month average follow-up. Demographics included: mean age 57 years, 47 per cent male, 63 per cent obese, and 34 per cent with contamination. Rates of SSO per VHWG grade were 9 per cent grade I, 45 per cent grade II, and 55 per cent grade III. Forty-three of 59 patients who developed complications were eventually successful after reoperation leading to an 87 per cent restoration rate. Select factors independently associated with reoperation included biological mesh and clinical history of infection. Although rates of SSO were higher than the VHWG published, we experienced high salvage rates except in patients who underwent biologic repair. We recommend restricted use of biologic mesh in contaminated and clean fields as well as modifications to the VHWG grading and recommendations. [ABSTRACT FROM AUTHOR]

Published
2015
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35. Contributors

Author

Abbas, Abbas El-Sayed, Abdullah, Fizan, Abood, Gerard J., Abularrage, Christopher J., AbuRahma, Ali F., AbuRahma, Zachary T., Adams, David B., Afaneh, Cheguevara, Agopian, Vatche G., Ahmed, Ali Karim, Ahrendt, Steven A., Ahuja, Nita, Ahuja, Nitin K., Alarcon, Louis H., Albuja-Cruz, Maria B., Althans, Alison R., Althumairi, Azah A., Alverdy, John C., Anandam, Joselin L., Androes, Mark P., Ansari, Amir Mehdi, Arnaoutakis, Dean J., Arnold, Meghan A., Atallah, Chady I., Auchincloss, Hugh G., Axtell, Andrea L., Ayoung-Chee, Patricia, Azad, Nilofer, Azar, Faris K., Azoury, Saïd C., Bailey, Christina E., Bailey, Ian B., Balch, Charles M., Balch, Glen C., Ball, Chad G., Bandyk, Dennis F., Barie, Philip S., Bates, Andrew, Battafarano, Richard, Beard, Kristin Wilson, Beaulieu, Peter, Beaulieu, Robert J., Bedine, Marshall S., Bedzra, Edo K.S., Beekmann, Susan E., Behrns, Kevin E., Bellistri, John-Paul, Bello, Ricardo J., Benrashid, Ehsan, Berger, David L., Berian, Julia R., Bilimoria, Karl Y., Bjurlin, Marc A., Black, James H., III, Bland, Kirby, Blas, Joseph-Vincent V., Bleier, Joshua I., Blumetti, Jennifer, Bodzin, Adam, Boone, Brian A., Born, Louis J., Boughey, Judy C., Boyett, Daniel, Brady, Justin T., Brennan, Murray F., Brenner, Bruce M., Britt, L.D., Brock, Malcolm, Brownie, Evan R., Brunicardi, F. Charles, Brunt, L. Michael, Burgess, Jessica, Burke, Mark S., Burlew, Clay Cothren, Bush, Errol, Busuttil, Ronald W., Caffrey, Julie, Callender, Glenda G., Cambria, Richard P., Cameron, Andrew M., Camp, Melissa S., Campbell, Kurtis A., Carr, Shamus R., Cavnar, Michael J., Chaikof, Elliot L., Champagne, Bradley J., Haito Chavez, Yamile, Chen, Herbert, Chen, Yen-I, Chi, Albert, Chockalingam, Arun, Cholewczynski, Walter, Choti, Michael A., Christakis, Ioannis A., Christante, Dara H., Cintron, Jose R., Claridge, Jeffrey A., Clark, Damon, Cody, Hiram S., III, Cogbill, Thomas H., Cohan, Jessica N., Cooney, Damon S., Cooper, Zara, Corey, Britney L., Coté, Gregory A., Cox, Morgan L., Crawford, Todd C., Croce, Martin A., Cryer, H. Gill, Cuff, Robert F., Cunningham, Steven C., Dackiw, Alan P.B., Dagher, Nabil N., Dart, Benjamin W., IV, Datta, Jashodeep, Dattilo, Jeffery B., Davis, Bradley, Davis, Donald, Delaney, Conor P., Delman, Keith, DeMatteo, Ronald P., DeMeester, Steven R., DeMeester, Tom R., Dempsey, Daniel T., DiBrito, Sandra R., Dimick, Justin B., Dimou, Francesca M., Dixon, Peter, Donahue, James, Duh, Quan-Yang, Duncan, Mark, Durand, Christine M., Durazo, Francisco A., Earle, David, Edil, Barish H., Efron, David T., Efron, Jonathan E., Ehlert, Bryan A., Eisele, David W., Elliott, David, English, Sean J., Eriksen, Calvin, Eslami, Mohammad H., Esquivel, Jesus, Euhus, David M., Eun, John C., Evans, Douglas B., Evans, Heather L., Fabian, Timothy C., Fabri, Peter J., Fabrizio, Anne C., Fagenholz, Peter J., Fakhry, Carole, Fang, Sandy H., Fantus, Richard J., Feldman, Liane S., Feliciano, David V., Feller-Kopman, David, Ferrada, Paula A., Ferrari, Linda, Ferson, Peter F., Fichera, Alessandro, Fiedler, Amy G., Finnerty, Brendan M., Fischer, Josef E., Fisichella, P. Marco, Fleshman, James W., Fong, Zhi Ven, Forthman, Christopher L., Francone, Todd D., Frankel, Heidi, Franklin, David P., Gahtan, Vivian, Galandiuk, Susan, Gallagher, James J., Gangi, Alexandra, Garvey, Erin M., Gearhart, Susan L., Geiger, Timothy M., Gemignani, Mary L., Georgiades, Christos, Georgoff, Patrick E., Geschwind, Jean-Francois H., Gestring, Mark L., Ghaderi, Iman, Giglia, Joseph S., Giuliano, Armando E., Glebova, Natalia O., Gleisner, Ana L., Goldin, Steven B., Goldstein, Seth, Goodenough, Christopher J., Goussous, Naeem, Graham, Jay A., Grandhi, Miral Sadaria, Grant, Clive S., Gray, Richard J., Gregg, Shea C., Gribovskaja-Rupp, Irena, Griffen, Margaret M., Griffin, James F., Grimm, Joshua C., Guillem, Jose G., Ha, Jinny, Habib, Fahim, Hackam, David, Hamilton, James P., Harken, Alden H., Harmon, John W., Hartney, Mark, Hassoun, Heitham T., Haugen, Christine E., Haut, Elliott R., He, Jin, Hébert-Blouin, Marie-Noëlle, Helmink, Beth A., Henderson, David K., Heniford, B. Todd, Herline, Alan, Herman, Joseph M., Hicks, Caitlin W., Hines, O. Joe, Hogg, Melissa E., Holly, Brian P., Hong, Kelvin, Howley, Isaac W., Hoyler, Margo, Hughes, Kevin S., Hughes, Steven J., Hungness, Eric S., Hunter, John G., Hutcheon, David F., Hutter, Matthew M., Hyman, Neil H., Ignacio, Elizabeth Ann, Ijaz, Nadia, Jacobs, Lisa K., Jakhete, Neha, Jenkins, Donald H., Jensen, Robert T., Jha, Reena, Jobe, Blair A., Johnson, Eric K., Johnson, Lynt B., Joseph, Bellal, Jurkovich, Gregory J., Kadera, Brian, Kahan, Stacie A., Kaldas, Fady M., Kalloo, Anthony N., Kao, Lillian S., Kapadia, Muneera R., Kaplan, Lewis J., Kaups, Krista L., Kebebew, Electron, Kelley, Scott R., Kelly, Ronan, Kent, K. Craig, Khashab, Mouen A., Khouri, Nagi, Kim, Amy K., Kim, Karen M., Kiraly, Laszlo, Kirane, Amanda, Kleiman, David A., Klimberg, V. Suzanne, Klinger, Kerry, Knab, L. Mark, Kowdley, Gopal C., Kozarek, Richard A., Krampitz, Geoffrey W., Krezalek, Monika A., Krontiras, Helen, Krpata, David M., Kugler, Nathan, Kulkarni, Swati A., Kumbhari, Vivek, Kuwada, Timothy, Kuwayama, David, LaFace, Angela, LaMuraglia, Glenn M., Lancaster, R. Todd, Landreneau, Rodney J., Langan, Russell C., Lange, Julie R., Lay, Frank, Ledgerwood, Anna M., Lee, Andrew J., Leeper, W. Robert, Lehenbauer, David, Liddell, Robert P., Lidor, Anne, Lightner, Amy L., Lillemoe, Keith D., Lilley, Elizabeth J., Liu, Jieqiong, Liu, Yuk Ming, Loiacono, Laurie A., Lombardo, KMarie Reid, Lonze, Bonnie E., Loomis, Erica A., Lou, Irene, Lucas, Charles E., Luketich, James D., Lum, Ying Wei, Lunsford, Keri E., Lynch, Kevin, MacGillivray, Thomas E., Mackersie, Robert C., Magnuson, Thomas, Maier, Ronald V., Makary, Martin A., Makris, Konstantinos, Malangoni, Mark A., Malas, Mahmoud B., Maley, Warren R., Manson, Paul N., Mansour, M. Ashraf, Marmor, Rebecca A., Marti, Guy P., Martin, Laura, Martindale, Robert G., Mason, Leonard L., III, Mathew, Sarah Jean, Mathis, Kellie L., Mathisen, Douglas J., Matsangos, Aerielle E., Matthews, Jeffrey B., Maxwell, Robert, McCartan, Damian, McFadden, David W., McHenry, Christopher R., McIntyre, Robert C., Jr., McQuay, Nathaniel, Jr., Melancon, Joseph K., Menaker, Jay, Meneshian, Avedis, Menon, Raman, Meyer, Anthony A., Meyers, William C., Michelassi, Fabrizio, Mier, Fernando, Milner, Stephen M., Miraflor, Emily, Mitchem, Jonathan B., Moalem, Jacob, Modi, Rushabh, Molena, Daniela, Moore, Forrest O'dell, Moore, Scott M., Morse, Christopher R., Mullinax, John, Mureebe, Leila, Murphy, Adrian, Muscarella, Peter, II, Mustain, W. Conan, Myzak, Melinda Cherie, Napolitano, Lena M., Nealon, William Hawe, Netz, Uri, Neumayer, Leigh, Newman, Lisa, Ng, Christopher, Ng, Gladys, Nguyen, Hien T., Nilubol, Naris, Norton, Jeffrey A., O’Connell, Kathleen M., O’Keeffe, Terence, Okolo, Patrick I., III, O’Mara, Charles S., Osgood, Greg, Osgood, Michael J., Pachter, H. Leon, Paniccia, Alessandro, Pappas, Sam G., Pappas, Theodore N., Park, Pauline K., Parker, Catherine, Parthasarathy, Madhumithaa, Pasternak, Jesse D., Patel, Dhaval, Patel, Jayshil J., Patel, Madhukar S., Patel, Nishant, Patel, Shirali T., Paul, Jasmeet Singh, Pawlik, Timothy M., Pegoli, Walter, Jr., Peitzman, Andrew B., Pennathur, Arjun, Perler, Bruce A., Perone, Jennifer A., Perrier, Nancy D., Peters, Walter R., Phelan, Patrick J., Philosophe, Benjamin, Pieracci, Fredric M., Pitt, Henry A., Plichta, Jennifer K., Ponsky, Jeffrey L., Poor, Alexander E., Poruk, Katherine E., Prakash, Priya, Prescott, Jason D., Price, Leigh Ann, Pryor, Aurora D., Puig, Carlos A., Raeburn, Christopher D., Raigani, Siavash, Ramsay, Philip T., Rashidi, Laila, Rattner, David, Reid, Trista, Reifsnyder, Thomas, Reynolds, Jessica K., Riall, Taylor S., Rivere, Amy, Rizvi, Addi Z., Robinson, Bryce R.H., Robinson, Thomas N., Rodriguez, Aurelio, Rodriguez, John H., Rosemurgy, Alexander S., II, Rosen, Michael J., Rosso, Kelly J., Rosson, Gedge D., Rotondo, Michael F., Rueda, Mario, Ryan, Mark L., Ryer, Evan J., Sacks, Justin M., Salles, Arghavan, Santos, Byron F., Sarr, Michael G., Saur, Nicole M., Scalea, Thomas M., Schaetzel, Shaina, Schaheen, Lara, Schimpf, Dennis K., Schlachter, Todd, Schulick, Richard D., Schwartz, Diane A., Schweitzer, Michael A., Sciortino, Christopher, Semaan, Roy, Senagore, Anthony J., Shah, Amar, Shakoor, Aqsa, Shapiro, A.M. James, Shaw, Palma, Shepard, Alexander D., Sheridan, Robert, Shermak, Michele A., Sicklick, Jason K., Silverstein, Melvin, Simmons, Justin M., Sims, Carrie, Sise, Michael, Smith, Barbara L., Soares, Kevin C., Sonntag, David, Sosa, Julie A., Spain, David A., Spinner, Robert J., Stahl, Richard D., Stanley, Gregory A., Stanley, J. Daniel, Steele, Scott R., Stefanidis, Dimitrios, Stein, Sharon, Steurer, Marc P., Stevens, Kent A., Stone, Patrick A., Stonemetz, Jerry, Strasberg, Steven M., Streiff, Michael B., Stulberg, Jonah J., Sugimoto, Motokazu, Susarla, Srinivas M., Swann, Jacob, Swanstrom, Lee L., Talamini, Mark A., Tam, Vernissia, Tanabe, Kenneth K., Tarpley, John L., Taylor, Spence M., Teicher, Erik J., Teitelbaum, Ezra N., Thompson, Jon S., Thorsen, Amy J., Tieu, Alan H., Traverso, L. William, Tsai, Susan, Tsitskari, Maria, Tufaro, Anthony P., Turley, Ryan S., Udelsman, Robert, Umphrey, Heidi, Urist, Marshall, Varma, Madhulika G., Velanovich, Vic, Velmahos, George, Villano, Anthony M., Vito, Courtney A., Vollmer, Charles M., Jr., Vyas, Nilesh A., Wall, Matthew J., Jr., Waltz, Paul, Wang, Tracy S., Watkins, Michael T., Watson, Ryan S., Weaver, M. Libby, Weaver, Mitchell R., Webb, Travis P., Weber, Cynthia E., Weiss, Eric G., Weiss, Matthew J., Werner, Nicole L., Wexner, Steven D., Whyte, Richard, Wick, Elizabeth C., Wiesel, Ory, Wilson, Alison M., Wilson, Jennifer L., Winner, Megan, Witkowski, Elan R., Witkowski, Piotr, Wolf, Joshua H., Wolfgang, Christopher L., Wood, Douglas E., Wright, Cameron D., Yeo, Charles J., Yeo, Heather, Yi, Jeniann, Youngwirth, Linda M., Zarnegar, Rasa, Zeh, Herbert J., III, Zeiger, Martha A., Zenilman, Michael E., Zhan, Luke X., Zosa, Brenda M., Zoumberos, Melissa Silva, Zuberi, Kashif A., Zureikat, Amer H., and Zyromski, Nicholas J.

Published
2017
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37. Evaluation of Hospital Readmissions in Surgical Patients

Author

Sacks, Greg D., primary, Dawes, Aaron J., additional, Russell, Marcia M., additional, Lin, Anne Y., additional, Maggard-Gibbons, Melinda, additional, Winograd, Deborah, additional, Chung, Hallie R., additional, Tomlinson, James, additional, Tillou, Areti, additional, Shew, Stephen B., additional, Hiyama, Darryl T., additional, Cryer, H. Gill, additional, Brunicardi, F. Charles, additional, Hiatt, Jonathan R., additional, and Ko, Clifford, additional

Published
2014
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43. Centers for Medicare and Medicaid Services Quality Indicators Do Not Correlate With Risk-Adjusted Mortality at Trauma Centers

Author

Shafi, Shahid, primary, Parks, Jennifer, additional, Ahn, Chul, additional, Gentilello, Larry M., additional, Nathens, Avery B., additional, Hemmila, Mark R., additional, Pasquale, Michael D., additional, Meredith, J. Wayne, additional, Cryer, H. Gill, additional, Goble, Sandra, additional, Neil, Melanie, additional, Price, Chrystal, additional, and Fildes, John J., additional

Published
2010
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44. Improved Trauma System Multicasualty Incident Response: Comparison of Two Train Crash Disasters

Author

Cryer, H. Gill, primary, Hiatt, Jonathan R., additional, Eckstein, Marc, additional, Chidester, Cathy, additional, Raby, Stephanie, additional, Ernst, Timothy G., additional, Margulies, Dan, additional, Putnam, Brant, additional, Demetriades, Demetrios, additional, Gaspard, Donald, additional, Singh, Rambir, additional, Saad, Shawki, additional, Samuel, Christojohn, additional, and Upperman, Jeffery S., additional

Published
2010
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45. The Trauma Quality Improvement Program: Pilot Study and Initial Demonstration of Feasibility

Author

Hemmila, Mark R., primary, Nathens, Avery B., additional, Shafi, Shahid, additional, Calland, J. Forrest, additional, Clark, David E., additional, Cryer, H. Gill, additional, Goble, Sandra, additional, Hoeft, Christopher J., additional, Meredith, J. Wayne, additional, Neal, Melanie L., additional, Pasquale, Michael D., additional, Pomphrey, Michelle D., additional, and Fildes, John J., additional

Published
2010
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46. Acute Care Surgery after Renal Transplantation

Author

Benjamin, Elizabeth R., primary, Jim, Jeffrey, additional, Kim, Thomas J., additional, Meals, Clifton, additional, Gritsch, H. Albin, additional, Tillou, Areti, additional, Cryer, H. Gill, additional, and Hiatt, Jonathan R., additional

Published
2009
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49. Oxygen delivery in patients with adult respiratory distress syndrome who undergo surgery: correlation with multiple-system organ failure

Author

Cryer, H. Gill, Richardson, J. David, Longmire-Cook, Sarah, and Brown, C. Matthew

Subjects
Acute respiratory distress syndrome -- Prognosis, Acute respiratory distress syndrome -- Evaluation, Oxygen in the body -- Measurement, Acute respiratory distress syndrome -- Development and progression, Health
Abstract

Treatment of adult respiratory distress syndrome (ARDS, a respiratory emergency) has not advanced significantly in the last two decades, and clinicians have gotten no better at predicting which ARDS patients will survive. The disorder can be considered to have four phases, during the first three of which the patient's condition is reversible. Since patient evaluation performed on the first day of the diagnosis of ARDS has not improved prognosis, an approach using evaluation on days 1, 3, and 7 is presented. These days fall within the reversible period of ARDS. The records of 52 patients who developed ARDS after surgery were reviewed to determine the severity of their illness and physiologic and laboratory values. In addition, pulmonary variables were analyzed on the three days chosen. Thirty-two (62 percent) of these patients died, including all patients who were older than 65. The most important predictors of survival that could be corrected were the rate of oxygen delivery on day 3 and the gradient between oxygen concentration in the alveoli (the air-filled sacs in the lung) and oxygen concentration in the arteries. The main cause of death in ARDS patients is sepsis (widespread response to infection) and multiple-system organ failure (MSOF). The fact that physiological variables on day 3, rather than day 1, were more closely associated with the patient's outcome indicated that patient assessment performed then may give a more accurate prognosis. Optimal levels for various physiologic variables and for oxygen delivery and the oxygen gradient between lung and blood are provided. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1989

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