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3 results on '"Fischer, Cathy L."'

1. Effect of General Surgery Resident Participation in Thoracic Surgery on Oncologic Outcomes: An Observational Cohort Study

Author

Grogan, Riley S., Wieser, Alex P., Bennie, Barbara A., Fischer, Cathy L., Paramesh, Venki, and Jarman, Benjamin T.

Abstract

Background:Despite increasing sub-specialization, general surgeons continue to perform oncologic thoracic surgeries. Our objective was to determine whether general surgery resident participation in thoracic surgery affects surgical quality or oncologic outcomes. We hypothesized that patient outcomes with and without resident participation would be similar. Methods:We retrospectively reviewed the electronic health records of patients with stage 0-IV lung cancer undergoing oncologic pulmonary resection at Gundersen Health System during an 11-year period (2012-2022). Patients younger than 18 years or older than 85 years were excluded, as were those who had incomplete follow-up data or were unregistered in our institutional cancer registry. Patients were divided into groups based on whether residents or staff surgeons completed >50% of the critical portions of the operation. We compared 30-day morbidity outcomes, overall survival (OS), and disease-free survival (DFS). Results:Three hundred thirteen patients met inclusion criteria. Demographic and clinical characteristics were similar between groups, as were types of surgical resection and median operative times. A statistical difference was found in the distribution of surgical approach. The odds of morbidity were 65% higher in the Staff group (OR=1.65; 95% CI, 1.007-2.71). Resident participation was not significantly associated with OS or DFS (P=.32 and P=.54, respectively). Discussion:General surgery resident involvement in lung cancer operations is not associated with longer operative times but is associated with a higher likelihood of a thoracotomy. General surgery resident involvement was associated with decreased postoperative morbidity and did not significantly affect OS or DFS.

Published
2024
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3. Mapping Drug Overdose Demographic and Socioeconomic Characteristics in the Community.

Author

Rooney BL, Voter MT, Eberlein CM, Schossow AJ, and Fischer CL

Subjects
Analgesics, Opioid adverse effects, Drug Overdose economics, Heroin Dependence epidemiology, Humans, Male, Socioeconomic Factors, Substance-Related Disorders epidemiology, Wisconsin epidemiology, Drug Overdose epidemiology, Residence Characteristics
Abstract

Introduction: Drug use and drug overdose have increased at an alarming rate., Objective: To identify demographic and neighborhood social and economic factors associated with higher risk of overdose. These findings can be used to inform development of community programs and appropriately devote resources to prevent and treat drug abuse., Methods: The electronic health records of all patients seen in the emergency department or admitted to the hospital for a drug overdose in 2016 at Gundersen Health System in La Crosse, Wisconsin, were reviewed retrospectively. Patient data collected included age, sex, race/ethnicity, insurance type, overdose intention (intentional, unintentional), drug involved, and total charge for the episode of care. Patient residence was geocode mapped to census tract to analyze the relationship of drug overdose to neighborhood characteristics. Overdose rates were calculated by census tract and compared by several sociodemographic characteristics., Results: Four hundred nineteen patients were included in this study. Forty percent of overdoses were unintentional. Patients who were older, male, nonwhite, and who had no insurance were more likely to have unintentional overdoses. Opiates and heroin were most commonly present in unintentional overdoses, whereas benzodiazepines and sedatives were more common in intentional overdoses. Patients living in census tracts with a higher percentage of residents with some college also had a higher rate of unintentional overdose. Rates of overdose at the census tract level varied and were higher in tracts with lower median income, low income inequality ratio, high percentage of college attendance, and higher percentage of nonwhite residents. The average charge per overdose was $14,771 (median = $9,497) and totaled $6,188,923 for the year., Conclusions: This study provides demographic, geographic, and socioeconomic detail about drug overdose in the community that can be used to focus future treatment and prevention interventions., (Copyright© Wisconsin Medical Society.)

Published
2018

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