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186 results on '"Harbaugh, Calista M."'

4. Association of National Accreditation Program for Rectal Cancer Accreditation with Outcomes after Rectal Cancer Surgery.

Author

Harbaugh, Calista M., Kunnath, Nicholas J., Suwanabol, Pasithorn A., Dimick, Justin B., Hendren, Samantha K., and Ibrahim, Andrew M.

Subjects
*ABDOMINOPERINEAL resection, *ACCREDITATION, *T-test (Statistics), *ACADEMIC medical centers, *RESEARCH funding, *MEDICARE, *MULTIPLE regression analysis, *SCIENTIFIC observation, *PATIENT readmissions, *EVALUATION of medical care, *CANCER patients, *DESCRIPTIVE statistics, *CHI-squared test, *HOSPITAL mortality, *RETROSPECTIVE studies, *SURGICAL complications, *MEDICAL records, *ACQUISITION of data, *REOPERATION, *COMPARATIVE studies, *DATA analysis software, RECTUM tumors
Abstract

BACKGROUND: The National Accreditation Program for Rectal Cancer (NAPRC) defined a set of standards in 2017 centered on multidisciplinary program structure, evidence-based care processes, and internal audit to address widely variable rectal cancer practices and outcomes across US hospitals. There have been no studies to-date testing the association between NAPRC accreditation and rectal cancer outcomes. STUDY DESIGN: This was a retrospective, observational study of Medicare beneficiaries aged 65 to 99 years with rectal cancer who underwent proctectomy from 2017 to 2020. The primary exposure was NAPRC accreditation and the primary outcomes included mortality (in-hospital, 30 day, and 1 year) and 30-day complications, readmissions, and reoperations. Associations between NAPRC accreditation and each outcome were tested using multivariable logistic regression with risk-adjustment for patient and hospital characteristics. RESULTS: Among 1,985 hospitals, 65 were NAPRC-accredited (3.3%). Accredited hospitals were more likely to be nonprofit and teaching with 250 or more beds. Among 20,202 patients, 2,078 patients (10%) underwent proctectomy at an accredited hospital. Patients at accredited hospitals were more likely to have an elective procedure with a minimally invasive approach and sphincter preservation. Risk-adjusted in-hospital mortality (1.1% vs 1.3%; p = 0.002), 30-day mortality (2.1% vs 2.9%; p < 0.001), 30-day complication (18.3% vs 19.4%; p = 0.01), and 1-year mortality rates (11% vs 12.1%; p < 0.001) were significantly lower at accredited compared with nonaccredited hospitals. CONCLUSIONS: NAPRC-accredited hospitals have lower risk-adjusted morbidity and mortality for major rectal cancer surgery. Although NAPRC standards address variability in practice, without directly addressing surgical safety, our findings suggest that NAPRC-accredited hospitals may provide higher quality surgical care. [ABSTRACT FROM AUTHOR]

Published
2024
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21. Guidelines for Opioid Prescribing in Children and Adolescents After Surgery

Author

Kelley-Quon, Lorraine I., primary, Kirkpatrick, Matthew G., additional, Ricca, Robert L., additional, Baird, Robert, additional, Harbaugh, Calista M., additional, Brady, Ashley, additional, Garrett, Paula, additional, Wills, Hale, additional, Argo, Jonathan, additional, Diefenbach, Karen A., additional, Henry, Marion C.W., additional, Sola, Juan E., additional, Mahdi, Elaa M., additional, Goldin, Adam B., additional, St Peter, Shawn D., additional, Downard, Cynthia D., additional, Azarow, Kenneth S., additional, Shields, Tracy, additional, and Kim, Eugene, additional

Published
2021
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32. Effect of Drug Disposal Bag Provision on Proper Disposal of Unused Opioids by Families of Pediatric Surgical Patients

Author

Lawrence, Amy E., primary, Carsel, Alex J., additional, Leonhart, Karen L., additional, Richards, Holden W., additional, Harbaugh, Calista M., additional, Waljee, Jennifer F., additional, McLeod, Daryl J., additional, Walz, Patrick C., additional, Minneci, Peter C., additional, Deans, Katherine J., additional, and Cooper, Jennifer N., additional

Published
2019
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46. Using Analytic Morphomics to Predict Long-Term Risk in Kidney Donors

Author

Claffin, Jake, primary, Alameddine, Mitchell B., additional, Englesbe, Michael J., additional, Cron, David. C., additional, Terjimanian, Michael N., additional, Friedman, Jeffrey F., additional, Klei, Jennifer D., additional, Harbaugh, Calista M., additional, Hussain, Adnan, additional, Waits, Seth A., additional, and Wang, Stewart C., additional

Published
2016
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47. Persistent Opioid Use Among Pediatric Patients After Surgery.

Author

Harbaugh, Calista M., Lee, Jay S., Hsou Mei Hu, McCabe, Sean Esteban, and Voepel-Lewis, Terri

Subjects
*AGE distribution, *CHOLECYSTECTOMY, *CHRONIC pain, *COLECTOMY, *CONFIDENCE intervals, *DATABASES, *LONGITUDINAL method, *MEDICAL care use, *MEDICAL prescriptions, *NARCOTICS, *POSTOPERATIVE period, *SEX distribution, *SUBSTANCE abuse, *PAIN management, *EVIDENCE-based medicine, *HEALTH insurance reimbursement, *PROFESSIONAL practice, *ELIGIBILITY (Social aspects), *TREATMENT effectiveness, *DISEASE incidence, *RETROSPECTIVE studies, *PREOPERATIVE period, *ODDS ratio
Abstract

BACKGROUND: Despite efforts to reduce nonmedical opioid misuse, little is known about the development of persistent opioid use after surgery among adolescents and young adults. We hypothesized that there is an increased incidence of prolonged opioid refills among adolescents and young adults who received prescription opioids after surgery compared with nonsurgical patients. METHODS: We performed a retrospective cohort study by using commercial claims from the Truven Health Marketscan research databases from January 1, 2010, to December 31, 2014. We included opioid-naïvee patients ages 13 to 21 years who underwent 1 of 13 operations. A random sample of 3% of nonsurgical patients who matched eligibility criteria was included as a comparison. Our primary outcome was persistent opioid use, which was defined as ≥1 opioid prescription refill between 90 and 180 days after the surgical procedure. RESULTS: Among eligible patients, 60.5% filled a postoperative opioid prescription (88 637 patients). Persistent opioid use was found in 4.8% of patients (2.7% -15.2% across procedures) compared with 0.1% of those in the nonsurgical group. Cholecystectomy (adjusted odds ratio 1.13; 95% confidence interval, 1.00-1.26) and colectomy (adjusted odds ratio 2.33; 95% confidence interval, 1.01-5.34) were associated with the highest risk of persistent opioid use. Independent risk factors included older age, female sex, previous substance use disorder, chronic pain, and preoperative opioid fill. CONCLUSIONS: Persistent opioid use after surgery is a concern among adolescents and young adults and may represent an important pathway to prescription opioid misuse. Identifying safe, evidence-based practices for pain management is a top priority, particularly among at-risk patients. [ABSTRACT FROM AUTHOR]

Published
2018
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49. Morphometric Age and Surgical Risk

Author

Englesbe, Michael J., primary, Terjimanian, Michael N., additional, Lee, Jay S., additional, Sheetz, Kyle H., additional, Harbaugh, Calista M., additional, Hussain, Adnan, additional, Holcombe, Sven A., additional, Sullivan, June, additional, Campbell, Darrell A., additional, Wang, Stewart C., additional, and Sonnenday, Christopher J., additional

Published
2013
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50. Abdominal Aortic Calcification and Surgical Outcomes in Patients With No Known Cardiovascular Risk Factors

Author

Harbaugh, Calista M., primary, Terjimanian, Michael N., additional, Lee, Jay S., additional, Alawieh, Abbas Z., additional, Kowalsky, Daniel B., additional, Tishberg, Lindsay M., additional, Krell, Robert W., additional, Holcombe, Sven A., additional, Wang, Stewart C., additional, Campbell, Darrell A., additional, and Englesbe, Michael J., additional

Published
2013
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