Trajectory Analysis of Health Care Utilization Before and After Major Surgery.

Objective: To characterize patterns of health care utilization before and after surgery and determine any association with preoperative frailty.

Background: Frail patients experience worse postoperative outcomes and increased costs during the surgical encounter. Evidence is comparatively lacking for the longer-term effects of frailty on postoperative health care utilization.

Non-inferiority of fragmented care for high-risk pediatric neuroblastoma patients: a single institution analysis.

Pediatric neuroblastoma (NB) patients receive multi-modal therapy and may experience care fragmented among multiple institutions with a significant travel burden, which has been associated with poor outcomes for some adult cancers. We hypothesized that fragmented care for pediatric NB patients is associated with inferior outcomes compared to treatment consolidated at one location. We reviewed paper and electronic records for pediatric NB patients who received ≥1 hematopoietic stem cell transplant (HSCT) at Duke from 1990-2017.

Mobile Application to Identify Cancer Treatment-Related Financial Assistance: Results of a Randomized Controlled Trial.

Purpose: Insured patients with cancer face high treatment-related, out-of-pocket (OOP) costs and often cannot access financial assistance. We conducted a randomized, controlled trial of Bridge, a patient-facing app designed to identify eligible financial resources for patients. We hypothesized that patients using Bridge would experience greater OOP cost reduction than controls.

Examining the Effect of Travel Distance to Pediatric Cancer Centers and Rurality on Survival and Treatment Experiences: A Systematic Review.

Accessing pediatric cancer treatment remains problematic for rural families or those living at increased distances from specialized centers. Rural adult cancer patients or those living far removed from treatment may present with later stage disease, receive different treatments than their closer counterparts, and experience worsened survival. While the financial and psychosocial strain of increased travel is well documented, effects of travel distance on similar outcomes for pediatric cancer patients remain ill-defined.

The patient experience of ABVD treatment in Hodgkin lymphoma: a retrospective cohort study of patient-reported distress.

Purpose: Psychological distress is prevalent in Hodgkin lymphoma (HL). Many patients, regardless of prognosis, receive ABVD chemotherapy as first-line treatment, but few studies have specifically examined the nature of distress during this shared treatment experience.

Methods: We conducted a retrospective study of patient-reported distress in HL patients receiving ABVD treatment at a single tertiary care facility.

Impact of Chronic Obstructive Pulmonary Disease on Postoperative Complication Rates, Ambulation, and Length of Hospital Stay After Elective Spinal Fusion (≥3 Levels) in Elderly Spine Deformity Patients.

Objective: To investigate the impact that chronic obstructive pulmonary disease (COPD) has on postoperative complication rates, ambulation, and hospital length of stay for elderly spinal deformity patients after elective spinal fusion (≥3 levels).

Methods: The medical records of 559 elderly (≥60 years old) spine deformity patients undergoing elective spinal fusion (≥3 levels) at a major academic institution from 2005 to 2015 were reviewed. We identified 60 patients with COPD (10.

Preoperative Hemoglobin Level is Associated with Increased Health Care Use After Elective Spinal Fusion (≥3 Levels) in Elderly Male Patients with Spine Deformity.

Background: Measures of health care use such as length of hospital stay (LOS) are used as proxies for quality of care after spine surgery. Accordingly, hospitals and health systems are investing considerable resources into the preoperative identification of patients at risk for prolonged LOS. This study aims to investigate the impact of preoperative level on outcomes and LOS after spinal fusion.

Pediatric traumatic brain injury at Mbarara Regional Referral Hospital, Uganda.

Background: In Uganda, TBI constitute the majority of neurosurgical admissions and deaths specially in the pediatric population. This study aims to determine the factors associated with poor outcome among pediatric TBI cases at a major referral hospital in western Uganda.

Methods: This study was conducted at Mbarara Regional Referral Hospital (MRRH) in western Uganda.

Relationship Among Koenig Depression Scale and Postoperative Outcomes, Ambulation, and Perception of Pain in Elderly Patients (≥65 Years) Undergoing Elective Spinal Surgery for Adult Scoliosis.

Background: The aim of this study was to assess whether the Koenig Depression Scale (KDS) can identify depressed elderly patients undergoing elective spine surgery for deformity at risk for inferior postoperative outcomes including complication rates, ambulation ability, and patient-reported outcomes.

Methods: The medical records of 92 elderly patients (≥65 years) undergoing a planned elective spinal surgery for correction of adult degenerative scoliosis were reviewed for this study. Preoperative baseline depression was assessed using the validated KDS that was administered by a board-certified geriatrician.