Publications by authors named "Jillian K Smith"
Background: A novel data warehouse based on automated retrieval from an institutional health care information system (HIS) was made available to be compared with a traditional prospectively maintained surgical database.
Methods: A newly established institutional data warehouse at a single-institution academic medical center autopopulated by HIS was queried for International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnosis codes for pancreatic neoplasm. Patients with ICD-9-CM diagnosis codes for pancreatic neoplasm were captured.
Background: Patients are increasingly confronted with systems for rating hospitals. However, the correlations between publicized ratings and actual outcomes after pancreatectomy are unknown.
Methods: The Massachusetts Division of Health Care Finance and Policy Hospital Inpatient Discharge Database was queried to identify pancreatic cancer resections carried out during 2005-2009.
Background: Although debate continues on US healthcare and insurance reform, data are lacking on the effect of insurance on community-level cancer outcomes. Therefore, the objective of the present study was to examine the association of insurance and cancer outcomes.
Materials And Methods: The US Census Bureau Current Population Survey, Small Area Health Insurance Estimates (2000) were used for the rates of uninsurance.
Pancreatic cancer is an aggressive and highly lethal malignancy. Surgical resection is a modest tool, but it provides the only potential for curative therapy and often prolongs survival. This article reviews the progress made on both local and national levels towards an era of safer pancreatic surgery, while discussing both perioperative outcomes and long-term survival after resection.
View Article and Find Full Text PDFBackground: Undergoing a pancreatectomy obligates the patient to risks and benefits. For complex operations such as pancreatectomy, the objective assessment of baseline risks may be useful in decision-making. We developed an integer-based risk score estimating in-hospital mortality after pancreatectomy, incorporating institution-specific mortality rates to enhance its use.
View Article and Find Full Text PDFIntroduction: Abdominal imaging is often performed after pancreatic cancer resection. We attempted to quantify the volume and estimate the cost of complex imaging after pancreatectomy nationwide, and to determine whether their frequent use confers benefit.
Methods: Patients with pancreatic adenocarcinoma who underwent resection were identified in Surveillance, Epidemiology and End Results-Medicare (1991-2005).
Background: All open and laparoscopic colectomies submitted to the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) were evaluated for trends and improvements in operative outcomes.
Methods: 48,247 adults (≥18 y old) underwent colectomy in ACS NSQIP, as grouped by surgical approach (laparoscopic versus open), urgency (emergent versus elective), and operative year (2005 to 2008). Primary outcomes measured morbidity, mortality, perioperative, and postoperative complications.
Purpose: Tumor registry (TR) data are becoming more prominently cited in research through increased use of the National Cancer Database. We aimed to establish the accuracy of TR data by comparing them with physician medical record review (MD review) using pancreatic neuroendocrine tumors (NETs) as an example.
Methods: For MD review, the health information system of an academic medical center was queried for patients with pancreatic International Classification of Diseases, ninth revision (ICD-9), codes from January 2000 to August 2008.
Background: A growth in the utilization of high-risk allografts is reflective of a critical national shortage and the increasing waiting list mortality. Using risk-adjusted models, the aim of the present study was to determine whether a volume-outcome relationship existed among liver transplants at high risk for allograft failure.
Methods: From 2002 to 2008, the Scientific Registry of Transplant Recipients (SRTR) database for all adult deceased donor liver transplants (n = 31 587) was queried.
The use of high-risk donor livers, which is reflective of the gross national shortage of organs available for transplantation, has gained momentum. Despite the demand, many marginal livers are discarded annually. We evaluated the impact of center volume on survival outcomes associated with liver transplantation using high-donor risk index (DRI) allografts.
View Article and Find Full Text PDFBackground: The incidence of hepatocellular carcinoma (HCC) is increasing in the United States, and the care of these patients remains highly specialized and complex. Multiple treatment options are available for HCC but their use and effectiveness remain unknown.
Methods: Using Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data, 8730 patients who were diagnosed with HCC between 1991 and 2005 were identified.
Introduction: Distinct outcome measures such as in-hospital and 30-day mortality have been used to evaluate pancreatectomy results. We posited that these measures could be compared using national data, providing more precision for evaluating published outcomes after pancreatectomy.
Methods: Patients undergoing resection for pancreatic cancer were identified from the linked SEER-Medicare databases (1991-2002).
Potential benefit of resection for stage IV gastric cancer: a national survey.
J Gastrointest Surg
November 2010
Introduction: Controversy exists as to whether patients with stage IV gastric cancer should undergo surgical resection. We examined the association of gastrectomy with survival in this population.
Methods: Stage IV gastric cancer diagnoses were identified using the SEER database (1988-2005).
Background: Although resection of pancreatic neuroendocrine tumors (PNETs) has a demonstrated survival advantage, further evaluation of the overall morbidity of these procedures is needed. Our objective was to examine a composite outcome of major postoperative complications, including in-hospital mortality.
Materials And Methods: The Nationwide Inpatient Sample (NIS), 1998-2006, was used to identify all patients with a diagnosis of PNET who had undergone pancreatectomy.
Background: Blacks have a higher incidence of pancreatic adenocarcinoma and worse outcomes compared to whites. Identifying barriers in pancreatic cancer care may explain survival differences and provide areas for intervention.
Methods: Pancreatic adenocarcinoma patients were identified in the Surveillance, Epidemiology, and End Results Registry (1991-2002).
Hypothesis: That factors affecting outcomes of surgical resection in the treatment of gastric cancer can be identified using a large US database.
Design: Retrospective observational study.
Setting: The Nationwide Inpatient Sample from January 1, 1998, through December 31, 2003.