Publications by authors named "Josef Madrigal"
Background: Despite the high prevalence of atrial fibrillation (AF), the incidence and impact of care fragmentation (CF) following hospitalization for this condition remain unstudied.
Objectives: The present study used a national database to determine the incidence of and risk factors associated with CF. Outcomes following CF were also examined.
Association of Safety-Net Hospital Status With Outcomes Following Head and Neck Cancer Operations.
Otolaryngol Head Neck Surg
September 2024
Objective: To assess perioperative and readmission outcomes of patients undergoing head and neck cancer (HNCA) surgery at safety-net hospitals (SNHs) in a modern cohort.
Study Design: Retrospective cohort study.
Setting: Nationwide Readmissions Database (NRD), 2010 to 2019.
Objective: The purpose of the present study was to assess the duration of operative time and outcomes related to patients with an increased American Society of Anesthesiologists (ASA) Physical Status classification in the setting of hospital-based maxillofacial surgical procedures.
Study Design: The study was a retrospective multi-institutional cohort study using the American College of Surgeons National Surgical Quality Improvement Program database to enroll patients who underwent maxillofacial procedures between 2012 and 2019. The primary independent variable was ASA Physical Status Classification (I, II, III, IV).
Objective: Depression remains prevalent in patients undergoing head and neck cancer (HNCA) operations. The present study aimed to assess the impact of depression on perioperative and readmission outcomes following HNCA resection.
Methods: All elective hospitalizations involving HNCA resection were identified from the 2010-2019 Nationwide Readmissions Database.
Background: The incidence of thyroid pathology increases with age. Yet octogenarians may face increased rates of complications after thyroid surgery. Using a nationally representative cohort, we evaluated the outcomes of thyroidectomy among octogenarians.
View Article and Find Full Text PDFCare fragmentation (CF), or readmission at a nonindex hospital, has been linked to inferior clinical and financial outcomes for patients. However, its impact on patients with acute myocardial infarction (AMI) is unclear. This study investigated the prevalence and impact of CF on the outcomes of patients with AMI.
View Article and Find Full Text PDFBackground: There is a paucity of data examining the impact of advancing chronic kidney disease stages on outcomes following revascularization for acute limb ischemia. The present study examined the association of chronic kidney disease with in-hospital mortality, amputation, and resource utilization following revascularization for acute limb ischemia using a nationally representative cohort.
Methods: The 2016-2018 National Inpatient Sample was queried to identify all adult hospitalizations with lower extremity acute limb ischemia requiring surgical and/or endovascular interventions.
Background: Deep inferior epigastric artery perforator flaps are increasingly utilized over other autologous methods of breast reconstruction. We evaluated the relationship between annual hospital volume and costs after breast reconstruction with the deep inferior epigastric artery perforator flap.
Methods: All female patients undergoing elective implant or autologous tissue breast reconstruction were identified using the 2016-2019 Nationwide Readmission Database.
Article Synopsis
- Kidney transplant (KTx) recipients undergoing cardiac surgeries (like bypass or valve repairs) face higher risks of in-hospital mortality and complications compared to non-KTx patients.
- Among nearly 1.4 million patients studied, KTx recipients had nearly 2.5 times the odds of dying in the hospital and over 1.5 times the risk of complications.
- Treatment at hospitals that perform KTx can significantly lower risks of kidney injury, suggesting that KTx patients may benefit from specialized care to improve their surgical outcomes.
Background: Respiratory failure after pulmonary lobectomy is a serious complication associated with increased mortality in limited institutional series. The present study evaluated factors associated with respiratory failure and sought to ascertain the presence of interhospital variation.
Methods: The 2016-2018 Nationwide Readmissions Database was queried to identify elective adult (≥18 years) hospitalizations for pulmonary lobectomy with the diagnosis of lung cancer.
Objectives: Risk of mortality and major comorbidity remains high following hepatic resection. Given recent advancements in nonsurgical techniques to control hepatic malignancy, accurate assessment of surgical candidates, especially those considered frail, has become imperative. The present study aimed to characterize the impact of frailty on clinical and financial outcomes following hepatic resection in older individuals.
View Article and Find Full Text PDFImportance: Wide state-level variability in waiting list outcomes have been noted for patients listed for heart transplant in the US, but little is known regarding center-level transplant rates since the heart allocation policy change.
Objective: To evaluate center-level transplant rates following the recent allocation policy change for heart transplant.
Design, Setting, And Participants: This cohort study used data from the United Network for Organ Sharing database from October 18, 2015, to March 1, 2020, for a nationwide analysis of transplant centers in the US.
Introduction: The wellbeing of sexual and gender minority (SGM) medical students and the impact of their experiences on career trajectory remain poorly understood. The present study aimed to characterize the incidence of mistreatment in SGM trainees as well as general perspectives on the acceptance of SGM individuals across medical and surgical specialties.
Methods: This was a cross sectional survey study of all actively enrolled medical students within the six University of California campuses conducted in March 2021.
Laryngeal complications (LCs) following cardiac operations contribute to increased morbidity and resource utilization. Using a nationally representative cohort of cardiac surgical patients, we characterized the incidence of LC as well as its associated clinical and financial outcomes. All adults undergoing coronary artery bypass grafting and/or valvular operations were identified using the 2010-2017 Nationwide Readmissions Database.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates how the experience level of hospitals, measured by annual surgical caseload, affects outcomes for patients undergoing head and neck cancer surgery with flap reconstruction.
- Over nine years, it was found that while the overall rate of surgeries increased, patients treated at high-volume centers faced fewer complications, shorter hospital stays, and lower costs, although mortality rates remained unaffected.
- The results suggest that establishing volume standards for these procedures could enhance patient outcomes in surgical settings.
Background: Outcomes of cardiac operations in patients with chronic lymphocytic leukemia (CLL) have been examined in limited series. The present study aimed to assess the impact of CLL on clinical outcomes and resource utilization after cardiac operations in a nationally representative cohort.
Methods: All adult patients undergoing elective coronary artery bypass grafting, valve repair, or valve replacement were identified utilizing the 2010 to 2017 Nationwide Readmissions Database.
Background: Although patients with opioid use disorder have been shown to be more susceptible to traumatic injury, the impact of opioid use disorder after trauma-related admission remains poorly characterized. The present nationally representative study evaluated the association of opioid use disorder on clinical outcomes after traumatic injury warranting operative intervention.
Methods: The 2010 to 2018 Nationwide Readmissions Database was used to identify adult trauma victims who underwent major operative procedures.
Article Synopsis
- - Undergraduate students at UCLA conducted research using RNA interference (RNAi) and fluorescent proteins to pinpoint genes crucial for blood cell development in fruit flies, screening around 3,500 genes and finding 137 that affected hematopoiesis.
- - By targeting RNAi to different cell types involved in blood cell maturation, the researchers identified specific gene subsets that either facilitate or inhibit this process, revealing new insights into gene functions related to RNA processing and vesicular trafficking.
- - The CURE (Course-Based Undergraduate Research Experience) model not only enhanced students' understanding and skills in science but also improved retention rates in STEM fields, demonstrating the value of hands-on research in education.
Objective: While opioid use disorder (OUD) has been previously associated with increased morbidity and resource use in cardiac operations, its impact on readmissions is understudied.
Methods: Patients undergoing coronary artery bypass grafting and valve repair or replacement, excluding infective endocarditis, were identified in the 2010-16 Nationwide Readmissions Database. Using International Classification of Diseases 9/10, we tabulated OUD and other characteristics.
Objective: Intuitively, the chronic disease burden of surgical patients varies considerably by surgical specialty, although sparse evidence in the literature supports this notion. We sought to characterize the medical complexity of surgical patients by surgical specialty and to quantify the association between medical complexity and outcomes.
Methods: The National Inpatient Sample, an all-payer inpatient database representative of 97% of all U.
Article Synopsis
- * Among over a million patients, 16.6% were transferred, and transfer patients experienced more complications, longer hospital stays, higher costs, and higher rates of readmission.
- * Transferring patients to high-volume centers improved survival rates and reduced the likelihood of them being readmitted to the original hospital, highlighting the significance of transfer status in patient management.
Background: Despite the introduction of several measures to reduce incidence, postoperative infections have been reported to increase. We aimed to assess trends in the incidence and impact of postoperative infections using a recent national cohort.
Methods: Patients undergoing the most commonly performed elective inpatient procedures in 9 surgical specialties were identified from the 2006 to 2014 National Inpatient Sample.
Extracorporeal life support (ECLS) has been increasingly utilized to manage cardiac and pulmonary dysfunction. The impact of obesity on outcomes of ECLS is poorly defined. The purpose of the study was to compare in-hospital mortality, resource use, complications, and readmissions in obese versus non-obese patients receiving ECLS.
View Article and Find Full Text PDFArticle Synopsis
- Malnutrition is linked to higher mortality and complications in patients undergoing transcatheter aortic valve implantation (TAVI), a procedure for severe aortic stenosis.
- Out of over 105,000 patients studied, 5% were malnourished and faced significantly worse outcomes, including a much higher mortality rate of 10.4% compared to 2.2%, more complications, longer hospital stays, and increased costs.
- The study emphasizes the need for better preoperative assessments and addressing malnutrition to potentially enhance patient outcomes in this at-risk group.