Users of chronic prescription opioids decrease in the first 12 months following bariatric surgery.

Objective: Obesity is an independent risk factor for chronic pain frequently treated with opioids. Our study investigated the effect of Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) on chronic opioid prescription use.

Methods: Using the IBM MarketScan database (2010-2017), we analyzed adult chronic opioid users who underwent bariatric surgery.

Risk factors and temporal associations of progression of the atopic march in children with early-onset atopic dermatitis.

Background: Risk factors and the temporal relationship between atopic dermatitis (AD) and atopic march remain understudied.

Objective: Determine risk factors for atopic march in early-onset AD patients and the temporality between AD and atopic march.

Methods: We used the MarketScan Research Database for our retrospective cohort analysis from 2010 to 2018, comparing infants diagnosed with AD before age 1 with controls without early-onset AD.

Statewide Variation in Practices and Charges for Primary Spontaneous Pneumothorax in Maryland, United States: A Retrospective Study.

Background: The optimal treatment for primary spontaneous pneumothorax (PSP) remains undefined. Furthermore, the overall utilization and costs of various treatment approaches are incompletely understood. We investigated hospital charges and resource utilization by management strategy across the state of Maryland in adult and pediatric patients with PSP.

National Patterns of Hospital Admission Versus Home Recovery Following Mastectomy for Breast Cancer.

Background: We examined national patterns of care and perioperative outcomes for women after mastectomy, comparing home recovery (HR) with hospital admission.

Patients And Methods: Using Martketscan data (2017-2019), women ≥ 18 years old who underwent mastectomy ± reconstruction were identified and classified as either home recovery (same calendar day discharge) or hospital admission (stays > 1 calendar day). Comorbidities and receipt of chemo/immunotherapy 6 months prior to surgery and post-surgical 30-day complications were measured.

Glycemic Control in Diabetic Foot Ulcers: A Comparative Analysis of Wound and Wound-free Periods in Adults With Type 1 and Type 2 Diabetes.

Objective: Our aim in this study was to determine whether there are differences in glycemia during wound and wound-free states among individuals with diabetes at a multidisciplinary diabetic foot and wound clinic from 2012 to 2019.

Methods: We conducted a retrospective analysis of prospectively collected data over 7.4 years from the Johns Hopkins Multidisciplinary Diabetic Foot and Wound Clinic.

Cost Comparison of Digital Nerve Repair Techniques.

Purpose: Direct cost comparison of nerve allograft with other techniques for repairing short digital nerve gaps are lacking. This study compares the costs of various techniques for digital nerve repair, anticipating significant cost increases for allograft implants.

Methods: The State Ambulatory Surgery and Services Database for Florida, New York, and Wisconsin from 2015-2020 was used.

Clinical factors associated with ultrashort length of stay in patients undergoing lower extremity bypass for peripheral arterial disease.

Background: Length of stay (LOS) is a major driver of cost and resource utilization following lower extremity bypass (LEB). However, the variable comorbidity burden and mobility status of LEB patients makes implementing enhanced recovery after surgery pathways challenging. The aim of this study was to use a large national database to identify patient factors associated with ultrashort LOS among patients undergoing LEB for peripheral artery disease.

Sex-Related Differences in Utilization and Outcomes of Extracorporeal Cardio-Pulmonary Resuscitation for Refractory Cardiac Arrest.

Sparse data exist on sex-related differences in extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest (rCA). We explored the role of sex on the utilization and outcomes of ECPR for rCA by retrospective analysis of the Extracorporeal Life Support Organization (ELSO) International Registry. The primary outcome was in-hospital mortality.

The impact of undergoing elective pediatric lung resection during respiratory syncytial virus peak season on patient outcomes: A nationwide retrospective analysis.

Objectives: Observational data to support delaying elective pediatric thoracic surgery during peak respiratory viral illness season is lacking. This study evaluated whether lung surgery during peak viral season is associated with differences in postoperative outcomes and resource utilization.

Methods: A retrospective observational cohort study was performed using the Pediatric Health Information System (PHIS).

Outcomes of SADI and OAGB Compared to RYGB from the Metabolic and Bariatric Surgery Quality Improvement Program: The North American Experience.

Background: Rapid adoption of sleeve gastrectomy (SG) in the last decade aptly reflects the desire of patients and surgeons for alternatives to RYGB and DS. While SG provides good outcomes, other options that address specific patient needs are warranted. Recently approved by ASMBS, SADI, and OAGB have garnered increasing interest due to their single anastomosis technique.

More problems, more money: Identifying and predicting high-cost rescue after colorectal surgery.

Background: Successful rescue after elective surgery is associated with increased healthcare costs, but costs vary widely. Treating all rescue events the same may overlook targeted opportunities for improvement. The purpose of this study was to predict high-cost rescue after elective colorectal surgery.

Epidemiology of ophthalmic trauma in the United States from 2009-2018: A Nationwide Emergency Department Sample Analysis.

Purpose: To determine the incidence, characteristics, disposition, and economic burden of emergency department (ED) visits for ophthalmic trauma in the United States (US).

Design: Retrospective study.

Methods: The Nationwide Emergency Department Sample was used to calculate and characterize ED visits for ophthalmic trauma in the US from 2009 to 2018.

The Degree of Preoperative Hypoalbuminemia Is Associated with Risk of Postoperative Complications in Metabolic and Bariatric Surgery Patients.

Background: The incidence and impact of hypoalbuminemia in bariatric surgery patients is poorly characterized. We describe its distribution in laparoscopic sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB) patients undergoing primary or revision surgeries and assess its impact on postoperative complications.

Methods: The Metabolic and Bariatric Surgery Quality Improvement Program Database (2015 to 2021) was analyzed.

Early observations with an ERAS pathway for thyroid and parathyroid surgery: Moving the goalposts forward.

Background: Enhanced recovery after surgery pathways have become the standard of care in various surgical specialties. In this study, we discuss our initial experience with a staged enhanced recovery after surgery pathway in endocrine surgery and assess the impact of this pathway on select perioperative outcomes and unanticipated admissions.

Methods: We collected information regarding all thyroid/parathyroid surgeries performed by endocrine surgeons at our institution before and after the implementation of the multi-intervention enhanced recovery after surgery pathway.

The association between severe maternal morbidity and mortality and race/ethnicity with community type in Maryland.

Background: Severe maternal morbidity and mortality are increasing in the United States with continued healthcare disparities among Non-Hispanic Black women. However, there is sparse data on the disparities of severe maternal morbidity and mortality by race/ethnicity as it relates to community type.

Objective: To determine whether residing in rural communities increases the racial/ethnic disparities in severe maternal morbidity and mortality.

Diverticulitis in Older Adults: Is Cognitive Impairment Associated With Outcomes?

Introduction: Older age is associated with increased prevalence of both diverticulitis and cognitive impairment. The association between cognitive impairment and outcomes among older adults presenting to the emergency department (ED) for diverticulitis is unknown.

Methods: Adults aged ≥65 y presenting to an ED with a primary diagnosis of colonic diverticulitis were identified using the Nationwide Emergency Department Sample (2016-2019) and stratified by cognitive impairment status in this retrospective cohort study.

Deep Anterior Lamellar Keratoplasty and Penetrating Keratoplasty for Keratoconus: A Claims-Based Analysis.

Purpose: The purpose of this study was to report 1) demographic and clinical characteristics for US patients with keratoconus undergoing deep anterior lamellar keratoplasty (DALK) or penetrating keratoplasty (PK) and 2) complication rates for the 2 procedures.

Methods: We performed a retrospective review of 2010 to 2018 health records for patients with keratoconus age younger than 65 years using the IBM MarketScan Database. A multivariable model adjusting for potential confounders was used to determine factors associated with receiving DALK over PK.

Racial and Ethnic Disparities in Outcomes Among Newborns with Congenital Diaphragmatic Hernia.

Importance: There is some data to suggest that racial and ethnic minority infants with congenital diaphragmatic hernia (CDH) have poorer clinical outcomes.

Objective: To determine what patient- and institutional-level factors are associated with racial and ethnic differences in CDH mortality.

Design, Setting, And Participants: Multicenter cohort study of 49 US children's hospitals using the Pediatric Health Information System database from January 1, 2015, to December 31, 2020.

The impact of a statewide payment reform on transcatheter aortic valve replacement (TAVR) utilization and readmissions.

Background: Transcatheter aortic valve replacement (TAVR) is an increasingly used but relatively expensive procedure with substantial associated readmission rates. It is unknown how cost-constrictive payment reform measures, such as Maryland's All Payer Model, impact TAVR utilization given its relative expense. This study investigated the impact of Maryland's All Payer Model on TAVR utilization and readmissions among Maryland Medicare beneficiaries.

Risk of Tertiary, Quaternary, and Quinary Proliferative Vitreoretinopathy: Analysis of a Nationwide Database (2010-2017).

Objective: Primary proliferative vitreoretinopathy (PVR) is established as an important cause of the failed repair of a fresh retinal detachment (RD) and the consequent need for secondary repair. However, the burden of multiple repairs beyond the initial failure has not been studied in detail. We aimed to determine the association between primary PVR and the occurrence of tertiary, quaternary, and quinary RD repairs, using a nationwide database.

Factors Associated with Length of Stay and Cost among Pediatric Hospitalizations with a Primary Ophthalmic Diagnosis.

Purpose: To investigate factors associated with prolonged length of stay and high cost among pediatric hospitalizations with a primary ophthalmic diagnosis.

Methods: This retrospective, cross-sectional study utilized data on pediatric admissions with a primary ophthalmic diagnosis from the multicenter 2016 Kids' Inpatient Database. Multivariable logistic regression models adjusted for demographic, hospital, and admission characteristics were used to evaluate factors associated with prolonged stay and high cost, defined as exceeding the 75 percentile (>4 days and $12,642, respectively).

Alert-Triggered Patient Education Versus Nurse Feedback for Nonadministered Venous Thromboembolism Prophylaxis Doses: A Cluster-Randomized Controlled Trial.

Background Many hospitalized patients are not administered prescribed doses of pharmacologic venous thromboembolism prophylaxis. Methods and Results In this cluster-randomized controlled trial, all adult non-intensive care units (10 medical, 6 surgical) in 1 academic hospital were randomized to either a real-time, electronic alert-triggered, patient-centered education bundle intervention or nurse feedback intervention to evaluate their effectiveness for reducing nonadministration of venous thromboembolism prophylaxis. Primary outcome was the proportion of nonadministered doses of prescribed pharmacologic prophylaxis.

Cardioprotective mechanisms of mitochondria-targeted S-nitrosating agent and adenosine triphosphate-sensitive potassium channel opener are mutually exclusive.

Background: Myocytes exposed to stress exhibit significant swelling and reduced contractility. These consequences are ameliorated by adenosine triphosphate-sensitive potassium (K) channel opener diazoxide (DZX) via an unknown mechanism. K channel openers also provide cardioprotection in multiple animal models.

Association Between Early Speech-Language Pathology Consultation and Pneumonia After Cardiac Surgery.

Purpose: Patients undergoing cardiac surgery are reported to be at higher risk for oropharyngeal dysphagia and aspiration, which may predispose them to respiratory complications such as pneumonia. Speech-language pathology consultation facilitates early identification of swallowing difficulties providing appropriate and timely interventions during the postoperative period. This study explores the association between pneumonia and timing of speech-language pathology order entry and evaluation following cardiac surgery.

Heparin-Induced Thrombocytopenia After Cardiac Surgery-A Statewide Review of Health Care Utilization.

Background: Despite its severe consequences, clinical and economic impacts of heparin-induced thrombocytopenia (HIT) after cardiac operations have not been well characterized. This study assessed statewide incidence, outcomes, and resource consumption associated with HIT after cardiac operations.

Methods: This was a retrospective investigation of cardiac surgery patients using the Maryland Health Services Cost Review Commission's database from 2012 to 2020.