Publications by authors named "Konmal Ali"
Background: Little is known about the burden and outcomes of diverticulitis in patients under the age of 50. This knowledge gap hinders the development of effective management strategies and preventive measures for this population.
Objective: This study aimed to analyze national trends in hospitalizations, interventions, and outcomes for early-onset (age <50) diverticulitis in comparison to standard-onset (age ≥50) cohorts.
Purpose: Patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) have been noted to face increased cancer incidence. Yet, the impact of concomitant renal dysfunction on acute outcomes following elective surgery for cancer remains to be elucidated.
Methods: All adult hospitalizations entailing elective resection for lung, esophageal, gastric, pancreatic, hepatic, or colon cancer were identified in the 2016-2020 National Inpatient Sample.
Objective: To characterize contemporary surgeons' viewpoints and perspectives on the academic mission during healthcare corporatization.
Summary Background Data: Academic surgery, traditionally driven by the tripartite missions of excellence in clinical care, scientific research, and education, faces increasing challenges from a corporatized healthcare environment. While previous studies have addressed the financial aspects of corporatization, a comprehensive evaluation of academic surgeons' attitudes and experiences remains lacking.
Background: Although existing work has evaluated outcomes associated with care fragmentation (CF), these adverse consequences may be accentuated in patients undergoing bariatric operations. This retrospective study examined the association of CF with clinical and financial outcomes among patients receiving bariatric surgery.
Methods: All adult (≥18 years) records for bariatric operations were tabulated from the 2016-2021 Nationwide Readmissions Database.
Introduction: Frailty, a measure of physiological aging and reserve, has been validated as a prognostic indicator of mortality in patients with cirrhosis. However, large-scale analyses of the independent association of frailty with clinical and financial outcomes following liver transplantation (LT) are lacking.
Methods: Adults (≥18 years) undergoing LT were identified in the 2016-2020 National Readmissions Database.
Background: The present study aimed to compare outcomes between cholecystectomy on index versus delayed admission for acute cholangitis.
Methods: The 2011-2020 Nationwide Readmissions Database was used to identify adult patients admitted for acute cholangitis who underwent cholecystectomy. Study cohorts were defined based on timing of surgery.
Article Synopsis
- Recent studies indicate that non-operative management can be a safe alternative to surgery for treating acute uncomplicated appendicitis, but there's inconsistent application of this approach across hospitals.
- A study analyzed data from over 447,000 hospitalizations to evaluate factors influencing the rate of non-operative management, finding that about 11.7% of patients were treated non-operatively, with significant variability depending on the hospital's practices.
- Findings revealed that hospitals with higher rates of non-operative management (over 90th percentile) had worse surgical outcomes, suggesting a need for further research to understand the factors leading to increased non-operative treatment utilization.
Background: With the aging population in the United States, the incidence of abdominal aortic aneurysms is shifting to older ages. Given changing demographic characteristics and increasing health care expenditures, the present study evaluated the degree of center-level variation in the cost of elective abdominal aortic aneurysm repair.
Methods: We identified all adult (≥18 years) hospitalizations for elective repair of nonruptured abdominal aortic aneurysms in the 2017 to 2020 Nationwide Readmissions Database.
Background: Black race has been associated with increased resource utilization after operation for small bowel obstruction (SBO). While prior literature has similarly demonstrated differences between urban and rural institutions, limited work has defined the impact of rurality on resource utilization by race.
Methods: The 2016-2020 National Inpatient Sample was used to identify adults undergoing adhesiolysis after non-elective admission for SBO.
Background: Cholecystectomy remains the standard management for acute cholecystitis. Given that rates of nonoperative management have increased, we hypothesize the existence of significant hospital-level variability in operative rates. Thus, we characterized patients who were managed nonoperatively at normal and lower operative hospitals (>90th percentile).
View Article and Find Full Text PDFBackground: While race and insurance have been linked with greater likelihood of hernia incarceration and emergent presentation, the association of broader social determinants of health (SDOH) with outcomes following urgent repair remains to be elucidated.
Study Design: All adult hospitalizations entailing emergent repair for strangulated inguinal, femoral, and ventral hernias were identified in the 2016-2020 Nationwide Readmissions Database. Socioeconomic vulnerability was ascertained using relevant diagnosis codes.
Despite considerable national attention, racial disparities in surgical outcomes persist. We sought to consider whether race-based inequities in outcomes following major elective surgery have improved in the contemporary era. All adult hospitalization records for elective coronary artery bypass grafting, abdominal aortic aneurysm repair, colectomy, and hip replacement were tabulated from the 2016-2020 National Inpatient Sample.
View Article and Find Full Text PDFArticle Synopsis
- The study examines fat embolism as a serious complication in trauma patients undergoing major surgeries, using data from the National Inpatient Sample between 2005 and 2020.
- Out of over 10.6 million hospitalizations, only 7,479 patients (0.07%) were diagnosed with fat embolism, who were generally younger and more likely to be treated at high-volume trauma centers compared to those without this condition.
- The findings indicated that fat embolism significantly increased mortality rates, complications, hospitalization costs, and length of stay, highlighting the need for better early detection and management strategies in trauma settings.
Article Synopsis
- Alcohol withdrawal syndrome (AWS) complicates postoperative management in trauma patients, making it difficult to screen for, especially since their condition often requires urgent attention.
- A study of nearly 3 million trauma hospitalizations revealed that 1.23% developed AWS, significantly increasing risks for in-hospital mortality and various complications such as infectious, cardiac, and respiratory issues.
- Male patients, those on Medicaid, and individuals with head injuries or thoracic surgeries were more likely to develop AWS, highlighting the need for better screening methods to improve care and outcomes in trauma settings.
Previous studies have shown an association between acute limb ischemia and higher mortality in patients with acute myocardial infarction. Although peripheral artery disease (PAD) is a well-known risk factor for development of macrovascular pathology, the effect of its severity is not well investigated in patients hospitalized for acute coronary syndrome (ACS). Using a national cohort of patients with various degrees of PAD, we investigated in-hospital outcomes in patients who were admitted for ACS.
View Article and Find Full Text PDFBackground: Despite increasing utilization and survival benefit over the last decade, extracorporeal membrane oxygenation (ECMO) remains resource-intensive with significant complications and rehospitalization risk. We thus utilized machine learning (ML) to develop prediction models for 90-day nonelective readmission following ECMO.
Methods: All adult patients receiving ECMO who survived index hospitalization were tabulated from the 2016-2020 Nationwide Readmissions Database.
Background: Appendectomy remains a common pediatric surgical procedure with an estimated 80,000 operations performed each year. While prior work has reported the existence of racial disparities in postoperative outcomes, we sought to characterize potential income-based inequalities using a national cohort.
Methods: All non-elective pediatric (<18 years) hospitalizations for appendectomy were tabulated in the 2016-2020 National Inpatient Sample.
Background: Extracorporeal membrane oxygenation (ECMO) has emerged as a life-sustaining measure for individuals with end-stage cardiopulmonary derangements. An estimated one-third of patients must be transferred to a specialized center to receive this intervention. Therefore, the present study sought to characterize the impact of interhospital transfer (IHT) status on outcomes following ECMO.
View Article and Find Full Text PDFBackground: Contralateral prophylactic mastectomy (CPM) remains a personal decision, influenced by psychosocial factors, including cosmesis and peace of mind. Although use of CPM is disproportionately low among Black patients, the degree to which these disparities are driven by patient- vs hospital-level factors remains unknown.
Study Design: Patients undergoing mastectomy for nonmetastatic ductal or lobular breast cancer were tabulated using the National Cancer Database from 2004 to 2020.
Article Synopsis
- Over 20 million people in the U.S. are affected by substance use disorder (SUD), impacting 4% of hospitalized patients and raising concerns regarding its effects on health outcomes after elective abdominal surgeries.
- A study analyzed data from over 1 million adult patients who underwent five types of elective surgeries between 2016-2020, finding that those with SUD were typically younger, more often male, and had lower incomes or were of Black race.
- Results showed that SUD patients had similar in-hospital mortality rates but faced higher chances of complications, longer hospital stays, increased costs, and a greater likelihood of not being discharged to their homes, indicating the need for targeted interventions.
Off-pump coronary revascularization (OPCAB) has been proposed to benefit patients who are at a greater surgical risk because it avoids the use of extracorporeal circulation. Although, historically, older patients were considered high-risk candidates, recent studies implicate frailty as a more comprehensive measure of perioperative fitness. Yet, the outcomes of OPCAB in frail patients have not been elucidated.
View Article and Find Full Text PDFBackground: Despite the favorable outcomes and safety profile associated with metabolic and bariatric surgery (MBS), complications may occur postoperatively, necessitating emergency general surgery (EGS) intervention.
Objectives: To evaluate the association of outcomes in patients with prior MBS following EGS interventions.
Setting: Academic, University-affiliated; USA.
Background: Small bowel obstruction (SBO) is a complication of bariatric surgery. However, outcomes of surgical intervention for SBO among patients with prior bariatric surgery remain ill-defined. We used a nationally representative cohort to characterize the outcomes of the SBO management approach in patients with a prior bariatric operation.
View Article and Find Full Text PDFBackground: Although early discharge after colectomy has garnered significant interest, contemporary, large-scale analyses are lacking.
Objective: The present study utilized a national cohort of patients undergoing colectomy to examine costs and readmissions following early discharge.
Methods: All adults undergoing elective colectomy for primary colon cancer were identified in the 2016-2019 Nationwide Readmissions Database.
Background: With a growing emphasis on value of care, understanding factors associated with rising healthcare costs is increasingly important. In this national study, we evaluated the degree of center-level variation in the cost of spinal fusion.
Methods: All adults undergoing elective spinal fusion were identified in the 2016 to 2020 National Inpatient Sample.