Publications by authors named "Melissa M Boltz"
Background: Endoscopic mucosal resection comprises the first-line treatment for large cecal polyps. With up to 14% of unresectable colonic polyps harboring malignancy, the management of endoscopically unresectable cecal polyps remains an oncologic right hemicolectomy, which can be associated with substantial postoperative morbidity.
Objective: This study compares the outcomes of patients with cecal polyps who underwent either endoscopic mucosal resection, a cecectomy, or a right hemicolectomy.
Background: Postoperative cervical hematoma after major head and neck surgery is a feared complication. However, risk factors for developing this complication and attributable costs are not well-established.
Methods: The Nationwide Inpatient Sample database was utilized compare patients with and without postoperative cervical hematoma.
Background: Postoperative cervical hematoma (PCH) after thyroid and parathyroid surgery is a well-known complication. This study used data from the Nationwide Inpatient Sample to identify risk factors, estimate mortality, length of stay (LOS), and total costs attributable to PCH in patients undergoing procedures for thyroid and parathyroid diseases.
Methods: Patients aged >18 y who underwent thyroid or parathyroid surgery between 2001 and 2011 were identified and stratified by the occurrence of PCH.
Background: In parathyroid hyperplasia (HPT), parathyroid glands within the cervical thymus are a cause for recurrence. As a result of differences in pathophysiology, variable practice patterns exist regarding performing bilateral cervical thymectomy (BCT) in primary hyperplasia versus hyperplasia from renal failure or familial disease. The objective of this study was to capture patients where thymic tissue was found with subtotal parathyroidectomy (PTX) and intended BCT, identify number of thymic supernumerary glands (SNGs), and determine overall cure rate.
View Article and Find Full Text PDFIntroduction: Fall risk for older adults is a multi-factorial public health problem as 90% of geriatric injuries are caused by traumatic falls. The CDC estimated 33% of adults >65 years incurred a fall in 2011, with 30% resulting in moderate injury. While much has been written about overall risk to trauma patients on oral anticoagulant (OAC) therapy, less has been reported on outcomes in the elderly trauma population.
View Article and Find Full Text PDFBackground: Little is known about costs associated with differentiated thyroid cancer (DTC) and follow-up care. This study used data from the Surveillance Epidemiology and End Results (SEER) database to examine cumulative costs attributable to disease stage and treatment options of DTC in elderly patients over 5 years.
Methods: We identified 2,823 patients aged >65 years with DTC and 5,646 noncancer comparison cases from SEER Medicare data between 1995 and 2005.
Objective: Data from the Surveillance Epidemiology and End Results Medicare-linked database were used to estimate the incidence of and risk factors associated with recurrent thyroid cancer, and to assess the impact of recurrence on mortality following diagnosis, controlling for mortality as a competing risk.
Design: We identified 2883 patients over 65 years of age diagnosed with a single, primary well-differentiated thyroid cancer between 1995 and 2007. A recurrence was considered if the patient had evidence of I-131 therapy, imaging for metastatic thyroid carcinoma, or complete thyroidectomy beyond 6 months of diagnosis.
As payment policies for surgical complications evolve, surgeons and hospitals need to understand the financial implications of postoperative events. Using data from the National Surgical Quality Improvement Program (NSQIP), the authors estimated mortality, length of stay (LOS), and total cost attributable to multiple postoperative events in general and vascular surgery patients. Data were collected using standard NSQIP practices at a single academic center between 2007 and 2009.
View Article and Find Full Text PDFObjective: The purpose of this study was to compare the cost-effectiveness of the National Surgical Quality Improvement Program (NSQIP) at an academic medical center between the first 6 months and through the first and second years of implementation.
Background: The NSQIP has been extended to private-sector hospitals since 1999, but little is known about its cost-effectiveness.
Methods: Data included 2229 general or vascular surgeries, 699 of which were conducted after NSQIP was in place for 6 months.
Electronic measures of surgical site infection: implications for estimating risks and costs.
Infect Control Hosp Epidemiol
August 2011
Objective: Electronic measures of surgical site infections (SSIs) are being used more frequently in place of labor-intensive measures. This study compares performance characteristics of 2 electronic measures of SSIs with a clinical measure and studies the implications of using electronic measures to estimate risk factors and costs of SSIs among surgery patients.
Methods: Data included 1,066 general and vascular surgery patients at a single academic center between 2007 and 2008.
Background: Although much has been written about excess cost and duration of stay (DOS) associated with surgical site infections (SSIs) after cardiothoracic surgery, less has been reported after vascular and general surgery. We used data from the National Surgical Quality Improvement Program (NSQIP) to estimate the total cost and DOS associated with SSIs in patients undergoing general and vascular surgery.
Methods: Using standard NSQIP practices, data were collected on patients undergoing general and vascular surgery at a single academic center between 2007 and 2009 and were merged with fully loaded operating costs obtained from the hospital accounting database.