Publications by authors named "Sanford E Roberts"
Mucinous cystic neoplasms (MCNs) are rare tumors primarily observed in the pancreas but occasionally found in other locations such as the retroperitoneum, ovary, liver, and spleen. These neoplasms are histologically classified based on the degree of dysplasia, with some associated with invasive carcinoma. Colorectal surgeons infrequently encounter MCNs.
View Article and Find Full Text PDFObjective: To determine the association between post-discharge mental healthcare and odds of readmission after emergency general surgery (EGS) hospitalization for patients with serious mental illness (SMI).
Background Data: A mental health visit (MHV) after medical hospitalization is associated with decreased readmissions for patients with SMI. The impact of a MHV after surgical hospitalization is unknown.
Objective: The aim of this study was to develop and validate an instrument to measure Belonging in Surgery among surgical residents.
Background: Belonging is the essential human need to maintain meaningful relationships and connections to one's community. Increased belongingness is associated with better well-being, job performance, and motivation to learn.
Objective: Many emergency general surgery (EGS) conditions can be managed operatively or nonoperatively, with outcomes that vary by diagnosis. We hypothesized that operative management would lead to higher in-hospital costs but to cost savings over time.
Background: EGS conditions account for $28 billion in health care costs in the United States annually.
Importance: The benefit of primary care physician (PCP) follow-up as a potential means to reduce readmissions in hospitalized patients has been found in other medical conditions and among patients receiving high-risk surgery. However, little is known about the implications of PCP follow-up for patients with an emergency general surgery (EGS) condition.
Objective: To evaluate the association between PCP follow-up and 30-day readmission rates after hospital discharge for an EGS condition.
Introduction: Analyzing hospital-free days (HFDs) offers a patient-centered approach to health services research. We hypothesized that, within emergency general surgery (EGS), multimorbidity would be associated with fewer HFDs, whether patients were managed operatively or nonoperatively.
Methods: EGS patients were identified using national Medicare claims data (2015-2018).
Introduction: Many emergency general surgery (EGS) conditions can be managed both operatively or nonoperatively; however, it is unknown whether the decision to operate affects Black and White patients differentially.
Methods: We identified a nationwide cohort of Black and White Medicare beneficiaries, hospitalized for common EGS conditions from July 2015 to June 2018. Using near-far matching to adjust for measurable confounding and an instrumental variable analysis to control for selection bias associated with treatment assignment, we compare outcomes of operative and nonoperative management in a stratified population of Black and White patients.
Article Synopsis
- * This study sought to understand if visiting a primary care doctor before emergency surgeries is linked to lower mortality rates in older Black and White adults.
- * The research included over 102,000 Medicare patients aged 66 and older from US hospitals, analyzing their health outcomes based on prior primary care use before undergoing emergency general surgery.
Background: Multimorbidity is associated with an increased risk of poor surgical outcomes among older adults; however, identifying multimorbidity in the clinical setting can be a challenge.
Objective: We created the Multimorbid Patient Identifier App (MMApp) to easily identify patients with multimorbidity identified by the presence of a Qualifying Comorbidity Set and tested its feasibility for use in future clinical research, validation, and eventually to guide clinical decision-making.
Methods: We adapted the Qualifying Comorbidity Sets' claims-based definition of multimorbidity for clinical use through a modified Delphi approach and developed MMApp.
Background: Communication is key to success in bariatric surgery. This study aims to understand how outcomes after bariatric surgery differ between patients with a non-English primary language and those with English as their primary language.
Methods: This retrospective, observational cohort study of bariatric surgery patients age ≥ 18 years utilized the Michigan, Maryland, and New Jersey State Inpatient Databases and State Ambulatory Surgery and Services Databases, 2016 to 2018.
Objective: To understand how multimorbidity impacts operative versus nonoperative management of emergency general surgery (EGS) conditions.
Background: EGS is a heterogenous field, encompassing operative and nonoperative treatment options. Decision-making is particularly complex for older patients with multimorbidity.
Objective: Lack of insurance has been independently associated with an increased risk of in-hospital mortality after abdominal aortic aneurysm repair, possibly due to worse control of comorbidities and delays in diagnosis and treatment. Medicaid expansion has improved insurance rates and access to care, potentially benefiting these patients. We sought to assess the association between Medicaid expansion and outcomes after abdominal aortic aneurysm repair.
View Article and Find Full Text PDFBackground: Mental illness is associated with worse outcomes after emergency general surgery. To understand how preoperative processes of care may influence disparate outcomes, we examined rates of surgical consultation, treatment, and operative approach between older adults with and without serious mental illness (SMI).
Study Design: We performed a nationwide, retrospective cohort study of Medicare beneficiaries aged 65.
Importance: Variation in outcomes across hospitals adversely affects surgical patients. The use of high-quality hospitals varies by population, which may contribute to surgical disparities.
Objective: To simulate the implications of data-driven hospital selection for social welfare among patients who underwent colorectal cancer surgery.
Background: Qualifying comorbidity sets (QCS) are tools used to identify multimorbid patients at increased surgical risk. It is unknown how the QCS framework for multimorbidity affects surgical risk in different racial groups.
Methods: This retrospective cohort study included Medicare patients age ≥65.
Background: Little is known about the impact of multimorbidity on long-term outcomes for older emergency general surgery patients.
Study Design: Medicare beneficiaries, age 65 and older, who underwent operative management of an emergency general surgery condition were identified using Centers for Medicare & Medicaid claims data. Patients were classified as multimorbid based on the presence of a Qualifying Comorbidity Set (a specific combination of comorbid conditions known to be associated with increased risk of in-hospital mortality in the general surgery setting) and compared with those without multimorbidity.
Importance: A surgical consultation is a critical first step in the care of patients with emergency general surgery conditions. It is unknown if Black Medicare patients and White Medicare patients receive surgical consultations at similar rates when they are admitted from the emergency department.
Objective: To determine whether Black Medicare patients have similar rates of surgical consultations when compared with White Medicare patients after being admitted from the emergency department with an emergency general surgery condition.
As the surgical community continues to work towards greater diversity, equity, and inclusion, the need for buy-in from all surgeons-including those of the White majority-becomes increasingly apparent. This article invites all surgeons to aid in diversity, equity, and inclusion efforts as "allies," "upstanders," and "champions for change," and provides 2 specific frameworks for enacting allyship within the surgical field. Overt and conscious efforts to embrace allyship are imperative as we seek to fulfill our professional responsibilities to patients and will help create a workplace environment where all persons feel accepted, valued, welcomed, and respected.
View Article and Find Full Text PDFObjective: To determine the effect of operative versus nonoperative management of emergency general surgery conditions on short-term and long-term outcomes.
Background: Many emergency general surgery conditions can be managed either operatively or nonoperatively, but high-quality evidence to guide management decisions is scarce.
Methods: We included 507,677 Medicare patients treated for an emergency general surgery condition between July 1, 2015, and June 30, 2018.
Background: Little is known about the impact of multimorbidity on outcomes for older emergency general surgery patients.
Objective: The aim was to understand whether having multiple comorbidities confers the same amount of risk as specific combinations of comorbidities (multimorbidity) for a patient undergoing emergency general surgery.
Research Design: Retrospective observational study using state discharge data.
Facial nerve trauma often leads to disfiguring facial muscle paralysis. Despite several promising advancements, facial nerve repair procedures often do not lead to complete functional recovery. Development of novel repair strategies requires testing in relevant preclinical models that replicate key clinical features.
View Article and Find Full Text PDFBackground: Disparate colorectal cancer outcomes persist in vulnerable populations. We aimed to examine the distribution of research across the colorectal cancer care continuum, and to determine disparities in the utilization of Surgery among Black patients.
Methods: A systematic review and meta-analysis of colorectal cancer disparities studies was performed.
This cross-sectional study investigates intersections among race, ethnicity, and sex from 2000 to 2019 among senior faculty in radiation oncology.
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