Cardiac rehabilitation and readmissions after heart transplantation.

Background: Exercise-based cardiac rehabilitation (CR) is under-utilized. CR is indicated after heart transplantation, but there are no data regarding CR participation in transplant recipients. We characterized current CR utilization among heart transplant recipients in the United States and the association of CR with 1-year readmissions using the 2013-2014 Medicare files.

Urinary retention and catheter use among U.S. female Medicare beneficiaries: Prevalence and risk factors.

Aims: To identify the prevalence of and risk factors for urinary retention and catheterization among female Medicare beneficiaries.

Methods: We identified women with a diagnosis of urinary retention in a 5% sample of Medicare claims in 2012. Women were categorized into three groups based on the occurrence and duration of urinary catheterization within a 1 year period: 1) no catheterization; 2) short-term catheterization (ie, one or more catheterizations in less than 30 days); and 3) chronic catheterization (catheterizations in multiple 30 day periods within 1 year).

Perioperative complications of conduit urinary diversion with concomitant cystectomy for benign indications: A population-based analysis.

Aims: Beyond single-institution case series, limited data are available to describe risks of performing a concurrent cystectomy at the time of urinary diversion for benign end-stage lower urinary tract dysfunction. Using a population-representative sample, this study aimed to analyze factors associated with perioperative complications in patients undergoing urinary diversion with or without cystectomy.

Methods: A representative sample of patients undergoing urinary diversion for benign indications was identified from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from 1998 to 2011.

An Empiric Evaluation of the Effect of Variation in Intensity of Followup for Surgically Treated Renal Neoplasms on Cancer Specific Survival.

Purpose: Followup protocols after the surgical management of renal cell carcinoma lack clear evidence linking the intensity of imaging surveillance to improved outcomes. In this context we characterized the relationship between surveillance imaging intensity and cancer specific survival.

Materials And Methods: Using SEER-Medicare data we identified 7,603 men with renal cell carcinoma treated surgically between 2004 and 2009.

Temporal Trends in Conduit Urinary Diversion With Concomitant Cystectomy for Benign Indications: A Population-based Analysis.

Objective: To describe national trends in cystectomy at the time of urinary diversion for benign indications. Multiple practice patterns exist regarding the necessity for concomitant cystectomy with urinary diversion for benign end-stage lower urinary tract dysfunction. Beyond single-institution reports, limited data are available to describe how concurrent cystectomy is employed on a national level.

Gender, race, and variation in the evaluation of microscopic hematuria among Medicare beneficiaries.

Background: Female gender and black race are associated with delayed diagnosis and inferior survival in patients with bladder cancer.

Objective: We aimed to determine the association between gender, race, and evaluation of microscopic hematuria (an early sign of bladder cancer).

Design And Participants: This was a cohort study using a 5 % random sample of fee-for-service Medicare beneficiaries diagnosed with incident hematuria (International Classification of Diseases, Ninth Revision [ICD-9] code 599.

Increasing use of observation among men at low risk for prostate cancer mortality.

Purpose: There are growing concerns regarding the overtreatment of localized prostate cancer. It is also relatively unknown whether there has been increased uptake of observational strategies for disease management. We assessed the temporal trend in observation of clinically localized prostate cancer, particularly in men with low risk disease, who were young and healthy enough to undergo treatment.

Trends in urodynamics in U.S. female medicare beneficiaries, 2000-2010.

Aims: To document variations and temporal trends in the use of urodynamics (UDS) in female U.S. Medicare beneficiaries.

Trends in the use of evidence-based therapy for resectable gastric cancer.

Background And Objectives: Two pivotal randomized controlled trials (RCTs), the Intergroup (INT-0116) and Medical Research Council Adjuvant Gastric Infusional Chemotherapy (MAGIC) trials, demonstrated a survival benefit of multimodality therapy in patients with resectable gastric cancer. The purpose of this study was to determine utilization rates of these treatment regimens in the United States and to identify factors associated with receipt of evidence-based care.

Methods: We performed a retrospective cohort study of patients with Stage IB-IV (M0) gastric adenocarcinoma who underwent resection from 1991 to 2009 using the linked SEER-Medicare database.

Epidemiology of vocal fold paralyses after total thyroidectomy for well-differentiated thyroid cancer in a Medicare population.

Objectives: The population-level incidence of vocal fold paralysis after thyroidectomy for well-differentiated thyroid carcinoma (WDTC) is not known. This study aimed to measure longitudinal incidence of postoperative vocal fold paralyses and need for directed interventions in the Medicare population undergoing total thyroidectomy for WDTC.

Study Design: Retrospective cohort study.

Trends in the multimodality treatment of resectable colorectal liver metastases: an underutilized strategy.

Objective: Advances in multimodality therapy have led to increased survival for patients with metastatic colorectal cancer, but the impact on patients undergoing resection for colorectal liver metastases is unclear. The purpose of this study was to evaluate patterns of treatment for resectable colorectal liver metastases in the USA over the last two decades.

Methods: Using the Surveillance, Epidemiology, and End Results-Medicare database, 1,926 patients who underwent hepatic resection for colorectal liver metastasis between 1991 and 2007 were included and divided into two cohorts: period 1 (1991-2000) and period 2 (2001-2007).

Volume outcomes of cystectomy--is it the surgeon or the setting?

Purpose: Hospital volume and surgeon volume are each associated with outcomes after complex oncological surgery. However, the interplay between hospital and surgeon volume, and their impact on these outcomes has not been well characterized. We studied the relationship between surgeon and hospital volume, and overall mortality after radical cystectomy.

Centralization of radical prostatectomy in the United States.

Purpose: Radical prostatectomy is a common treatment for organ confined prostate cancer and its use is increasing. We examined how the increased volume is being distributed and what hospital characteristics are associated with increasing volume.

Materials And Methods: We identified all men age 40 to less than 80 years who underwent radical prostatectomy for prostate cancer from 2000 to 2008 in the NIS (Nationwide Inpatient Sample) (586,429).

Immediate effects of the initial FDA notification on the use of surgical mesh for pelvic organ prolapse surgery in medicare beneficiaries.

Aims: Prompted by increased reports of complications with the use of mesh for pelvic organ prolapse (POP) surgery, the FDA issued an initial public health notification (PHN) in 2008. We proposed to determine if the numbers of POP cases augmented with surgical mesh performed in U.S.

Lymph node yield at radical cystectomy predicts mortality in node-negative and not node-positive patients.

Objective: To better define the relationship between lymph node count and survival in patients undergoing radical cystectomy for bladder cancer by identifying and controlling for key confounding variables in a large population-based cohort. Considerable controversy remains regarding the correlation between node count and survival, and most prior analyses have not accounted for both patient and provider factors.

Methods: The Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database was used to identify patients with urothelial bladder carcinoma who underwent radical cystectomy from 1992 to 2006.