Predicting Unplanned Trauma ICU Admissions for Initial Nonoperative, Non-ICU Patients.

Introduction: Unplanned intensive care unit (ICU) admissions are associated with increased morbidity and mortality. This study uses interpretable machine learning to predict unplanned ICU admissions for initial nonoperative trauma patients admitted to non-ICU locations.

Methods: TQIP (2020-2021) was queried for initial nonoperative adult patients admitted to non-ICU locations.

OnetoMap Meta-Data: Healthcare Analytics Through Research.

Introduction: Big Data has revolutionized healthcare research through the three Vs: volume, veracity, and variety. This study introduces the OnetoMap meta-data repository, a centralized inventory developed in collaboration with the University of South Florida's Department of Surgery.

Methods: The repository offers extensive details about each database, including its primary purpose, available variables, and examples of high-impact research utilizing these databases.

Hospitals with decreasing cost-to-charge ratios bill greater surgical charges for similar outcomes.

Background: The cost-to-charge ratio reflects the markup of hospital services. A lower cost-to-charge ratio indicates lower costs and/or greater charges. This study examines factors associated with cost-to-charge ratio trends to determine whether decreasing cost-to-charge ratio is associated with worse surgical outcomes.

For the Love of the Game: Calculating the Premium Associated With Academic Surgical Practice.

Objective: We sought to determine the premium associated with a career in academic surgery, as measured by compensation normalized to the work relative value unit (wRVU).

Background: An academic surgical career embodying innovation and mentorship offers intrinsic rewards but is not well monetized. We know compensation for academic surgeons is less than their nonacademic counterparts, but the value of clinical effort, as normalized to the wRVU, between academic and nonacademic surgeons has not been well characterized.

Survival Tree Provides Individualized Estimates of Survival After Lung Transplant.

Introduction: Identifying contributors to lung transplant survival is vital in mitigating mortality. To enhance individualized mortality estimation and determine variable interaction, we employed a survival tree algorithm utilizing recipient and donor data.

Methods: United Network Organ Sharing data (2000-2021) were queried for single and double lung transplants in adult patients.

Expanded analysis for patients with acute cholecystitis indicates outcomes vary based on COVID-19 status and treatment modality.

Background: The impact of different phases of COVID-19 infection on outcomes from acute calculous cholecystitis (ACC) is not well understood. Therefore, we examined outcomes of acute cholecystitis during the COVID-19 pandemic, comparing the effect of different treatment modalities and COVID-19 infection status. We hypothesized that patients with acute COVID-19 would have worse outcomes than COVID-negative patients, but there would be no difference between COVID-negative and COVID-recovered patients.

Removal of retrievable inferior vena cava filters before discharge: Is it associated with increased incidence of pulmonary embolism?

Background: Severely injured trauma patients are at high risk of developing deep venous thrombosis and pulmonary emboli (PE), and may have contraindications to prophylactic or therapeutic anticoagulation. Retrievable inferior vena cava filters (rIVCFs) are used to act as a mechanical obstruction to prevent PE in high risk populations and those with deep venous thrombosis who cannot be anticoagulated. The removal rate of rIVCFs is variable in trauma centers, including our previous published rate of 50% to 89%/year.

The paralyzing effect of insurance status on throughput of acute spinal cord patients.

Objective: To determine whether lack of insurance is a predictor of poor outcomes and increased healthcare expenditure for SCI patients.

Methods: Retrospective cohort study of trauma patients admitted with an acute, severe (AIS ≥ 3) SCI and admission score of ASIA-A to a Level 1 trauma center (2012-2016). Patient characteristics and outcomes (LOS, complications) were compared between insured and uninsured patients.

Time to stroke: A Western Trauma Association multicenter study of blunt cerebrovascular injuries.

Background: Screening for blunt cerebrovascular injuries (BCVIs) in asymptomatic high-risk patients has become routine. To date, the length of this asymptomatic period has not been defined. Determining the time to stroke could impact therapy including earlier initiation of antithrombotics in multiply injured patients.