National analysis of outcomes in timing of cholecystectomy for acute cholangitis.

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.

Fertility and pregnancy outcomes in primary hyperparathyroidism: Observations from a large insured population.

Context: Primary hyperparathyroidism (PHPT) has initially been implicated in adverse maternal and neonatal outcomes, while subsequent population studies have failed to show an association.

Objective: To compare maternal, pregnancy, and neonatal outcomes in patients with and without PHPT.

Design: Retrospective matched-cohort study (2005-2020).

Neoadjuvant chemotherapy is associated with improved disease-free survival in pancreatic cancer patients undergoing pancreaticoduodenectomy with vascular resection.

Background And Objectives: Neoadjuvant chemotherapy (NAC) is becoming favored for all pancreatic adenocarcinoma (PDAC). Patients with seemingly resectable disease infrequently still display vascular involvement intraoperatively. Outcomes following NAC versus upfront surgery in patients undergoing pancreaticoduodenectomy (PD) with vascular resection are unknown.

National Trends and Outcomes in the Operative Management of Thyroid Storm.

Background: Thyroid storm is a rare but potentially lethal manifestation of thyrotoxicosis. Guidelines recommend nonoperative management of thyroid storm, but thyroidectomy can be performed if patients fail medical therapy or need immediate resolution of the storm. Outcomes of thyroidectomy for management of thyroid storm remain ill-defined.

Laparoscopic compared to open approach for distal gastrectomy may reduce pneumonia risk for patients with gastric cancer.

Background: Whether laparoscopic approach to gastrectomy for gastric cancer (GC) reduces the risk of pneumonia remains unknown. In this study, we compared pneumonia outcomes for patients with GC who underwent either laparoscopic gastrectomy (LG) or open gastrectomy (OG).

Methods: The ACS NSQIP database was queried to identify patients with GC who underwent LG or OG between Jan 2012 - Dec 2018.

Learning Curves in Establishing a New Minimally Invasive Pancreas Program.

Introduction: Robotic pancreaticoduodenectomy (rPD) is a complex operation with a reported learning curve of 80 cases. Two recent graduates of a formal robotic complex general surgical oncology training program have been performing rPD at our institution since 2016, which had no previous institutional experience with rPD.

Objective: To evaluate the learning curve associated with developing a new robotic pancreaticoduodenectomy (rPD) program by fellowship trained surgeons with institutional support.

Factors Associated With High Resource Use in Elective Adult Cardiac Surgery From 2005 to 2016.

Background: Lack of consensus remains about factors that may be associated with high resource use (HRU) in adult cardiac surgical patients. This study aimed to identify patient-related, hospital, and perioperative characteristics associated with HRU admissions involving elective cardiac operations.

Methods: Data from the National Inpatient Sample was used to identify patients who underwent coronary artery bypass graft, valve replacement, and valve repair operations between 2005 and 2016.

National Use and Short-term Outcomes of Video and Robot-Assisted Thoracoscopic Thymectomies.

Background: Transsternal open thymectomy has long been the most widely used approach for thymectomy, but recent decades have seen the introduction of minimally invasive surgery (MIS), such as video-assisted thoracoscopic surgery (VATS) and robot-assisted thoracoscopic surgery (RATS) thymectomy. This retrospective cohort study provides a national comparison of trends, outcomes, and resource utilization of open, VATS, and RATS thymectomy.

Methods: Admissions for thymectomies from 2008 to 2014 were identified in the National Inpatient Sample.

An Investigation of Cognitive Processing of Fear Appeal Messages Promoting HPV Vaccination: Predictors and Outcomes of Magnitude and Valence of Cognitive Responses.

An improvement in HPV vaccination rates is one of the primary goals of public health organizations. Toward this end, fear appeal communication is commonly used in health interventions, warning individuals of threats of HPV infection and promoting vaccination. However, little is known about how threat-related emotions, such as fear and anxiety, influence the cognitive processing of vaccination information and how this processing is associated with vaccination intention.

National trends and outcomes of inpatient robotic-assisted versus laparoscopic cholecystectomy.

Background: Laparoscopic cholecystectomy has reached nearly universal adoption in the management of gallstone-related disease. With advances in operative technology, robotic-assisted cholecystectomy has been used increasingly in many practices, but few studies have examined the adoption of robotic assistance for inpatient cholecystectomy and the temporal outcomes on a national scale. The present study aimed to identify trends in utilization, as well as outcomes and factors associated with the use of robotic-assisted cholecystectomy.

National trends and outcomes in timing of ERCP in patients with cholangitis.

Introduction: Guidelines recommend early endoscopic retrograde cholangiopancreatography for the management of acute cholangitis, but the definition of the term "early" remains debatable. This study analyzed national trends in the timing of endoscopic retrograde cholangiopancreatography and identified the ideal time to perform preoperative endoscopic retrograde cholangiopancreatography in patients with acute cholangitis.

Methods: The 2005 to 2016 National Inpatient Sample was used to identify patients undergoing cholecystectomy for acute cholangitis.

Impact of center volume on outcomes of surgical repair for type A acute aortic dissections.

Background: Acute type A aortic dissection is a cardiovascular emergency requiring operative intervention. Despite advancements in operative technique and increased specialization of cardiovascular care, operative mortality, and morbidity after repair of type A aortic dissection remain high. Our aim was to assess national trends in outcomes of type A aortic dissection repair and the impact of institutional thoracic aortic repair volume on clinical outcomes and resource use in the United States.

National Analysis of Coronary Artery Bypass Grafting in Autoimmune Connective Tissue Disease.

Background: Autoimmune connective tissue diseases (CTDs) are associated with accelerated atherosclerosis and inflammation, while often requiring immunosuppression. Large-scale outcomes of coronary artery bypass graft (CABG) surgery in this population have not been reported thus far. This study characterized trends in use of CABG in patients with CTDs and the impact of the disease on mortality, in-hospital complications, length of stay, and costs.

Effects of Facebook Comments on Attitude Toward Vaccines: The Roles of Perceived Distributions of Public Opinion and Perceived Vaccine Efficacy.

This study investigated if and how exposure to Facebook comments about vaccines influences one's attitude toward the vaccines. In this investigation, comments were examined in light of their effect on attitude toward vaccines through perceived distribution of public opinion on vaccines, and perceived vaccine efficacy was tested as a factor moderating relative effects of comments on perception of public opinion distributions. Results from an experimental study ( = 271) showed that exposure to a greater number of comments in a thread expressing (un)favorable opinions on the flu vaccine led to (un)favorable attitude toward the flu vaccine through a change in perceived distribution of public opinions on the vaccination.

A Case of Granulomatosis with Polyangiitis: Consequences of Delayed Diagnosis in a Life-threatening Malady.

Granulomatosis with polyangiitis (GPA) is one of three described anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV). Early diagnosis and treatment of GPA is paramount, as it may help prevent irreversible end-organ damage, especially renal and pulmonary failure. A 72-year-old male with a past medical history of lung adenocarcinoma in remission, chronic sinusitis status-post multiple sinus surgeries, and coronary artery disease presented with shortness of breath, dark urine, and asymmetric polyarthralgias.

Increased baseline ECG R-R dispersion predicts improvement in systolic function after atrial fibrillation ablation.

Background: Atrial fibrillation (AF) is associated with left ventricular (LV) systolic dysfunction which may improve after AF ablation. We hypothesised that increased ventricular irregularity, as measured by R-R dispersion on the baseline ECG, would predict improvement in the left ventricular ejection fraction (LVEF) after AF ablation.

Methods: Patients with LVEF <50% at two US centres (2007-2016), having both a preablation and postablation echocardiogram or cardiac MRI, were included.

Readmissions after Ileostomy Creation Using a Nationwide Database.

Readmissions occur frequently in patients undergoing ostomy creation, ranging from 12 per cent to more than 30 per cent. The objective of this study was to compare the reasons for early intermediate readmissions after surgical procedures involving formation of ileostomies at a national level. Patients receiving a new ileostomy were identified in the 2010 to 2014 Nationwide Readmission Database.

Short-Term Readmissions After Open, Thoracoscopic, and Robotic Lobectomy for Lung Cancer Based on the Nationwide Readmissions Database.

Background: Readmission after surgery is an established surrogate indicator of quality of care. We aimed to compare short-term readmission rates and patient outcomes between open, video-assisted thoracoscopic (VATS), and robotic lobectomies in the Nationwide Readmissions Database (NRD).

Methods: Adults who underwent open, VATS, or robotic lobectomy for lung cancer from 2010 to 2014 were evaluated.

Impact of New-Onset Postoperative Depression on Readmission Outcomes After Surgical Coronary Revascularization.

Background: Depression affects between 10% and 40% of cardiac surgery patients and is associated with significantly worse outcomes. The incidence and impact of new-onset depression beyond acute follow-up remain ill-defined. The present study aimed to evaluate the incidence, risk factors, and prognostic implication of depression on 90-d readmission rates after coronary artery bypass grafting (CABG) surgery.

Comparison of Frequency of Late Gastrointestinal Bleeding With Transcatheter Versus Surgical Aortic Valve Replacement.

Improvements in technology and operator experience have led to exponential growth of transcatheter aortic valve implantation (TAVI) programs. Late bleeding complications were recently highlighted after TAVI with a high impact on morbidity. The purpose of the present study was to assess the incidence and financial impact of late Gastrointestinal (GI) bleeding after TAVI, and compare with the surgical cohort.

National trends in volume-outcome relationships for extracorporeal membrane oxygenation.

Background: The use of extracorporeal membrane oxygenation (ECMO) has emerged as a common therapy for severe cardiopulmonary dysfunction. We aimed to describe the relationship of institutional volume with patient outcomes and examine transfer status to tertiary ECMO centers.

Materials And Methods: Using the National Inpatient Sample, we identified adult patients who received ECMO from 2008 to 2014.

Trends in mortality and resource utilization for extracorporeal membrane oxygenation in the United States: 2008-2014.

Background: Extracorporeal membrane oxygenation is used as a life-sustaining measure in patients with acute or end-stage cardiac or respiratory failure. We analyzed national trends in extracorporeal membrane oxygenation use and outcomes and assessed the influence of hospital demographics.

Methods: Adult extracorporeal membrane oxygenation patients in the 2008-2014 National Inpatient Sample were evaluated.

Heparin-induced thrombocytopenia in cardiac surgery: Incidence, costs, and duration of stay.

Background: Heparin is routinely used in many cardiovascular procedures to prevent thrombosis. An antibody-mediated process, heparin-induced thrombocytopenia occurs in a small subset of patients exposed to heparin. Though some have suggested a recent increase in the incidence of heparin-induced thrombocytopenia, data on the impact of heparin-induced thrombocytopenia on costs and duration of stay after cardiac surgery is generally lacking.