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For: Stocking JC, Utter GH, Drake C, Aldrich JM, Ong MK, Amin A, Marmor RA, Godat L, Cannesson M, Gropper MA, Romano PS. Postoperative respiratory failure: An update on the validity of the Agency for Healthcare Research and Quality Patient Safety Indicator 11 in an era of clinical documentation improvement programs. Am J Surg 2020;220:222-228. [PMID: 31757440 PMCID: PMC10091853 DOI: 10.1016/j.amjsurg.2019.11.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/28/2019] [Accepted: 11/10/2019] [Indexed: 11/26/2022]

For:	Stocking JC, Utter GH, Drake C, Aldrich JM, Ong MK, Amin A, Marmor RA, Godat L, Cannesson M, Gropper MA, Romano PS. Postoperative respiratory failure: An update on the validity of the Agency for Healthcare Research and Quality Patient Safety Indicator 11 in an era of clinical documentation improvement programs. Am J Surg 2020;220:222-228. [PMID: 31757440 PMCID: PMC10091853 DOI: 10.1016/j.amjsurg.2019.11.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/28/2019] [Accepted: 11/10/2019] [Indexed: 11/26/2022]

Number

Cited by Other Article(s)

Stocking JC, Taylor SL, Fan S, Wingert T, Drake C, Aldrich JM, Ong MK, Amin AN, Marmor RA, Godat L, Cannesson M, Gropper MA, Utter GH, Sandrock CE, Bime C, Mosier J, Subbian V, Adams JY, Kenyon NJ, Albertson TE, Garcia JGN, Abraham I. A Least Absolute Shrinkage and Selection Operator-Derived Predictive Model for Postoperative Respiratory Failure in a Heterogeneous Adult Elective Surgery Patient Population. CHEST CRITICAL CARE 2023;1:100025. [PMID: 38434477 PMCID: PMC10907009 DOI: 10.1016/j.chstcc.2023.100025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]

Abstract

BACKGROUND

Postoperative respiratory failure (PRF) is associated with increased hospital charges and worse patient outcomes. Reliable prediction models can help to guide postoperative planning to optimize care, to guide resource allocation, and to foster shared decision-making with patients.

RESEARCH QUESTION

Can a predictive model be developed to accurately identify patients at high risk of PRF?

STUDY DESIGN AND METHODS

In this single-site proof-of-concept study, we used structured query language to extract, transform, and load electronic health record data from 23,999 consecutive adult patients admitted for elective surgery (2014-2021). Our primary outcome was PRF, defined as mechanical ventilation after surgery of > 48 h. Predictors of interest included demographics, comorbidities, and intraoperative factors. We used logistic regression to build a predictive model and the least absolute shrinkage and selection operator procedure to select variables and to estimate model coefficients. We evaluated model performance using optimism-corrected area under the receiver operating curve and area under the precision-recall curve and calculated sensitivity, specificity, positive and negative predictive values, and Brier scores.

RESULTS

Two hundred twenty-five patients (0.94%) demonstrated PRF. The 18-variable predictive model included: operations on the cardiovascular, nervous, digestive, urinary, or musculoskeletal system; surgical specialty orthopedic (nonspine); Medicare or Medicaid (as the primary payer); race unknown; American Society of Anesthesiologists class ≥ III; BMI of 30 to 34.9 kg/m2; anesthesia duration (per hour); net fluid at end of the operation (per liter); median intraoperative FIO2, end title CO2, heart rate, and tidal volume; and intraoperative vasopressor medications. The optimism-corrected area under the receiver operating curve was 0.835 (95% CI,0.808-0.862) and the area under the precision-recall curve was 0.156 (95% CI, 0.105-0.203).

INTERPRETATION

This single-center proof-of-concept study demonstrated that a structured query language extract, transform, and load process, based on readily available patient and intraoperative variables, can be used to develop a prediction model for PRF. This PRF prediction model is scalable for multicenter research. Clinical applications include decision support to guide postoperative level of care admission and treatment decisions.

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Affiliation(s)

Jacqueline C Stocking Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
Sandra L Taylor Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
Sili Fan Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
Theodora Wingert Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
Christiana Drake Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
J Matthew Aldrich Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
Michael K Ong Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
Alpesh N Amin Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
Rebecca A Marmor Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
Laura Godat Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
Maxime Cannesson Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
Michael A Gropper Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
Garth H Utter Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
Christian E Sandrock Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
Christian Bime Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
Jarrod Mosier Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
Vignesh Subbian Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
Jason Y Adams Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
Nicholas J Kenyon Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
Timothy E Albertson Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
Joe G N Garcia Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL
Ivo Abraham Division of Pulmonary, Critical Care and Sleep Medicine (J. C. S., C. E. S., J. Y. A., N. J. K., and T. E. A.), Department of Internal Medicine, the Department of Public Health Sciences (S. L. T. and S. F.), the Outcomes Research Group (G. H. U.), Department of Surgery, University of California Davis, Sacramento, the Department of Anesthesiology and Perioperative Medicine (T. W. and M. C.), University of California Los Angeles, the Department of Medicine (M. K. O.), University of California Los Angeles, the VA Greater Los Angeles Healthcare System (M. K. O.), Los Angeles, the Department of Statistics (C. D.), University of California Davis, Davis, the Department of Anesthesia and Perioperative Care (J. M. A. and M. A. G.), University of California, San Francisco, San Francisco, the Department of Medicine (A. N. A.), University of California Irvine, Irvine, the Department of Surgery (R. A. M. and L. G.), University of California San Diego, San Diego, the College of Medicine (C. B. and J. M.), University of Arizona Health Sciences, the Department of Biomedical Engineering (V. S.), College of Engineering, the Center for Health Outcomes and PharmacoEconomic Research (I. A.), University of Arizona, Tucson, AZ, and The University of Florida-Scripps Research Institute (J. G. N. G.), Jupiter, FL

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Hamed M, Asoglu H, Lampmann T, Winkelmann LM, Salemdawod A, Müller M, Vatter H, Banat M, Eichhorn L. Pain management with epidural catheter and epidural analgesia after spinal dorsal instrumentation of lumbar spine. Medicine (Baltimore) 2023;102:e32902. [PMID: 36800634 PMCID: PMC9936043 DOI: 10.1097/md.0000000000032902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open

Hamed M, Brandecker S, Lampmann T, Asoglu H, Salemdawod A, Güresir E, Vatter H, Banat M. Early fusion outcome after surgical treatment of single-level and multi-level pyogenic spondylodiscitis: experience at a level 1 center for spinal surgery-a single center cohort study. J Orthop Surg Res 2023;18:107. [PMID: 36793045 PMCID: PMC9930249 DOI: 10.1186/s13018-023-03584-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 02/06/2023] [Indexed: 02/17/2023] Open

Lemdani MS, Choudhry HS, Tseng CC, Fang CH, Sukyte-Raube D, Patel P, Eloy JA. Impact of Facility Volume on Patient Safety Indicator Events After Transsphenoidal Pituitary Surgery. Otolaryngol Head Neck Surg 2023;168:227-233. [PMID: 35380889 DOI: 10.1177/01945998221089826] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/07/2022] [Indexed: 11/15/2022]

Hamed M, Brandecker S, Rana S, Potthoff AL, Eichhorn L, Bode C, Schmeel FC, Radbruch A, Schäfer N, Herrlinger U, Köksal M, Giordano FA, Vatter H, Schneider M, Banat M. Postoperative prolonged mechanical ventilation correlates to poor survival in patients with surgically treated spinal metastasis. Front Oncol 2022;12:940790. [PMID: 36387073 PMCID: PMC9647167 DOI: 10.3389/fonc.2022.940790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/13/2022] [Indexed: 12/02/2022] Open

Patient Safety Comparison of Frameless and Frame-Based Stereotactic Navigation for Brain Biopsy-A Single Center Cohort Study. Brain Sci 2022;12:brainsci12091178. [PMID: 36138914 PMCID: PMC9497181 DOI: 10.3390/brainsci12091178] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 11/16/2022] Open

Stocking JC, Drake C, Aldrich JM, Ong MK, Amin A, Marmor RA, Godat L, Cannesson M, Gropper MA, Romano PS, Sandrock C, Bime C, Abraham I, Utter GH. Outcomes and risk factors for delayed-onset postoperative respiratory failure: a multi-center case-control study by the University of California Critical Care Research Collaborative (UC³RC). BMC Anesthesiol 2022;22:146. [PMID: 35568812 PMCID: PMC9107656 DOI: 10.1186/s12871-022-01681-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 04/27/2022] [Indexed: 11/28/2022] Open

Abstract

BACKGROUND

Few interventions are known to reduce the incidence of respiratory failure that occurs following elective surgery (postoperative respiratory failure; PRF). We previously reported risk factors associated with PRF that occurs within the first 5 days after elective surgery (early PRF; E-PRF); however, PRF that occurs six or more days after elective surgery (late PRF; L-PRF) likely represents a different entity. We hypothesized that L-PRF would be associated with worse outcomes and different risk factors than E-PRF.

METHODS

This was a retrospective matched case-control study of 59,073 consecutive adult patients admitted for elective non-cardiac and non-pulmonary surgical procedures at one of five University of California academic medical centers between October 2012 and September 2015. We identified patients with L-PRF, confirmed by surgeon and intensivist subject matter expert review, and matched them 1:1 to patients who did not develop PRF (No-PRF) based on hospital, age, and surgical procedure. We then analyzed risk factors and outcomes associated with L-PRF compared to E-PRF and No-PRF.

RESULTS

Among 95 patients with L-PRF, 50.5% were female, 71.6% white, 27.4% Hispanic, and 53.7% Medicare recipients; the median age was 63 years (IQR 56, 70). Compared to 95 matched patients with No-PRF and 319 patients who developed E-PRF, L-PRF was associated with higher morbidity and mortality, longer hospital and intensive care unit length of stay, and increased costs. Compared to No-PRF, factors associated with L-PRF included: preexisiting neurologic disease (OR 4.36, 95% CI 1.81-10.46), anesthesia duration per hour (OR 1.22, 95% CI 1.04-1.44), and maximum intraoperative peak inspiratory pressure per cm H₂0 (OR 1.14, 95% CI 1.06-1.22).

CONCLUSIONS

We identified that pre-existing neurologic disease, longer duration of anesthesia, and greater maximum intraoperative peak inspiratory pressures were associated with respiratory failure that developed six or more days after elective surgery in adult patients (L-PRF). Interventions targeting these factors may be worthy of future evaluation.

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Affiliation(s)

Jacqueline C Stocking Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of California Davis, 4150 V Street, Suite 3400, Sacramento, CA, 95817, USA.
Christiana Drake Department of Statistics, University of California Davis, Davis, CA, USA
J Matthew Aldrich Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA
Michael K Ong Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
Alpesh Amin Department of Medicine, University of California Irvine, Irvine, CA, USA
Rebecca A Marmor Department of Surgery, University of California San Diego, San Diego, CA, USA
Laura Godat Department of Surgery, University of California San Diego, San Diego, CA, USA
Maxime Cannesson Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, CA, USA
Michael A Gropper Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA
Patrick S Romano Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of California Davis, 4150 V Street, Suite 3400, Sacramento, CA, 95817, USA Center for Healthcare Policy and Research, University of California Davis, Sacramento, CA, USA
Christian Sandrock Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of California Davis, 4150 V Street, Suite 3400, Sacramento, CA, 95817, USA
Christian Bime College of Medicine, University of Arizona Health Sciences, Tucson, AZ, USA
Ivo Abraham Center for Health Outcomes and PharmacoEconomic Research, University of Arizona, Tucson, AZ, USA
Garth H Utter Center for Healthcare Policy and Research, University of California Davis, Sacramento, CA, USA Department of Surgery, Outcomes Research Group, University of California Davis, Sacramento, CA, USA

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Orabi D, Naples R, Brundidge D, Snyder K, Gohar M, Agarwal D, Govindarajan S, Tu C, Fung K, Argalious M, Mathur P, Asfaw SH. Postoperative Respiratory Failure After Elective Abdominal Surgery: A Case-Control Study. J Surg Res 2022;274:160-168. [PMID: 35180492 DOI: 10.1016/j.jss.2021.12.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 12/25/2021] [Accepted: 12/30/2021] [Indexed: 10/19/2022]