The effect of tobacco use on outcomes of laparoscopic and open ventral hernia repairs: a review of the NSQIP dataset

Kubasiak, John; Landin, MacKenzie; Schimpke, Scott; Poirier, Jennifer; Myers, Jonathan A.; Millikan, Keith W.; Luu, Minh B.

doi:10.1007/s00464-016-5280-4

Cited by 41 publications

(21 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, data also demonstrate underutilization of minimally invasive techniques in patients who may benefit from this approach. 15 , 16 , 17 These data demonstrate deviation from evidence-based guidelines, which is associated with suboptimal patient outcomes and increased episodes of care payments resulting from readmissions, recurrences, and complications for persons undergoing abdominal wall hernia repair. 24 , 25 , 26 The underlying causes of variation in adoption of evidence-based hernia guidelines are unknown, with the motivations and behaviors associated with individual surgeon practice largely unexplored.…”

Section: Introductionmentioning

confidence: 95%

“…Evidence-based guidelines pertaining to both patient selection and elements of operative technique are available, although often not heeded. 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 For example, a recent population-based study 17 , 18 , 19 , 20 , 21 , 22 , 23 found that up to 25% of persons undergoing elective abdominal wall hernia repair are actively smoking or morbidly obese or have inadequate glycemic control. Furthermore, data also demonstrate underutilization of minimally invasive techniques in patients who may benefit from this approach.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Exploration of Surgeon Motivations in Management of Abdominal Wall Hernias

et al. 2020

View full text Add to dashboard Cite

Key Points Question How can implementation frameworks such as the Theoretical Domains Framework be used to identify domains associated with the adoption of best practices in surgery? Findings This qualitative study used abdominal wall hernia as a case study and found that the surgeon knowledge, beliefs about the consequences, social or professional role and identity, environmental context and resources, and social influences domains were associated with decision-making. Meaning These findings suggest that implementation frameworks offer a method for better understanding which factors motivate behavior change among surgeons.

show abstract

Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Exploration of Surgeon Motivations in Management of Abdominal Wall Hernias

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The NSQIP risk score has been widely validated and applied to predict outcomes in various surgical populations, but has not been applied in delirium prediction. 12,[16][17][18][19] We hypothesized that NSQIP risk of serious complications (NSQIP-SC) would be a stronger predictor of delirium over NSQIP risk of death (NSQIP-D) as the causal relationship between serious complications and delirium is likely stronger than the association between delirium and the risk of death. 20 As delirium is a cognitive disorder, we further hypothesized that cognitive data (that is not included in NSQIP scores) could enhance the prediction of the surgical risk scores.…”

Section: Introductionmentioning

confidence: 99%

Derivation of a simple postoperative delirium incidence and severity prediction model

Lindroth

Bratzke

Twadell

et al. 2018

Preprint

View full text Add to dashboard Cite

Background: Delirium is an important postoperative complication, yet a simple and effective delirium prediction model remains elusive. We hypothesized that the combination of the National Surgical Quality Improvement Program (NSQIP) risk calculator for serious complications (NSQIP-SC) or risk of death (NSQIP-D), and cognitive tests of executive function (Trail Making Test A and B [TMTA, TMTB]), could provide a parsimonious model to predict postoperative delirium incidence or severity.Methods: Data were collected from 100 adults (>65yo) undergoing major non-cardiac surgery. In addition to NSQIP-SC, NSQIP-D, TMTA and TMTB, we collected participant age, sex, ASA score, tobacco use, type of surgery, depression, Framingham risk score, and preoperative blood pressure. Delirium was diagnosed with the Confusion Assessment Method (CAM), and the Delirium Rating Scale-R-98 (DRS) was used to assess symptom severity. LASSO and Best Subsets logistic and linear regression were employed in line with TRIPOD guidelines.Results: Three participants were excluded due to intraoperative deaths (2) and alcohol withdrawal (1). Ninety-seven participants with a mean age of 71.68+4.55, 55% male (31/97 CAM+, 32%) and a mean Peak DRS of 21.5+6.40 were analyzed. Of the variables included, only NSQIP-SC and TMTB were identified to be predictors of postoperative delirium incidence (p<0.001, AUROC 0.81, 95% CI: 0.72, 0.90) and severity (p<0.001, Adj. R2: 0.30). Conclusions:In this cohort, preoperative NSQIP-SC and TMTB were identified as predictors of postoperative delirium incidence and severity. Future studies should verify whether this twofactor model could be used for accurate delirium prediction.

show abstract

“…This is illustrated in the cognitive trajectory in Figure 1. [25][26][27][28][29] We hypothesized that NSQIP risk of serious complications (NSQIP-SC) would be a stronger predictor of delirium over NSQIP risk of death (NSQIP-D) as the causal relationship between serious complications and delirium is likely stronger than the association between delirium and the risk of death. Therefore, it is crucial to consider the future precipitating event in delirium severity prediction models when possible.…”

mentioning

confidence: 99%

“…[22][23][24] Built using data from 1 414 006 patients including 1557 distinct surgical procedures, the NSQIP risk score has been widely validated and applied to predict outcomes in various surgical populations but has not been applied in delirium severity risk assessment. [25][26][27][28][29] We hypothesized that NSQIP risk of serious complications (NSQIP-SC) would be a stronger predictor of delirium over NSQIP risk of death (NSQIP-D) as the causal relationship between serious complications and delirium is likely stronger than the association between delirium and the risk of death. 30 As delirium is a cognitive disorder, we further hypothesized that cognitive data (that are not included in the NSQIP calculation) could enhance the prediction of the surgical risk scores.…”

mentioning

confidence: 99%

Predicting postoperative delirium severity in older adults: The role of surgical risk and executive function

Lindroth

Bratzke

Twadell

et al. 2019

Int J Geriat Psychiatry

View full text Add to dashboard Cite

Objectives Delirium is an important postoperative complication, yet predictive risk factors for postoperative delirium severity remain elusive. We hypothesized that the NSQIP risk calculation for serious complications (NSQIP‐SC) or risk of death (NSQIP‐D), and cognitive tests of executive function (Trail Making Tests A and B [TMTA and TMTB]), would be predictive of postoperative delirium severity. Further, we demonstrate how advanced statistical techniques can be used to identify candidate predictors. Methods/Design Data from an ongoing perioperative prospective cohort study of 100 adults (65 y old or older) undergoing noncardiac surgery were analyzed. In addition to NSQIP‐SC, NSQIP‐D, TMTA, and TMTB, participant age, sex, American Society of Anesthesiologists (ASA) score, tobacco use, surgery type, depression, Framingham risk score, and preoperative blood pressure were collected. The Delirium Rating Scale‐R‐98 (DRS) measured delirium severity; the Confusion Assessment Method (CAM) identified delirium. LASSO and best subsets linear regression were employed to identify predictive risk factors. Results Ninety‐seven participants with a mean age of 71.68 ± 4.55, 55% male (31/97 CAM+, 32%), and a mean peak DRS of 21.5 ± 6.40 were analyzed. LASSO and best subsets regression identified NSQIP‐SC and TMTB to predict postoperative delirium severity (P < 00.001, adjusted R2: 0.30). NSQIP‐SC and TMTB were also selected as predictors for postoperative delirium incidence (AUROC 0.81, 95% CI, 0.72‐0.90). Conclusions In this cohort, we identified NSQIP risk score for serious complications and a measure of executive function, TMT‐B, to predict postoperative delirium severity using advanced modeling techniques. Future studies should investigate the utility of these variables in a formal delirium severity prediction model.

show abstract

The effect of tobacco use on outcomes of laparoscopic and open ventral hernia repairs: a review of the NSQIP dataset

Cited by 41 publications

References 14 publications

Exploration of Surgeon Motivations in Management of Abdominal Wall Hernias

Exploration of Surgeon Motivations in Management of Abdominal Wall Hernias

Derivation of a simple postoperative delirium incidence and severity prediction model

Predicting postoperative delirium severity in older adults: The role of surgical risk and executive function

Contact Info

Product

Resources

About