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Article ; Online: Commentary: Locoregional metastasis of adrenocortical carcinoma and lymphadenectomy - Disease clearance or identification of high-risk features?

Oltmann, Sarah C / Miller, Barbra S

2021 Volume 223, Issue 6, Page(s) 1040–1041

MeSH term(s)	Adrenal Cortex Neoplasms/pathology ; Adrenal Cortex Neoplasms/surgery ; Adrenocortical Carcinoma/pathology ; Humans ; Lymph Node Excision ; Neoplasm Recurrence, Local
Language	English
Publishing date	2021-12-04
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2021.12.004
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Article ; Online: Best Practices and a Business Case for Surgical Site Infection Prevention.

Kang, Minji / Andrew, Maria E / Farishta, Akil / Oltmann, Sarah C / Sreeramoju, Pranavi V

AORN journal

2023 Volume 117, Issue 5, Page(s) 277–290

Abstract: Surgical site infections (SSIs) can be costly and result in prolonged hospital stays; readmissions; and additional diagnostic tests, therapeutic antibiotic treatments, and surgical procedures. Evidence-based practices for preventing SSIs include ... ...

Abstract	Surgical site infections (SSIs) can be costly and result in prolonged hospital stays; readmissions; and additional diagnostic tests, therapeutic antibiotic treatments, and surgical procedures. Evidence-based practices for preventing SSIs include environmental cleaning; instrument cleaning, decontamination, and sterilization; preoperative bathing; preoperative Staphylococcus aureus decolonization; intraoperative antimicrobial prophylaxis; hand hygiene; and surgical hand antisepsis. Strong partnerships among infection prevention personnel, perioperative nurses, surgeons, and anesthesia professionals may enhance perioperative infection prevention. Facility and physician-specific SSI rates should be reported to physicians and frontline personnel in a timely, accessible manner. Together with costs associated with SSIs, these data help determine the success of an infection prevention program. Leaders can develop a comprehensive business case proposal for perioperative infection prevention programs. The proposal should describe the need for the program and anticipated return on investment; it also should focus on the goal of decreasing SSIs by establishing metrics for assessing outcomes and addressing barriers.
MeSH term(s)	Humans ; Surgical Wound Infection/prevention & control ; Surgical Wound Infection/drug therapy ; Anti-Bacterial Agents/therapeutic use ; Staphylococcal Infections/drug therapy ; Staphylococcus aureus ; Antisepsis
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2023-04-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	603972-8
ISSN	1878-0369 ; 0001-2092
ISSN (online)	1878-0369
ISSN	0001-2092
DOI	10.1002/aorn.13912
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Article ; Online: Evaluation of an Adrenal Incidentaloma.

Jason, Dylan S / Oltmann, Sarah C

The Surgical clinics of North America

2019 Volume 99, Issue 4, Page(s) 721–729

Abstract: Given the frequent use of cross-sectional imaging in medicine, adrenal masses are discovered at an increasing rate. Once detected, it is critical to ensure the patient undergoes the appropriate biochemical/hormonal workup to rule out any aberrant ... ...

Abstract	Given the frequent use of cross-sectional imaging in medicine, adrenal masses are discovered at an increasing rate. Once detected, it is critical to ensure the patient undergoes the appropriate biochemical/hormonal workup to rule out any aberrant activity and ensure imaging features do not raise suspicion for a malignant neoplasm. Patients with hormonal overactivity, concerning size, and/or imaging characteristics must be referred for surgical consideration. For those not requiring adrenalectomy, it is important to determine which patients mandate follow-up to ensure no further growth or development of hormonal production. It is also critical to understand what is the appropriate follow-up.
MeSH term(s)	Adrenal Gland Neoplasms/diagnosis ; Adrenal Gland Neoplasms/surgery ; Adrenalectomy/methods ; Diagnosis, Differential ; Humans ; Incidental Findings
Language	English
Publishing date	2019-05-09
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	215713-5
ISSN	1558-3171 ; 0039-6109
ISSN (online)	1558-3171
ISSN	0039-6109
DOI	10.1016/j.suc.2019.04.009
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Article ; Online: Are PROMs ideally suited for most common endocrine surgical patients and procedures?

Oltmann, Sarah C / Nwariaku, Fiemu E

Surgery

2018 Volume 165, Issue 1, Page(s) 240–241

MeSH term(s)	Endocrine Surgical Procedures ; Humans ; Patient Reported Outcome Measures ; Quality of Life ; Surveys and Questionnaires ; Thyroid Diseases
Language	English
Publishing date	2018-11-08
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2018.08.034
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Article ; Online: How do we improve patient access to high-volume thyroid surgeons?

Oltmann, Sarah C / Holt, Shelby A

Surgery

2014 Volume 156, Issue 6, Page(s) 1450–1452

MeSH term(s)	Female ; Humans ; Male ; Neoplasm Recurrence, Local/pathology ; Thyroid Neoplasms/pathology ; Thyroid Neoplasms/surgery ; Thyroidectomy/methods ; Thyroidectomy/statistics & numerical data
Language	English
Publishing date	2014-12
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2014.08.083
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Article ; Online: Doing away with the rule of 10 %.

Oltmann, Sarah C / Chen, Herbert

Annals of surgical oncology

2013 Volume 20, Issue 5, Page(s) 1403–1404

MeSH term(s)	Adrenal Gland Neoplasms/genetics ; Female ; Genetic Testing ; Humans ; Male ; Mutation Rate ; Paraganglioma, Extra-Adrenal/genetics ; Pheochromocytoma/genetics
Language	English
Publishing date	2013-05
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-013-2944-3
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Article ; Online: Access to Paid Parental Leave for Academic Surgeons.

Itum, Dina S / Oltmann, Sarah C / Choti, Michael A / Piper, Hannah G

The Journal of surgical research

2018 Volume 233, Page(s) 144–148

Abstract: Background: Parental leave is linked to health benefits for both child and parent. It is unclear whether surgeons at academic centers have access to paid parental leave. The aim of this study was to determine parental leave policies at the top academic ... ...

Abstract	Background: Parental leave is linked to health benefits for both child and parent. It is unclear whether surgeons at academic centers have access to paid parental leave. The aim of this study was to determine parental leave policies at the top academic medical centers in the United States to identify trends among institutions. Methods: The top academic medical centers were identified (US News & World Report 2016). Institutional websites were reviewed, or human resource departments were contacted to determine parental leave policies. "Paid leave" was defined as leave without the mandated use of personal time off. Institutions were categorized based on geographical region, funding, and ranking to determine trends regarding availability and duration of paid parental leave. Results: Among the top 91 ranked medical schools, 48 (53%) offer paid parental leave. Availability of a paid leave policy differed based on private versus public institutions (70% versus 38%, P < 0.01) and on medical center ranking (top third = 77%; middle third = 53%; and bottom third = 29%; P < 0.01) but not based on region (P = 0.06). Private institutions were more likely to offer longer paid leaves (>6 wk) than public institutions (67% versus 33%; P = 0.02). No difference in paid leave duration was noted based on region (P = 0.60) or rank (P = 0.81). Conclusions: Approximately, 50% of top academic medical centers offer paid parental leave. Private institutions are more likely to offer paid leave and leave of longer duration. There is considerable variability in access to paid parenteral leave for academic surgeons.
MeSH term(s)	Humans ; Parental Leave/statistics & numerical data ; Private Sector/statistics & numerical data ; Public Sector/statistics & numerical data ; Schools, Medical/organization & administration ; Schools, Medical/statistics & numerical data ; Surgeons/statistics & numerical data ; United States
Language	English
Publishing date	2018-02-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2018.01.001
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Article ; Online: Rapid Relief: Thyroidectomy is a Quicker Cure than Radioactive Iodine Ablation (RAI) in Patients with Hyperthyroidism.

Davis, James R / Dackiw, Alan P / Holt, Shelby A / Nwariaku, Fiemu E / Oltmann, Sarah C

World journal of surgery

2018 Volume 43, Issue 3, Page(s) 812–817

Abstract: Background: Time to hormonal control after definitive management of hyperthyroidism is unknown but may influence patient and physician decision making when choosing between treatment options. The hypothesis is that the euthyroid state is achieved faster ...

Abstract	Background: Time to hormonal control after definitive management of hyperthyroidism is unknown but may influence patient and physician decision making when choosing between treatment options. The hypothesis is that the euthyroid state is achieved faster after thyroidectomy than RAI ablation. Methods: A retrospective review of all patients undergoing definitive therapy for hyperthyroidism was performed. Outcomes after thyroidectomy were compared to RAI. Results: Over 3 years, 217 patients underwent definitive therapy for hyperthyroidism at a county hospital: 121 patients received RAI, and 96 patients underwent thyroidectomy. Age was equivalent (p = 0.72). More males underwent RAI (25% vs 15%, p = 0.05). Endocrinologists referred for both treatments equally (p = 0.82). Both treatments were offered after a minimum 1-year trial of medical management (p = 0.15). RAI patients mostly had Graves (93%), versus 73% of thyroidectomy patients (p < 0.001). Thyroidectomy patients more frequently had eye symptoms (35% vs 13%, p < 0.001), compressive symptoms (74% vs 15%, p < 0.001), or were pregnant/nursing (14% vs 0, p < 0.001). While the thyroidectomy patients had a documented discussion of all treatment modalities, 79% of RAI patients did not have a documented discussion regarding the option of surgical management (p < 0.001). Both treatment groups achieved an euthyroid state (71% vs 65%, p = 0.39). Thyroidectomy patients became euthyroid faster [3 months (2-7 months) versus 9 months (4-14 months); p < 0.001]. Conclusions: Thyroidectomy for hyperthyroidism renders a patient to an euthyroid state faster than RAI. This finding may be important for patients and clinicians considering definitive options for hyperthyroidism.
MeSH term(s)	Adult ; Communication ; Female ; Graves Disease/blood ; Graves Disease/complications ; Graves Disease/therapy ; Humans ; Iodine Radioisotopes/therapeutic use ; Male ; Middle Aged ; Patient Education as Topic ; Retrospective Studies ; Thyroidectomy ; Time Factors ; Triiodothyronine/blood
Chemical Substances	Iodine Radioisotopes ; Triiodothyronine (06LU7C9H1V)
Language	English
Publishing date	2018-11-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-018-4864-7
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Article ; Online: Preoperative impairment is associated with a higher postdischarge level of care.

Ehlenbach, Colin C / Tevis, Sarah E / Kennedy, Gregory D / Oltmann, Sarah C

The Journal of surgical research

2014 Volume 193, Issue 1, Page(s) 1–6

Abstract: Background: Although preoperative risk factors have been shown to lead to postdischarge institutionalization, an association between preoperative risk factors, preoperative level of required care, and discharge to higher levels of care has not ... ...

Abstract	Background: Although preoperative risk factors have been shown to lead to postdischarge institutionalization, an association between preoperative risk factors, preoperative level of required care, and discharge to higher levels of care has not previously been demonstrated. Materials and methods: Using an institutional American College of Surgeons National Surgical Quality Improvement Program database, a retrospective review of elderly patients undergoing nonemergent inpatient general surgery procedures was performed with the goal of identifying preoperative risk factors that indicated the need for a higher level of care on hospital discharge. Univariate and multivariate analyses were performed on the patient population. Results: Over a 4-y period, 585 patients (29%) within the database were aged ≥65 y. In this population, 12% of patients required discharge to a higher level of care compared with their preoperative origin. In patients aged ≥65 y, impaired cognition, decreased functional capacity, advanced age (≥79 y), high American Society of Anesthesiologists class, and long hospital length of stay were found in univariate analysis to be associated with postoperative discharge to a higher level of care, although all of these variables except decreased functional capacity were also associated with a higher discharge level of care in multivariate analysis. Conclusions: Cognitive and functional capacity scoring can be used as simple ways to indicate discharge to a higher level of care for older adults. Preoperative counseling in high-risk older adults needs to include the likelihood for discharge to a higher level of care, so that a possible referral to social work can be placed during discharge planning.
MeSH term(s)	Aged ; Aged, 80 and over ; Chronic Disease ; Cognition Disorders/epidemiology ; Female ; General Surgery/statistics & numerical data ; Humans ; Male ; Multivariate Analysis ; Patient Care Team/standards ; Patient Care Team/statistics & numerical data ; Patient Discharge/standards ; Patient Discharge/statistics & numerical data ; Postoperative Care/standards ; Postoperative Care/statistics & numerical data ; Preoperative Period ; Quality Improvement ; Referral and Consultation/statistics & numerical data ; Retrospective Studies ; Risk Factors ; Social Work/standards ; Social Work/statistics & numerical data
Language	English
Publishing date	2014-07-29
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2014.07.057
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Article ; Online: Using telemedicine on an acute care surgery service: improving clinic efficiency and access to care.

Parnell, Kaela / Kuhlenschmidt, Kali / Madni, Dina / Chernyakhovsky, Cynthia / Donovan, Inna / Garofalo, Karen / Hambrick, Susan / Scott, Daniel J / Oltmann, Sarah C / Luk, Stephen

Surgical endoscopy

2020 Volume 35, Issue 10, Page(s) 5760–5765

Abstract: Background: Telemedicine has been shown to improve patient access to medical care while potentially improving overall healthcare efficiency. It has not been consistently explored on an acute care surgery service as a method of increasing clinic ... ...

Abstract	Background: Telemedicine has been shown to improve patient access to medical care while potentially improving overall healthcare efficiency. It has not been consistently explored on an acute care surgery service as a method of increasing clinic availability and efficiency within a safety-net hospital system. Socioeconomic hardships associated with an in-person clinic visit can deter patients with limited resources. A virtual clinic for post-operative laparoscopic cholecystectomy patients was developed. We hypothesized that a virtual follow-up increases clinic efficiency and availability for new patients without compromising patient safety. Methods: A retrospective review of patient and clinic outcomes before and after implementing virtual post-op visits for uncomplicated laparoscopic cholecystectomy patients on an acute care surgery service was performed. Providers called post-operative patients using a standardized questionnaire. Data included outpatient clinic composition (new vs. post-operative patients), elective operations scheduled, emergency department visits, and loss to follow-up rates. Results: February to March 2017 was the baseline pre-intervention period, while February to March 2019 was post-intervention. Pre-intervention clinics consisted of 17% new and 50% post-op visits, in comparison to 31% new and 27% post-op visits in the post-intervention group (p < 0.01). Elective operations scheduled increased slightly from 8.4 to 11.5 per 100 patient visits, but was not statistically significant (p = 0.09). There was no change in the number of post-operative patients returning to the emergency department (p = 0.91) or loss to follow-up (p = 0.30) rates. Conclusions: Through the implementation of virtual post-operative visits for laparoscopic cholecystectomy patients, clinic efficiency improved by increasing new patient encounters, decreasing post-operative volume, and trending towards increased operations scheduled. This change did not compromise patient safety. Further implementation of telemedicine on an acute care surgery service is a promising method to expand services offered to an at-risk population and increase efficiency in a resource-limited environment.
MeSH term(s)	Ambulatory Care Facilities ; COVID-19 ; Health Services Accessibility ; Humans ; Retrospective Studies ; Telemedicine
Language	English
Publishing date	2020-10-13
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-020-08055-9
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