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Article: Accuracy of Self-Reported Physical Capacities as a Clinical Screening Test for Older Adults With Mobility Disability.

Sciamanna, Christopher N / Lemaster, Kent A / Danilovich, Margaret K / Conroy, David E / Schmitz, Kathryn H / Silvis, Matthew / Ladwig, Matthew / Ballentine, Noel

Gerontology & geriatric medicine

2023 Volume 9, Page(s) 23337214231167979

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2023-04-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2844974-5
ISSN	2333-7214 ; 2333-7214
ISSN (online)	2333-7214
ISSN	2333-7214
DOI	10.1177/23337214231167979
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Article ; Online: Stepping back: why patient safety is in need of a broader view than the safety climate survey provides.

LeMaster, Christopher H / Wears, Robert L

Annals of emergency medicine

2012 Volume 60, Issue 5, Page(s) 564–566

MeSH term(s)	Emergency Service, Hospital/statistics & numerical data ; Female ; Humans ; Male ; Medical Errors/statistics & numerical data ; Patient Safety
Language	English
Publishing date	2012-11
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	603080-4
ISSN	1097-6760 ; 0196-0644
ISSN (online)	1097-6760
ISSN	0196-0644
DOI	10.1016/j.annemergmed.2012.07.022
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Article ; Online: Implementing the central venous catheter infection prevention bundle in the emergency department: experiences among early adopters.

LeMaster, Christopher H / Hoffart, Nancy / Chafe, Tom / Benzer, Ted / Schuur, Jeremiah D

Annals of emergency medicine

2014 Volume 63, Issue 3, Page(s) 340–50.e1

Abstract: Study objective: Central line-associated bloodstream infections (CLABSI) cause preventable morbidity and mortality. Hospitals have reduced CLABSI by using a bundle of evidence-based infection prevention practices. Systems factors in the emergency ... ...

Abstract	Study objective: Central line-associated bloodstream infections (CLABSI) cause preventable morbidity and mortality. Hospitals have reduced CLABSI by using a bundle of evidence-based infection prevention practices. Systems factors in the emergency department (ED) present unique barriers to bundle adoption, and no guidelines exist for bundle implementation. We aim to identify barriers and facilitators to central line bundle adoption in EDs. Methods: We used a qualitative, grounded theory approach, enrolling 6 EDs that were early adopters of the central line bundle. We interviewed 49 administrators and staff (nurses and physicians) through 26 semistructured interviews and 3 focus groups of 6 to 8 individuals. Investigators read each transcript and then iteratively built and refined a set of themes that emerged from the data. Results: Barriers to central line bundle adoption included high acuity, time constraints, staffing, space, ED culture, high ED volume and acuity, role ambiguity, and a lack of methods to track compliance and infection surveillance. Facilitators included champions, staff engagement, workflow redesign that includes a checklist and central line kit or cart, clear staff responsibilities, observer empowerment, and compliance and infection surveillance data. Conclusion: The strategies for implementing and sustaining a central line infection prevention bundle in the ED are distinct from those of other clinical settings. Our findings describe the central line bundle workflow in the ED, staff motivations, and the critical systems factors that impede and foster its use. Knowledge of these systems factors should improve bundle adoption in the ED and thereby reduce hospital incidence of CLABSIs.
MeSH term(s)	Attitude of Health Personnel ; Catheter-Related Infections/prevention & control ; Catheterization, Central Venous/methods ; Catheterization, Central Venous/standards ; Checklist ; Emergency Service, Hospital/organization & administration ; Focus Groups ; Humans ; Interviews as Topic ; Patient Care Bundles/methods ; Patient Care Bundles/standards ; Qualitative Research
Language	English
Publishing date	2014-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	603080-4
ISSN	1097-6760 ; 0196-0644
ISSN (online)	1097-6760
ISSN	0196-0644
DOI	10.1016/j.annemergmed.2013.09.006
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Article ; Online: Clinical Implications of Low Absolute Blood Eosinophil Count in the SPIROMICS COPD Cohort.

LeMaster, W Blake / Quibrera, P Miguel / Couper, David / Tashkin, Donald P / Bleecker, Eugene R / Doerschuk, Claire M / Ortega, Victor E / Cooper, Christopher / Han, MeiLan K / Woodruff, Prescott G / O'Neal, Wanda K / Anderson, Wayne H / Alexis, Neil E / Bowler, Russell P / Barr, R Graham / Kaner, Robert J / Dransfield, Mark T / Paine, Robert / Kim, Victor /

Curtis, Jeffrey L / Martinez, Fernando J / Hastie, Annette T / Barjaktarevic, Igor

Chest

2022 Volume 163, Issue 3, Page(s) 515–528

Abstract: Background: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) considers blood eosinophil counts < 100 cells/μL (BEC: Research question: Are there differences between GOLD group D patients with high BEC and those with low BEC regarding ...

Abstract	Background: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) considers blood eosinophil counts < 100 cells/μL (BEC Research question: Are there differences between GOLD group D patients with high BEC and those with low BEC regarding baseline characteristics and longitudinal outcomes? Study design and methods: We used multivariable mixed models and logistic regression to contrast clinical characteristics and outcomes of BEC Results: We identified n = 485 with BEC Interpretation: In non-ICS-treated GOLD group D COPD, people with BEC Clinical trial registration: ClinicalTrials.gov; No.: NCT01969344; URL: www. Clinicaltrials: gov.
MeSH term(s)	Female ; Humans ; Eosinophils ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive ; Adrenal Cortex Hormones/therapeutic use ; Pulmonary Emphysema/drug therapy ; Emphysema ; Disease Progression ; Administration, Inhalation
Chemical Substances	Adrenal Cortex Hormones
Language	English
Publishing date	2022-11-04
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1016/j.chest.2022.10.029
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Article ; Online: Systematic review of emergency department central venous and arterial catheter infection.

Lemaster, Christopher H / Agrawal, Ashish T / Hou, Peter / Schuur, Jeremiah D

International journal of emergency medicine

2010 Volume 3, Issue 4, Page(s) 409–423

Abstract: Background: There is an extensive critical care literature for central venous catheter and arterial line infection, duration of catheterization, and compliance with infection control procedures. The emergency medicine literature, however, contains very ... ...

Abstract	Background: There is an extensive critical care literature for central venous catheter and arterial line infection, duration of catheterization, and compliance with infection control procedures. The emergency medicine literature, however, contains very little data on central venous catheters and arterial lines. As emergency medicine practice continues to incorporate greater numbers of critical care procedures such as central venous catheter placement, infection control is becoming a greater issue. Aims: We performed a systematic review of studies reporting baseline data of ED-placed central venous catheters and arterial lines using multiple search methods. Methods: Two reviewers independently assessed included studies using explicit criteria, including the use of ED-placed invasive lines, the presence of central line-associated bloodstream infection, and excluded case reports and review articles. Finding significant heterogeneity among studies, we performed a qualitative assessment. Results: Our search produced 504 abstracts, of which 15 studies were evaluated, and 4 studies were excluded because of quality issues leaving 11 cohort studies. Four studies calculated infection rates, ranging 0-24.1/1,000 catheter-days for central line-associated and 0-32.8/1,000 catheter-days for central line-related bloodstream infection. Average duration of catheterization was 4.9 days (range 1.6-14.1 days), and compliance with infection control procedures was 33-96.5%. The data were too poor to compare emergency department to in-hospital catheter infection rates. Conclusions: The existing data for emergency department-placed invasive lines are poor, but suggest they are a source of infection, remain in place for a significant period of time, and that adherence to maximum barrier precautions is poor. Obtaining accurate rates of infection and comparison between emergency department and inpatient lines requires prospective study.
Language	English
Publishing date	2010-11-05
Publishing country	England
Document type	Journal Article
ZDB-ID	2411462-5
ISSN	1865-1380 ; 1865-1372
ISSN (online)	1865-1380
ISSN	1865-1372
DOI	10.1007/s12245-010-0225-5
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Article: Progressive rash after recent antibiotic exposure.

LeMaster, Christopher H / Brown, David F M / Nadel, Eric S

The Journal of emergency medicine

2009 Volume 37, Issue 2, Page(s) 160–162

MeSH term(s)	Anti-Infective Agents/adverse effects ; Anti-Infective Agents/immunology ; Cephalosporins/adverse effects ; Cephalosporins/immunology ; Disease Progression ; Emergencies ; Exanthema/diagnosis ; Exanthema/etiology ; Humans ; Male ; Middle Aged ; Penicillins/adverse effects ; Penicillins/immunology ; Sulfonamides/adverse effects ; Sulfonamides/immunology ; Trimethoprim, Sulfamethoxazole Drug Combination/adverse effects ; Vasculitis, Leukocytoclastic, Cutaneous/diagnosis ; Vasculitis, Leukocytoclastic, Cutaneous/etiology
Chemical Substances	Anti-Infective Agents ; Cephalosporins ; Penicillins ; Sulfonamides ; Trimethoprim, Sulfamethoxazole Drug Combination (8064-90-2)
Language	English
Publishing date	2009-08
Publishing country	United States
Document type	Case Reports ; Clinical Conference ; Journal Article
ZDB-ID	605559-x
ISSN	0736-4679
ISSN	0736-4679
DOI	10.1016/j.jemermed.2009.05.012
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Article ; Online: Sentinel lymph node biopsy is associated with increased cost in higher risk thin melanoma.

Aiken, Taylor J / Stahl, Christopher C / Schwartz, Patrick B / Barrett, James / Acher, Alexandra W / Lemaster, Deborah / Leverson, Glen / Weber, Sharon / Neuman, Heather / Abbott, Daniel E

Journal of surgical oncology

2020 Volume 123, Issue 1, Page(s) 104–109

Abstract: Introduction: National Comprehensive Cancer Network guidelines recommend that sentinel lymph node biopsy (SLNB) be discussed with patients with thin melanoma at higher risk for lymph node metastasis (T1b or T1a with positive deep margins, lymphovascular ...

Abstract	Introduction: National Comprehensive Cancer Network guidelines recommend that sentinel lymph node biopsy (SLNB) be discussed with patients with thin melanoma at higher risk for lymph node metastasis (T1b or T1a with positive deep margins, lymphovascular invasion, or high mitotic index). We examined the association between SLNB and resource utilization in this cohort. Methods: We conducted a retrospective cohort study of patients that underwent wide local excision for higher risk thin melanomas from 2009 to 2018 at a tertiary care center. Patients who underwent SLNB were compared to those who did not undergo SLNB with regard to resource utilization, including total hospital cost. Results: A total of 70 patients were included in the analysis and 50 patients (71.4%) underwent SLNB. SLNB was associated with increased hospital costs ($6700 vs. $3767; p < .01) and increased operative time (68.5 vs. 36.0 min; p < .01). This cost difference persisted in multivariable regression (p < .01). Of patients who underwent successful SLN mapping, 3 out of 49 patients had a positive SLN (6.1%). The cost to identify a single positive sentinel lymph node (SLN) was $47,906. Conclusion: In patients with a higher risk of thin melanoma, SLNB is associated with increased cost despite a low likelihood of SLN positivity. These data better inform patient-provider discussions as the role of SLNB in thin melanoma evolves.
MeSH term(s)	Adult ; Aged ; Cost-Benefit Analysis ; Female ; Follow-Up Studies ; Humans ; Melanoma/economics ; Melanoma/pathology ; Melanoma/surgery ; Middle Aged ; Prognosis ; Retrospective Studies ; Sentinel Lymph Node/pathology ; Sentinel Lymph Node/surgery ; Sentinel Lymph Node Biopsy/economics ; Sentinel Lymph Node Biopsy/methods ; Skin Neoplasms/economics ; Skin Neoplasms/pathology ; Skin Neoplasms/surgery
Language	English
Publishing date	2020-09-16
Publishing country	United States
Document type	Clinical Trial ; Journal Article
ZDB-ID	82063-5
ISSN	1096-9098 ; 0022-4790
ISSN (online)	1096-9098
ISSN	0022-4790
DOI	10.1002/jso.26225
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Article ; Online: Intercostal nerve cryoablation is associated with lower hospital cost during minimally invasive Nuss procedure for pectus excavatum.

Aiken, Taylor J / Stahl, Christopher C / Lemaster, Deborah / Casias, Timothy W / Walker, Benjamin J / Nichol, Peter F / Leys, Charles M / Abbott, Daniel E / Brinkman, Adam S

Journal of pediatric surgery

2020 Volume 56, Issue 10, Page(s) 1841–1845

Abstract: ... with decreased opioid usage (15.0 versus 148.6 MME, p < 0.01) during the 24 h following surgery and ...

Abstract	Minimally invasive repair of pectus excavatum (Nuss procedure) is associated with significant pain, and efforts to control pain impact resource utilization. Bilateral thoracic intercostal nerve cryoablation has been proposed as a novel technique to improve post-operative pain control, though the impact on hospital cost is unknown. Methods: We conducted a retrospective study of patients undergoing a Nuss procedure from 2016 to 2019. Patients who received cryoablation were compared to those that received traditional pain control (patient-controlled analgesia or epidural). Outcome variables included postoperative opioid usage (milligram morphine equivalents, MME), length of stay (LOS), and hospital cost. Results: Thirty-five of 73 patients studied (48%) received intercostal nerve cryoablation. LOS (1.0 vs 4.0 days, p < 0.01) and total hospital cost ($21,924 versus $23,694, p = 0.04) were decreased in the cryoablation cohort, despite longer operative time (152 vs 74 min, p < 0.01). Cryoablation was associated with decreased opioid usage (15.0 versus 148.6 MME, p < 0.01) during the 24 h following surgery and this persisted over the entire postoperative period, including discharge opioid prescription (112.5 vs 300.0 MME, p < 0.01). Conclusion: Bilateral intercostal nerve cryoablation is associated with decreased postoperative opioid usage and decreased resource utilization in pediatric patients undergoing a minimally invasive Nuss procedure for pectus excavatum. Level of evidence: Retrospective comparative study, level III.
MeSH term(s)	Child ; Cryosurgery ; Funnel Chest/surgery ; Hospital Costs ; Humans ; Intercostal Nerves ; Minimally Invasive Surgical Procedures ; Pain, Postoperative/drug therapy ; Pain, Postoperative/etiology ; Pain, Postoperative/surgery ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2020-10-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	80165-3
ISSN	1531-5037 ; 0022-3468
ISSN (online)	1531-5037
ISSN	0022-3468
DOI	10.1016/j.jpedsurg.2020.10.009
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Article ; Online: Infection and natural history of emergency department-placed central venous catheters.

LeMaster, Christopher H / Schuur, Jeremiah D / Pandya, Darshan / Pallin, Daniel J / Silvia, Jennifer / Yokoe, Deborah / Agrawal, Ashish / Hou, Peter C

Annals of emergency medicine

2010 Volume 56, Issue 5, Page(s) 492–497

Abstract: Study objectives: Central line-associated bloodstream infection (CLABSI, hereafter referred to in this paper as "bloodstream infection") is a leading cause of hospital-acquired infection. To our knowledge, there are no previously published studies ... ...

Abstract	Study objectives: Central line-associated bloodstream infection (CLABSI, hereafter referred to in this paper as "bloodstream infection") is a leading cause of hospital-acquired infection. To our knowledge, there are no previously published studies designed to determine the rate of bloodstream infection among central venous catheters placed in the emergency department (ED). We design a retrospective chart review methodology to determine bloodstream infection and duration of catheterization for central venous catheters placed in the ED. Methods: Using hospital infection control, administrative, and ED billing databases, we identified patients with central venous catheters placed in the ED between January 1, 2007, and December 31, 2008, at one academic, urban ED with an annual census of 57,000. We performed a structured, explicit chart review to determine duration of catheterization and confirm bloodstream infection. Results: We screened 4,251 charts and identified 656 patients with central venous catheters inserted in the ED, 3,622 catheter-days, and 7 bloodstream infections. The rate of bloodstream infection associated with central venous catheters placed in the ED was 1.93 per 1,000 catheter-days (95% confidence interval 0.50 to 3.36). The mean duration of catheterization was 5.5 days (median 4; range 1 to 29 days). Among infected central venous catheters, the mean duration of catheterization was 8.6 days (median 7; range 2 to 19 days). A total of 667 central venous catheters were placed in the internal jugular (392; 59%), subclavian (145; 22%), and femoral (130; 19%) veins. The sensitivity of using ED procedural billing code for identifying ED-placed central venous catheters among patients subsequently admitted to any ICU was 74.9% (95% confidence interval 71.4% to 78.3%). Conclusion: The rate of ED bloodstream infection at our institution is similar to current rates in ICUs. Central venous catheters placed in the ED remain in admitted patients for a substantial period.
MeSH term(s)	Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Catheter-Related Infections/epidemiology ; Catheterization, Central Venous/adverse effects ; Catheterization, Central Venous/statistics & numerical data ; Cross Infection/epidemiology ; Emergency Service, Hospital/statistics & numerical data ; Female ; Humans ; Intensive Care Units/statistics & numerical data ; Male ; Middle Aged ; Retrospective Studies ; Sepsis/epidemiology ; Sepsis/etiology ; Sex Factors ; Time Factors ; United States/epidemiology ; Young Adult
Language	English
Publishing date	2010-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	603080-4
ISSN	1097-6760 ; 0196-0644
ISSN (online)	1097-6760
ISSN	0196-0644
DOI	10.1016/j.annemergmed.2010.05.033
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