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Article ; Online: Venous Thromboembolism Risk Factors in Women With Obesity Who Undergo Cesarean Delivery.

Fatokun, Tolulope B / Swartz, Sarah E / Ebeid, Ahmed / Cordes, Sophia A / Gimovsky, Alexis C / Sparks, Andrew D / Amdur, Richard L / Ahmadzia, Homa K

Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis

2024 Volume 30, Page(s) 10760296241247203

Abstract: Venous thromboembolism (VTE) is a leading cause of maternal mortality. Obesity and cesarean delivery are established risk factors for pregnancy-related VTE. We identified additional risk factors among patients with obesity who underwent a cesarean ... ...

Abstract	Venous thromboembolism (VTE) is a leading cause of maternal mortality. Obesity and cesarean delivery are established risk factors for pregnancy-related VTE. We identified additional risk factors among patients with obesity who underwent a cesarean delivery to identify those who need VTE prophylaxis. We conducted a secondary analysis of data from the Maternal-Fetal Medicine Units Network (MFMU) Cesarean Registry Database using a case-control design. Cases were identified as women with obesity having a pre-pregnancy body mass index of >30 kg/m
MeSH term(s)	Pregnancy ; Humans ; Female ; Venous Thromboembolism/prevention & control ; Anticoagulants/therapeutic use ; Endometritis/chemically induced ; Endometritis/complications ; Endometritis/drug therapy ; Pulmonary Embolism/etiology ; Risk Factors ; Obesity/complications ; Obesity/drug therapy ; Urinary Tract Infections/chemically induced ; Urinary Tract Infections/complications ; Urinary Tract Infections/drug therapy
Chemical Substances	Anticoagulants
Language	English
Publishing date	2024-04-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	1237357-6
ISSN	1938-2723 ; 1076-0296
ISSN (online)	1938-2723
ISSN	1076-0296
DOI	10.1177/10760296241247203
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Article: CEACAMS 1, 5, and 6 in disease and cancer: interactions with pathogens.

Thomas, Jerin / Klebanov, Addison / John, Sahara / Miller, Larry S / Vegesna, Anil / Amdur, Richard L / Bhowmick, Krishanu / Mishra, Lopa

Genes & cancer

2023 Volume 14, Page(s) 12–29

Abstract: The CEA family comprises 18 genes and 11 pseudogenes located at chromosome 19q13.2 and is divided into two main groups: cell surface anchored CEA-related cell adhesion molecules (CEACAMs) and the secreted pregnancy-specific glycoproteins (PSGs). CEACAMs ... ...

Abstract	The CEA family comprises 18 genes and 11 pseudogenes located at chromosome 19q13.2 and is divided into two main groups: cell surface anchored CEA-related cell adhesion molecules (CEACAMs) and the secreted pregnancy-specific glycoproteins (PSGs). CEACAMs are highly glycosylated cell surface anchored, intracellular, and intercellular signaling molecules with diverse functions, from cell differentiation and transformation to modulating immune responses associated with infection, inflammation, and cancer. In this review, we explore current knowledge surrounding CEACAM1, CEACAM5, and CEACAM6, highlight their pathological significance in the areas of cancer biology, immunology, and inflammatory disease, and describe the utility of murine models in exploring questions related to these proteins.
Language	English
Publishing date	2023-02-01
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2538519-7
ISSN	1947-6027 ; 1947-6019
ISSN (online)	1947-6027
ISSN	1947-6019
DOI	10.18632/genesandcancer.230
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Article ; Online: Prevalence and predictors of outcomes among ESRD patients with COVID-19.

Baptiste, Claire S / Adegbulugbe, Esther / Shankaranarayanan, Divya / Izzi, Zahra / Patel, Samir / Nakity, Rasha / Amdur, Richard L / Raj, Dominic

BMC nephrology

2023 Volume 24, Issue 1, Page(s) 67

Abstract: Background: End-stage renal disease patients on hemodialysis (ESRD) patients are at high risk for contracting COVID-19. In this propensity matched cohort study, we examined the prevalence of COVID-19 in emergency room (ER) patients and examined whether ... ...

Abstract	Background: End-stage renal disease patients on hemodialysis (ESRD) patients are at high risk for contracting COVID-19. In this propensity matched cohort study, we examined the prevalence of COVID-19 in emergency room (ER) patients and examined whether clinical outcomes varied by ESRD status. Methods: Patients who visited George Washington University Hospital ER from April 2020 to April 2021 were reviewed for COVID-19 and ESRD status. Among COVID-positive ER patients, the propensity for ESRD was calculated using a logistic regression model to create a propensity-matched sample of ESRD vs non-ESRD COVID-19 patients. A multivariable model examined whether ESRD was an independent predictor of death and other outcomes in COVID-19 patients. Results: Among the 27,106 ER patients, 2689 of whom were COVID-positive (9.9%). The odds of testing positive for COVID-19 were 0.97 ([95% CI: 0.78-1.20], p = 0.76) in ESRD vs non-ESRD patients after adjusting for age, sex, and race. There were 2414 COVID-positive individuals with non-missing data, of which 98 were ESRD patients. In this COVID-positive sample, ESRD patients experienced a higher incidence of stroke, sepsis, and pneumonia than non-ESRD individuals. Significant independent predictors of death included age, race, sex, insurance status, and diabetes mellitus. Those with no insurance had odds of death that was 212% higher than those with private insurance (3.124 [1.695-5.759], p < 0.001). ESRD status was not an independent predictor of death (1.215 [0.623-2.370], p = 0.57). After propensity-matching in the COVID-positive patients, there were 95 ESRD patients matched with 283 non-ESRD individuals. In this sample, insurance status continued to be an independent predictor of mortality, while ESRD status was not. ESRD patients were more likely to have lactic acidosis (36% vs 15%) and length of hospital stay ≥ 7 days (48% vs 31%), but no increase in odds for any studied adverse outcomes. Conclusions: In ER patients, ESRD status was not associated with higher odds for testing positive for COVID-19. Among ER patients who were COVID positive, ESRD was not associated with mortality. However, insurance status had a strong and independent association with death among ER patients with COVID-19.
MeSH term(s)	Humans ; Cohort Studies ; Prevalence ; COVID-19/epidemiology ; COVID-19/complications ; Kidney Failure, Chronic/epidemiology ; Kidney Failure, Chronic/therapy ; Kidney Failure, Chronic/complications ; Renal Dialysis ; Retrospective Studies ; Risk Factors
Language	English
Publishing date	2023-03-22
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2041348-8
ISSN	1471-2369 ; 1471-2369
ISSN (online)	1471-2369
ISSN	1471-2369
DOI	10.1186/s12882-023-03121-5
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Article ; Online: The Effect of Sizing Device Use During Laparoscopic Sleeve Gastrectomy on Rates of Postoperative Dehydration and Other 30-day Complications: An Analysis of the ACS-MBSAQIP Database.

DeAngelis, Erik J / Lee, Juliet / Habboosh, Noor / Ichiuji, Brynne A / Amdur, Richard L / Lin, Paul / Vaziri, Khashayar / Jackson, Hope T

Surgical laparoscopy, endoscopy & percutaneous techniques

2023 Volume 33, Issue 1, Page(s) 55–61

Abstract: Background: During laparoscopic sleeve gastrectomy (LSG), many surgeons use an intraoperative sizing device. However, the choice of intraoperative sizing device varies and the optimal choice or combination of sizing devices, such as a bougie or ... ...

Abstract	Background: During laparoscopic sleeve gastrectomy (LSG), many surgeons use an intraoperative sizing device. However, the choice of intraoperative sizing device varies and the optimal choice or combination of sizing devices, such as a bougie or esophagogastroduodenoscopy (EGD), is not known. The purpose of this study was to determine if there is an association between the use of a sizing device or a combination of sizing devices on rates of dehydration, bleeding, and staple line leak following LSG. Materials and methods: Patients between the ages of 18 to 80 who underwent elective LSG were identified using the American College of Surgeons Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (ACS-MBSAQIP) database from 2015 to 2019. Postoperative outcomes, including rates of dehydration, bleeding, and staple line leak, were compared across 4 groups: those that utilized bougie and EGD (both), those that utilized only bougie (bougie only), those that utilized only EGD (EGD only), and those that did not utilize either sizing device (neither). Results: In all, 533,151 cases met the inclusion criteria. On univariate analysis, the bougie-only group experienced the highest rates of dehydration events. On multivariate analysis, the use of both sizing devices was associated with significantly lower odds of events related to dehydration versus bougie only (aOR 0.869, P =0.0002), and bougie only was associated with significantly higher odds of events related to dehydration versus EGD only (aOR 1.773, P =0.0006).The neither-sizing device group did not show any statistically significant differences in any of the comparisons. Conclusions: Bougie use alone was associated with more dehydration-related complications, while EGD use demonstrated a protective effect. Not using a sizing device was associated with equivalent outcomes to all combinations of sizing devices. These findings highlight the need for the standardization of sizing devices during LSG and suggest that foregoing sizing devices may be a management option without early adverse sequelae.
MeSH term(s)	Humans ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Obesity, Morbid/surgery ; Obesity, Morbid/complications ; Dehydration/etiology ; Dehydration/complications ; Laparoscopy/adverse effects ; Bariatric Surgery/adverse effects ; Gastrectomy/adverse effects ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Treatment Outcome
Language	English
Publishing date	2023-02-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	1475108-2
ISSN	1534-4908 ; 1530-4515 ; 1051-7200
ISSN (online)	1534-4908
ISSN	1530-4515 ; 1051-7200
DOI	10.1097/SLE.0000000000001144
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Article ; Online: Predictors of 30-Day Pulmonary Complications after Video-Assisted Thoracoscopic Surgery Lobectomy.

Holleran, Timothy J / Napolitano, Michael A / Duggan, John P / Peters, Alex S / Amdur, Richard L / Antevil, Jared L / Trachiotis, Gregory D

The Thoracic and cardiovascular surgeon

2022 Volume 71, Issue 4, Page(s) 327–335

Abstract: Background: Pulmonary complications are the most common adverse event after lung resection, yet few large-scale studies have examined pertinent risk factors after video-assisted thoracoscopic surgery (VATS) lobectomy. Veterans, older and less healthy ... ...

Abstract	Background: Pulmonary complications are the most common adverse event after lung resection, yet few large-scale studies have examined pertinent risk factors after video-assisted thoracoscopic surgery (VATS) lobectomy. Veterans, older and less healthy compared with nonveterans, represent a cohort that requires further investigation. Our objective is to determine predictors of pulmonary complications after VATS lobectomy in veterans. Methods: A retrospective review was conducted on patients who underwent VATS lobectomy from 2008 to 2018 using the Veterans Affairs Surgical Quality Improvement Program database. Patients were divided into two cohorts based on development of a pulmonary complication within 30 days. Patient characteristics were compared via multivariable analysis to determine clinical predictors associated with pulmonary complication and reported as adjusted odds ratios (aORs) with 95% confidence intervals. Patients with preoperative pneumonia, ventilator dependence, and emergent cases were excluded. Results: In 4,216 VATS lobectomy cases, 480 (11.3%) cases had ≥1 pulmonary complication. Preoperative factors independently associated with pulmonary complication included chronic obstructive pulmonary disease (COPD) (aOR = 1.37 [1.12-1.69]; Conclusion: This analysis revealed several preoperative factors associated with development of pulmonary complications. It is imperative to optimize pulmonary-specific comorbidities such as COPD or dyspnea prior to VATS lobectomy. However, unhealthy alcohol consumption and hyponatremia were linked with development of pulmonary complication in our analysis and should be addressed prior to VATS lobectomy. Future studies should explore long-term consequences of pulmonary complications.
MeSH term(s)	Humans ; Lung Neoplasms/surgery ; Thoracic Surgery, Video-Assisted/adverse effects ; Hyponatremia/complications ; Hyponatremia/surgery ; Pneumonectomy/adverse effects ; Treatment Outcome ; Postoperative Complications/etiology ; Pulmonary Disease, Chronic Obstructive/complications ; Retrospective Studies ; Length of Stay ; Lung ; Dyspnea/complications ; Dyspnea/surgery
Language	English
Publishing date	2022-07-04
Publishing country	Germany
Document type	Journal Article
ZDB-ID	800050-5
ISSN	1439-1902 ; 0171-6425 ; 0946-4778 ; 0172-6137
ISSN (online)	1439-1902
ISSN	0171-6425 ; 0946-4778 ; 0172-6137
DOI	10.1055/s-0042-1748025
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Article ; Online: Improving Specialty Care Access via Telemedicine.

Burke, Guenevere V / Osman, Kareem A / Lew, Susie Q / Ehrhardt, Nicole / Robie, Andrew C / Amdur, Richard L / Martin, Lisa W / Sikka, Neal

Telemedicine journal and e-health : the official journal of the American Telemedicine Association

2022 Volume 29, Issue 1, Page(s) 109–115

Abstract: Introduction: ...

Abstract	Introduction:
MeSH term(s)	Humans ; Hypertension/epidemiology ; Hypertension/therapy ; Pandemics ; Prospective Studies ; Telemedicine
Language	English
Publishing date	2022-05-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2035659-6
ISSN	1556-3669 ; 1530-5627
ISSN (online)	1556-3669
ISSN	1530-5627
DOI	10.1089/tmj.2021.0597
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Article: Postoperative Complications Following Orthopedic Spine Surgery: Is There a Difference Between Men and Women?

Heyer, Jessica H / Cao, N A / Amdur, Richard L / Rao, Raj R

International journal of spine surgery

2019 Volume 13, Issue 2, Page(s) 125–131

Abstract: Background: Patient sex is known to affect outcomes following surgery. Prior studies have not specifically examined sex-stratified outcomes following spine surgery. The objective is to determine the differences between men and women in terms of 30-day ... ...

Abstract	Background: Patient sex is known to affect outcomes following surgery. Prior studies have not specifically examined sex-stratified outcomes following spine surgery. The objective is to determine the differences between men and women in terms of 30-day complications following spine surgery. Methods: The National Surgical Quality Improvement Program database was queried for patients undergoing spine surgery from 2005 to 2014. Postoperative data were analyzed to determine the differences between men and women with regard to 30-day complications. Results: A total of 41 315 patients (49.0% women, 51% men) were analyzed. Men were more likely to have diabetes ( Conclusions: Differences in complications are evident between men and women following spine surgery. These differences should be considered during preoperative planning and when consenting patients for surgery. Level of evidence: 4.
Language	English
Publishing date	2019-04-30
Publishing country	Netherlands
Document type	Journal Article
ISSN	2211-4599
ISSN	2211-4599
DOI	10.14444/6017
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Article ; Online: Analysis of American College of Cardiology/American Heart Association Guideline Author Self-Disclosure Compared With Open Payments Industry Disclosure.

Dudum, Ramzi / Sajja, Aparna / Amdur, Richard L / Choi, Brian G

Circulation. Cardiovascular quality and outcomes

2019 Volume 12, Issue 12, Page(s) e005613

MeSH term(s)	American Heart Association ; Authorship ; Conflict of Interest/economics ; Drug Industry/economics ; Drug Industry/ethics ; Humans ; Physicians/economics ; Physicians/ethics ; Policy Making ; Practice Guidelines as Topic ; Remuneration ; Self Disclosure ; Truth Disclosure/ethics ; United States
Language	English
Publishing date	2019-12-03
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	2483197-9
ISSN	1941-7705 ; 1941-7713
ISSN (online)	1941-7705
ISSN	1941-7713
DOI	10.1161/CIRCOUTCOMES.119.005613
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Article: Impact of smoking on outcomes following knee and shoulder arthroscopy.

Heyer, Jessica H / Perim, Dana A / Amdur, Richard L / Pandarinath, Rajeev

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie

2019 Volume 30, Issue 2, Page(s) 329–336

Abstract: Objective: The purpose of this study is to evaluate any association between preoperative smoking and perioperative and early postoperative complications in patients following shoulder and knee arthroscopic surgery.: Methods: This is a retrospective ... ...

Abstract	Objective: The purpose of this study is to evaluate any association between preoperative smoking and perioperative and early postoperative complications in patients following shoulder and knee arthroscopic surgery. Methods: This is a retrospective study using the prospectively collected National Surgery Quality Improvement Program database. All patients who underwent eight specific shoulder and knee arthroscopy procedures, identified by current procedural terminology codes, were included in this study and analyzed using univariate and multivariate analyses to determine the impact of preoperative smoking status on postoperative complications. These procedures were knee arthroscopy with meniscectomy (medial or lateral), knee arthroscopy with meniscectomy (medial and lateral), knee arthroscopy with chondroplasty, knee arthroscopy with anterior cruciate ligament reconstruction, shoulder arthroscopy with subacromial decompression, shoulder arthroscopy with debridement, subacromial arthroscopy with rotator cuff repair, and shoulder arthroscopy with distal clavicle excision. Thirty-day complications including cardiac, renal, wound, pulmonary, clotting, and mortality were assessed following knee and shoulder arthroscopy. Results: A total of 134,822 cases were included in the study. Multivariate analysis found that smoking was an independent risk factor for complications in shoulder arthroscopy with subacromial decompression (odd's ratio [OR] = 1.46; 95% confidence interval [CI] 1.030-2.075), shoulder arthroscopy with debridement (OR = 1.933; 95% CI 1.211-3.084), and knee arthroscopy with medial and lateral meniscectomy (OR = 1.97; 95% CI 1.407-2.757). Smoking was not an independent risk factor for complications in the other five procedures studied. Conclusions: Preoperative smoking was found to be an independent risk factor for complications for several arthroscopic procedures, though with variability between specific procedures.
MeSH term(s)	Adult ; Aged ; Anterior Cruciate Ligament Reconstruction/adverse effects ; Arthroscopy/adverse effects ; Clavicle/surgery ; Databases, Factual ; Debridement/adverse effects ; Decompression, Surgical/adverse effects ; Female ; Humans ; Knee Joint/surgery ; Male ; Meniscectomy/adverse effects ; Middle Aged ; Perioperative Period ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Risk Factors ; Rotator Cuff Injuries/surgery ; Shoulder Joint/surgery ; Smoking/epidemiology ; United States/epidemiology ; Young Adult
Language	English
Publishing date	2019-10-12
Publishing country	France
Document type	Journal Article
ZDB-ID	1231084-0
ISSN	1432-1068 ; 1633-8065 ; 0948-4817 ; 0940-3264
ISSN (online)	1432-1068
ISSN	1633-8065 ; 0948-4817 ; 0940-3264
DOI	10.1007/s00590-019-02577-2
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Zs.A 3479: Show issues

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Article ; Online: A Critical Examination of Length of Stay in Autologous Breast Reconstruction: A National Surgical Quality Improvement Program Analysis.

Kotha, Vikas S / Abadeer, Andrew I / Amdur, Richard L / Song, David H / Fan, Kenneth L

Plastic and reconstructive surgery

2020 Volume 147, Issue 1, Page(s) 24–33

Abstract: Background: This study aims to use the National Surgical Quality Improvement Program database to identify factors associated with extended postoperative length of stay after breast reconstruction with free tissue transfer.: Methods: Consecutive cases ...

Abstract	Background: This study aims to use the National Surgical Quality Improvement Program database to identify factors associated with extended postoperative length of stay after breast reconstruction with free tissue transfer. Methods: Consecutive cases of breast reconstruction with free tissue transfer were retrieved from the National Surgical Quality Improvement Program (2005 to 2017) database using CPT code 19364. Extended length of stay (dependent variable) was defined as greater than 5 days. Results: Nine thousand six hundred eighty-six cases were analyzed; extended length of stay was noted in 34 percent. On regression, patient factors independently associated with extended length of stay were body mass index (OR, 1.5; 95 percent CI, 1.2 to 1.9; p < 0.001), diabetes (OR, 1.3; 95 percent CI, 1.1 to 1.6; p = 0.003), and malignancy history (OR, 1.9; 95 percent CI, 1.22 to 3.02; p = 0.005). Operation time greater than 500 minutes (OR, 3; 95 percent CI, 2.73 to 3.28; p < 0.001) and immediate postmastectomy reconstruction (OR, 1.7; 95 percent CI, 1.16 to 2.48; p < 0.001) conferred risk for extended length of stay. Bilateral free tissue transfer was not significant. Operations performed in 2017 were at lower risk (OR, 0.2; 95 percent CI, 0.06 to 0.81; p = 0.02) for extended length of stay. Reoperation is more likely following operative transfusion and bilateral free tissue transfers, but less likely following concurrent alloplasty. Given a known operation time (minutes), postoperative length of stay (days) can be calculated using the following equation: length of stay = 2.559 + 0.003 × operation time. Conclusions: This study characterizes the risks for extended length of stay after free tissue transfer breast reconstruction using a prospective multicenter national database. The result of this study can be used to risk-stratify patients during surgical planning to optimize perioperative decision-making. Clinical question/level of evidence: Risk, III.
MeSH term(s)	Adult ; Body Mass Index ; Breast Neoplasms/surgery ; Clinical Decision-Making ; Diabetes Mellitus/epidemiology ; Female ; Free Tissue Flaps/adverse effects ; Free Tissue Flaps/transplantation ; Humans ; Length of Stay/statistics & numerical data ; Mammaplasty/adverse effects ; Mammaplasty/methods ; Mammaplasty/statistics & numerical data ; Mastectomy/adverse effects ; Middle Aged ; Operative Time ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Prospective Studies ; Quality Improvement ; Risk Assessment/methods ; Risk Assessment/statistics & numerical data ; Risk Factors ; Surgery, Plastic/organization & administration ; Surgery, Plastic/statistics & numerical data ; Time-to-Treatment/statistics & numerical data ; Transplantation, Autologous/statistics & numerical data ; United States
Language	English
Publishing date	2020-09-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	208012-6
ISSN	1529-4242 ; 0032-1052 ; 0096-8501
ISSN (online)	1529-4242
ISSN	0032-1052 ; 0096-8501
DOI	10.1097/PRS.0000000000007420
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