Featured Publications
On All Accounts: Cost-Effectiveness Analysis of Limited Preoperative Optimization Efforts Before Colon Cancer Surgery
Leeds IL, Drabo EF, Lehmann LS, Safar B, Johnston FM. On All Accounts: Cost-Effectiveness Analysis of Limited Preoperative Optimization Efforts Before Colon Cancer Surgery. Diseases Of The Colon & Rectum 2021, 64: 744-753. PMID: 33955409, PMCID: PMC8835996, DOI: 10.1097/dcr.0000000000001926.Peer-Reviewed Original ResearchConceptsCost-effectiveness analysisProbabilistic sensitivity analysesNet monetary benefitIncremental cost-effectiveness ratioTotal costCost-effectiveness ratioMonetary benefitsSensitivity analysisBreakeven costDominant strategyEconomic costsDecision analysis methodologyCostHypothetical scenariosAlto riesgoEl análisisAnálisisEconómicoBenefitsAnalysis methodologyReducción
2022
Do Cultures From Percutaneously Drained Intra-abdominal Abscesses Change Treatment? A Retrospective Review
Esposito A, Zhang Y, Nagarkatti N, Laird W, Coppersmith N, Reddy V, Leeds I, Mongiu A, Longo W, Hao R, Pantel H. Do Cultures From Percutaneously Drained Intra-abdominal Abscesses Change Treatment? A Retrospective Review. Diseases Of The Colon & Rectum 2022, 66: 451-457. PMID: 36538708, DOI: 10.1097/dcr.0000000000002644.Peer-Reviewed Original ResearchConceptsIntra-abdominal abscessPercutaneous drainAntimicrobial therapyLos pacientesAbdominal abscessSingle university-affiliated institutionRetrospective medical record reviewEmpiric antibiotic regimensSolid organ transplantsMedical record reviewUniversity-affiliated institutionCulture dataAntibiotic coursesAbdominal infectionAntibiotic regimensActive smokersMedian ageActive chemotherapyRecord reviewEvidence-based practiceMedian lengthUtility of cultureFemale sexIntraoperative culturesInclusion criteriaDo You Get What You Pay For? The Relationship of Price and Quality in Hospital Provided Procedures
Esposito AC, Laird WD, Zhang Y, Cerullo M, Li AX, Coppersmith NA, Reddy V, Leeds I, Mongiu A, Longo W, Pantel H. Do You Get What You Pay For? The Relationship of Price and Quality in Hospital Provided Procedures. Journal Of Surgical Research 2022, 278: 140-148. PMID: 35598497, DOI: 10.1016/j.jss.2022.04.035.Peer-Reviewed Original Research
2020
Frailer Patients Undergoing Robotic Colectomies for Colon Cancer Experience Increased Complication Rates Compared With Open or Laparoscopic Approaches.
Lo BD, Leeds IL, Sundel MH, Gearhart S, Nisly GRC, Safar B, Atallah C, Fang SH. Frailer Patients Undergoing Robotic Colectomies for Colon Cancer Experience Increased Complication Rates Compared With Open or Laparoscopic Approaches. Diseases Of The Colon & Rectum 2020, 63: 588-597. PMID: 32032198, DOI: 10.1097/dcr.0000000000001598.Peer-Reviewed Original ResearchConceptsInvasive surgical approachSurgical approachPrimary colon cancerFrailer patientsFrail patientsRobotic surgeryPostoperative complicationsComplication rateMajor complicationsRobotic colectomyOpen surgerySurgeons National Surgical Quality Improvement Program databaseColon cancerNational Surgical Quality Improvement Program databaseQuality Improvement Program databasePropensity scoreImprovement Program databaseColon cancer surgeryMultivariable logistic regressionFrailty indexLaparoscopic approachPrimary outcomeCancer surgeryOperative indicationsRetrospective study
2019
Missed psychosocial risk factors during routine preoperative evaluations are associated with increased complications after elective cancer surgery
Meyers PM, Leeds IL, Enumah ZO, Burkhart RA, He J, Haut ER, Efron JE, Johnston FM. Missed psychosocial risk factors during routine preoperative evaluations are associated with increased complications after elective cancer surgery. Surgery 2019, 166: 177-183. PMID: 31160060, PMCID: PMC8828252, DOI: 10.1016/j.surg.2019.04.015.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAgedCohort StudiesDatabases, FactualDigestive System NeoplasmsDisease-Free SurvivalElective Surgical ProceduresFemaleHumansMaleMiddle AgedNeoplasm InvasivenessNeoplasm StagingPostoperative ComplicationsPreoperative CarePrognosisPsychologyRetrospective StudiesSurvival AnalysisConceptsPsychosocial risk factorsRisk factorsChart reviewCancer surgeryPostoperative outcomesComplication ratePreoperative evaluationThirty-day postoperative complicationsTertiary academic medical centerAbdominal cancer surgeryElective cancer surgeryPatient's preoperative evaluationRoutine preoperative evaluationOverall complication rateRetrospective chart reviewWorse postoperative outcomesPreoperative risk stratificationIndividual risk factorsAcademic medical centerInadequate social supportPostoperative complicationsAdult patientsMajor complicationsRisk stratificationFormal screeningOutcomes for Ulcerative Colitis With Delayed Emergency Colectomy Are Worse When Controlling for Preoperative Risk Factors
Leeds IL, Sundel MH, Gabre-Kidan A, Safar B, Truta B, Efron JE, Fang SH. Outcomes for Ulcerative Colitis With Delayed Emergency Colectomy Are Worse When Controlling for Preoperative Risk Factors. Diseases Of The Colon & Rectum 2019, Publish Ahead of Print: &na;. PMID: 30451754, PMCID: PMC6456379, DOI: 10.1097/dcr.0000000000001276.Peer-Reviewed Original ResearchConceptsTotal abdominal colectomyPreoperative risk factorsUlcerative colitisAbdominal colectomyRisk factorsEmergency colectomyEarly surgeryHospital daysPostoperative complicationsMortality rateSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseEarly operationNational Surgical Quality Improvement ProgramAcute fulminant ulcerative colitisQuality Improvement Program databaseSurgical Quality Improvement ProgramFulminant ulcerative colitisOngoing medical managementImmediate surgical interventionImprovement Program databaseSingle institution experienceAcute ulcerative colitisDay of admissionTiming of surgeryPsychosocial Risks are Independently Associated with Cancer Surgery Outcomes in Medically Comorbid Patients
Leeds IL, Meyers PM, Enumah ZO, He J, Burkhart RA, Haut ER, Efron JE, Johnston FM. Psychosocial Risks are Independently Associated with Cancer Surgery Outcomes in Medically Comorbid Patients. Annals Of Surgical Oncology 2019, 26: 936-944. PMID: 30617868, PMCID: PMC8710142, DOI: 10.1245/s10434-018-07136-3.Peer-Reviewed Original ResearchConceptsPsychosocial risk factorsRisk factorsPsychosocial risksSurgical outcomesPrimary tumorShort-term surgical outcomesMultiple psychosocial risk factorsCancer surgery patientsColorectal primary tumorsProspective observational studyCancer surgery outcomesMultiple psychosocial risksThreefold oddsChart reviewComplication ratePostoperative courseSurgery patientsComorbid patientsMedian ageCancer surgeryMultivariable analysisPreoperative assessmentCancer patientsSurgery outcomesObservational study
2017
Racial and Socioeconomic Differences Manifest in Process Measure Adherence for Enhanced Recovery After Surgery Pathway
Leeds IL, Alimi Y, Hobson DR, Efron JE, Wick EC, Haut ER, Johnston FM. Racial and Socioeconomic Differences Manifest in Process Measure Adherence for Enhanced Recovery After Surgery Pathway. Diseases Of The Colon & Rectum 2017, 60: 1092-1101. PMID: 28891854, PMCID: PMC5647878, DOI: 10.1097/dcr.0000000000000879.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCohort StudiesColectomyColonic DiseasesColorectal SurgeryElective Surgical ProceduresFemaleHumansMaleMiddle AgedOutcome and Process Assessment, Health CarePatient CompliancePostoperative ComplicationsQuality ImprovementRacial GroupsSocioeconomic FactorsUnited StatesConceptsSurgery pathwayPathway implementationSocioeconomic statusWhite patientsPopulation subgroupsOverall adherenceShort-term surgical outcomesTertiary academic medical centerProcess measure adherenceThirty-day outcomesEnhanced recovery pathwayProcess measuresAcademic medical centerHigher socioeconomic statusElective colonPreoperative characteristicsQuality improvement purposesCohort studyComplication rateNonwhite patientsRectal resectionPain therapyMedian lengthSurgical outcomesMedical CenterThe independent effect of cancer on outcomes: a potential limitation of surgical risk prediction
Leeds IL, Canner JK, Efron JE, Ahuja N, Haut ER, Wick EC, Johnston FM. The independent effect of cancer on outcomes: a potential limitation of surgical risk prediction. Journal Of Surgical Research 2017, 220: 402-409.e6. PMID: 28923559, PMCID: PMC5712450, DOI: 10.1016/j.jss.2017.08.039.Peer-Reviewed Original ResearchConceptsCancer patientsDiagnosis of cancerBenign diseaseCancer populationNational Surgical Quality Improvement Program 2005Chronic obstructive pulmonary diseaseSurgical risk modelsSurgical risk predictionObstructive pulmonary diseaseWorse surgical outcomesMalignant gastrointestinal diseasesOdds of deathHigh complication rateMultivariable logistic regressionParticipant Use FileRisk of deathPrimary procedure codeHigh mortality rateComplication rateSurgical complicationsIndependent predictorsMultiple complicationsPulmonary diseaseElective surgeryNoncancer patientsEarly Surgical Intervention for Acute Ulcerative Colitis Is Associated with Improved Postoperative Outcomes
Leeds IL, Truta B, Parian AM, Chen SY, Efron JE, Gearhart SL, Safar B, Fang SH. Early Surgical Intervention for Acute Ulcerative Colitis Is Associated with Improved Postoperative Outcomes. Journal Of Gastrointestinal Surgery 2017, 21: 1675-1682. PMID: 28819916, PMCID: PMC6201293, DOI: 10.1007/s11605-017-3538-3.Peer-Reviewed Original ResearchConceptsAcute ulcerative colitisEarly surgical interventionUlcerative colitisLength of staySurgical interventionSurgery groupTotal colectomyHospitalization costsEarly operationMedian total hospitalization costModern immunotherapy eraRefractory ulcerative colitisHours of admissionImmediate surgical interventionUlcerative colitis patientsTotal hospitalization costsFurther prospective studiesNational Inpatient SampleImmunotherapy eraColitis patientsHospital outcomesPostoperative complicationsPostoperative outcomesUrgent surgeryComorbid patientsGracilis Flap for Perineal Closures in Minimally Invasive Abdominoperineal Resection
Leeds IL, Taylor JP, Pozo M, Safar B, Sacks JM, Fang SH. Gracilis Flap for Perineal Closures in Minimally Invasive Abdominoperineal Resection. The American Surgeon 2017, 83: 194-196. PMID: 28637543, DOI: 10.1177/000313481708300606.Peer-Reviewed Original Research
2016
Discharge decision-making after complex surgery: Surgeon behaviors compared to predictive modeling to reduce surgical readmissions
Leeds IL, Sadiraj V, Cox JC, Gao XS, Pawlik TM, Schnier KE, Sweeney JF. Discharge decision-making after complex surgery: Surgeon behaviors compared to predictive modeling to reduce surgical readmissions. The American Journal Of Surgery 2016, 213: 112-119. PMID: 28029373, PMCID: PMC5362294, DOI: 10.1016/j.amjsurg.2016.03.010.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAdultAgedAged, 80 and overAlgorithmsAttitude of Health PersonnelCohort StudiesDatabases, FactualDecision Making, Computer-AssistedDecision Support TechniquesFemaleHumansIncidenceLogistic ModelsMaleMiddle AgedPatient ReadmissionPredictive Value of TestsRetrospective StudiesRisk AssessmentSurgeonsSurgical Procedures, OperativeTertiary Care CentersUnited StatesYoung AdultOutcomes of abdominoperineal resection for management of anal cancer in HIV-positive patients: a national case review
Leeds IL, Alturki H, Canner JK, Schneider EB, Efron JE, Wick EC, Gearhart SL, Safar B, Fang SH. Outcomes of abdominoperineal resection for management of anal cancer in HIV-positive patients: a national case review. World Journal Of Surgical Oncology 2016, 14: 208. PMID: 27495294, PMCID: PMC4974747, DOI: 10.1186/s12957-016-0970-x.Peer-Reviewed Original ResearchMeSH KeywordsAbdomenAdultAge FactorsAgedAnus NeoplasmsCarcinoma, Squamous CellComorbidityFemaleFollow-Up StudiesHealth Status DisparitiesHIV InfectionsHospital MortalityHumansIncidenceLength of StayMaleMiddle AgedNeoplasm Recurrence, LocalPerineumPostoperative ComplicationsRetrospective StudiesRisk FactorsSalvage TherapyTreatment OutcomeConceptsHIV-positive patientsLength of stayHIV-negative patientsAnal cancerNational Inpatient SampleAbdominoperineal resectionHospitalization costsHIV infectionAnal squamous cell cancerAnal squamous cell carcinomaUtilization Project National Inpatient SampleGreater hospitalization costsWorse postoperative recoveryHIV-positive groupMethodsA retrospective reviewAnal cancer patientsSquamous cell cancerHuman immunodeficiency virusMultivariable logistic regressionSquamous cell carcinomaHospital mortalityHospital stayPerioperative complicationsPostoperative hemorrhagePostoperative outcomes
2015
Patient Symptomatology in Anal Dysplasia
Hicks CW, Wick EC, Leeds IL, Efron JE, Gearhart SL, Safar B, Fang SH. Patient Symptomatology in Anal Dysplasia. JAMA Surgery 2015, 150: 563-569. PMID: 25874644, DOI: 10.1001/jamasurg.2015.28.Peer-Reviewed Original ResearchConceptsLow-grade dysplasiaAnal dysplasiaHigh-grade dysplasiaAnal painAnal lesionsMultivariable analysisPatient symptomatologyHigh-grade anal dysplasiaHigh-risk patientsMajority of patientsPhysical examination findingsHigh-risk factorsAnal PapanicolaouInitial presentationExamination findingsHIV statusPatient's symptomsPhysical examinationMedical historyBiopsy specimensSilent diseaseRoutine screeningMAIN OUTCOMEHigh riskPatients
2012
Risk Factors for 30-Day Hospital Readmission among General Surgery Patients
Kassin MT, Owen RM, Perez SD, Leeds I, Cox JC, Schnier K, Sadiraj V, Sweeney JF. Risk Factors for 30-Day Hospital Readmission among General Surgery Patients. Journal Of The American College Of Surgeons 2012, 215: 322-330. PMID: 22726893, PMCID: PMC3423490, DOI: 10.1016/j.jamcollsurg.2012.05.024.Peer-Reviewed Original ResearchConceptsGeneral surgery proceduresGeneral surgery patientsRisk of readmissionPostoperative complicationsRisk factorsSurgery proceduresSurgery patientsHospital readmissionInpatient general surgery proceduresInstitutional clinical data warehousePoor quality patient careSignificant independent risk factorsPreoperative open woundSepsis/shockPostoperative pulmonary complicationsDays of dischargeIndependent risk factorUrinary tract infectionSingle academic centerType of procedureClinical data warehousePostoperative readmissionsPulmonary complicationsIndex hospitalizationPostoperative occurrence