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JOURNAL ARTICLE
Kiesha Fraser Doh, Zhana Bishop, Trishanne Gillings, Jonathan Johnson, Angela Boy, Rabbia S Waris, Amina M Bhatia, Matthew T Santore, Harold K Simon
BACKGROUND: In the United States, 33% of households with children contain firearms, however only one-third reportedly store firearms securely. It's estimated that 31% of unintentional firearm injury deaths can be prevented with safety devices. Our objective was to distribute safe storage devices, provide safe storage education, evaluate receptivity, and assess impact of intervention at follow-up. METHOD: At five independent, community safety events, parents received a safe storage device after completing a survey that assessed firearms storage methods and parental comfort with discussions regarding firearm safety...
2024: Frontiers in Public Health
#2
JOURNAL ARTICLE
Steven C Mehl, Adam M Vogel, Amy E Glasgow, Suzanne Moody, Meera Kotagal, Regan F Williams, Mark L Kayton, Emily C Alberto, Randall S Burd, Thomas J Schroeppel, Joanne E Baerg, Amanda Munoz, William B Rothstein, Laura A Boomer, Eric M Campion, Caitlin Robinson, Rachel M Nygaard, Chad J Richardson, Denise I Garcia, Christian J Streck, Michaela Gaffley, John K Petty, Cynthia Greenwell, Samir Pandya, Alicia M Waters, Robert T Russell, Brian K Yorkgitis, Jennifer Mull, Jeffrey Pence, Matthew T Santore, Taleen A MacArthur, Denise B Klinkner, Shawn D Safford, Tanya Trevilian, Megan Cunningham, Christa Black, Jessica Rea, Ryan G Spurrier, Aaron R Jensen, Bethany J Farr, David P Mooney, Bavana Ketha, Melvin S Dassinger, Anna Goldenberg-Sandau, Janika San Roman, Todd M Jenkins, Richard A Falcone, Stephanie F Polites
BACKGROUND: The benefit of targeting high ratio fresh frozen plasma (FFP):red blood cell (RBC) transfusion in pediatric trauma resuscitation is unclear as existing studies are limited to patients who retrospectively met criteria for massive transfusion. The purpose of this study is to evaluate the use of high ratio FFP:RBC transfusion and the association with outcomes in children presenting in shock. METHODS: A post-hoc analysis of a 24-institution prospective observational study (4/2018-9/2019) of injured children <18 years with elevated age-adjusted shock index was performed...
March 18, 2024: Journal of Trauma and Acute Care Surgery
#3
JOURNAL ARTICLE
Shannon L Cramm, Dionne A Graham, Martin L Blakely, Robert A Cowles, Shaun M Kunisaki, Aaron M Lipskar, Robert T Russell, Matthew T Santore, Jennifer R DeFazio, Cornelia L Griggs, Danielle I Aronowitz, Myron Allukian, Brendan T Campbell, Nicole M Chandler, Devon T Collins, Sarah J Commander, Katerina Dukleska, Justice C Echols, Joseph R Esparaz, Christina Feng, Claire Gerall, David N Hanna, Olivia A Keane, Sean E McLean, Elizabeth Pace, Stefan Scholz, Shelby R Sferra, Elisabeth T Tracy, Sacha Williams, Lucy Zhang, Katherine He, Shawn J Rangel
OBJECTIVE: To develop a severity-adjusted, hospital-level benchmarking comparative performance report for postoperative organ space infection and antibiotic utilization in children with complicated appendicitis. BACKGROUND: No benchmarking data exist to aid hospitals in identifying and prioritizing opportunities for infection prevention or antimicrobial stewardship in children with complicated appendicitis. METHODS: This was a multicenter cohort study using NSQIP-Pediatric data from 16 hospitals participating in a regional research consortium, augmented with antibiotic utilization data obtained through supplemental chart review...
February 22, 2024: Annals of Surgery
#4
JOURNAL ARTICLE
Shannon L Cramm, Dionne A Graham, Martin L Blakely, Shaun M Kunisaki, Nicole M Chandler, Robert A Cowles, Christina Feng, Katherine He, Robert T Russell, Myron Allukian, Brendan T Campbell, Sarah J Commander, Jennifer R DeFazio, Katerina Dukleska, Justice C Echols, Joseph R Esparaz, Claire Gerall, Cornelia L Griggs, David N Hanna, Olivia A Keane, Aaron M Lipskar, Sean E McLean, Elizabeth Pace, Matthew T Santore, Stefan Scholz, Shelby R Sferra, Elisabeth T Tracy, Lucy Zhang, Shawn J Rangel
IMPORTANCE: Gangrenous, suppurative, and exudative (GSE) findings have been associated with increased surgical site infection (SSI) risk and resource use in children with nonperforated appendicitis. Establishing the role for postoperative antibiotics may have important implications for infection prevention and antimicrobial stewardship. OBJECTIVE: To compare SSI rates in children with nonperforated appendicitis with GSE findings who did and did not receive postoperative antibiotics...
February 7, 2024: JAMA Surgery
#5
JOURNAL ARTICLE
Matthew L Margol, Goeto Dantes, Valerie L Dutreuil, Afrin Jahan, Matthew T Santore, Allison F Linden
INTRODUCTION: Social determinants of health (SDH) have been found to be important contributors to postoperative outcomes, especially those related to procedures that require significant postoperative resources. The association between short-term gastrostomy tube (GT) outcomes and SDH in the pediatric population is unknown. METHODS: A retrospective review was performed of all patients less than 18 y old who received a GT between January 2018 and December 2020 at a single institution...
February 1, 2024: Journal of Surgical Research
#6
JOURNAL ARTICLE
Olivia A Keane, Theresa Motley, Jenny Robinson, Alexis Smith, Heather L Short, Matthew T Santore
BACKGROUND: Appendicitis is one of the most common pediatric surgical procedures in the United States. However, wide variation remains in antibiotic prescribing and pain management across and within institutions. We aimed to minimize variation in antibiotic usage and decrease opioid prescribing at discharge for children with complicated appendicitis by implementation of a quality improvement (QI) initiative. METHODS: On December 1st, 2021, a QI initiative standardizing postoperative care for complicated appendicitis was implemented across a tertiary pediatric healthcare system with two main surgical centers...
November 7, 2023: Journal of Pediatric Surgery
#7
JOURNAL ARTICLE
Shannon L Cramm, Dionne A Graham, Christina Feng, Myron Allukian, Martin L Blakely, Nicole M Chandler, Robert A Cowles, Shaun M Kunisaki, Aaron M Lipskar, Robert T Russell, Matthew T Santore, Brendan T Campbell, Sarah J Commander, Jennifer R DeFazio, Katerina Dukleska, Justice C Echols, Joseph R Esparaz, Claire Gerall, Cornelia L Griggs, David N Hanna, Katherine He, Olivia A Keane, Sean E McLean, Elizabeth Pace, Stefan Scholz, Shelby R Sferra, Elisabeth T Tracy, Lucy Zhang, Shawn J Rangel
OBJECTIVE: To compare rates of postoperative drainage and culture profiles in children with complicated appendicitis treated with the two most common antibiotic regimens with and without antipseudomonal activity (piperacillin-tazobactam [PT] and ceftriaxone with metronidazole [CM]). SUMMARY OF BACKGROUND DATA: Variation in use of antipseudomonal antibiotics has been driven by a paucity of multicenter data reporting clinically relevant, culture-based outcomes. METHODS: Retrospective cohort study of patients with complicated appendicitis (7/2015-6/2020) using NSQIP-Pediatric data from 15 hospitals participating in a regional research consortium...
November 16, 2023: Annals of Surgery
#8
JOURNAL ARTICLE
Jessica Rauh, Goeto Dantes, Marshall Wallace, Amelia Collings, Gloria D Sanin, Gabriel E Cambronero, Maggie E Bosley, Aravindh S Ganapathy, James W Patterson, Romeo Ignacio, Jennifer Leslie Knod, Bethany Slater, Kylie Callier, Michael H Livingston, Hanna Alemayehu, Katerina Dukleska, Stefan Scholz, Matthew T Santore, Irving J Zamora, Lucas P Neff
BACKGROUND: Patients with choledocholithiasis are often treated with endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC). Upfront LC, intraoperative cholangiogram (IOC), and possible transcystic laparoscopic common bile duct exploration (LCBDE) could potentially avoid the need for ERCP. We hypothesized that upfront LC + IOC ± LCBDE will decrease length of stay (LOS) and the total number of interventions for children with suspected choledocholithiasis...
October 21, 2023: Journal of Pediatric Surgery
#9
JOURNAL ARTICLE
Olivia A Keane, Cindi Chambers, Colin M Brady, Jeff Rehberg, Srikant Iyer, Matthew T Santore
BACKGROUND: While the incidence of pediatric retained foreign objects (RFOs) during surgery is diminutive (1/32,000), RFOs are often the most common sentinel events reported. In 2021, our institution noted an increase in RFOs evidenced by a substantial decrease in days between events. We aimed to minimize the incidence of RFO which was measured as an increase days between events at our institution by implementation of a Quality Improvement (QI) initiative. STUDY DESIGN: This effort was conducted across four surgical centers within a tertiary children's healthcare system in December 2021...
August 28, 2023: Journal of the American College of Surgeons
#10
Samuel R Donnenfeld, Jennifer M Lovin, Matthew T Santore, Sarah G Mitchell, Edwin A Smith
Congenital melanocytic nevi (CMN) are present at birth or develop within the first few months of life. Giant CMN (GCMN) are a rare variant and may involve the external genitalia with a confluent "bathing trunk" distribution. Rapid growth of proliferative nodules of melanocytic cells may cause disfigurement and anatomical distortion resulting in psychological distress and loss of functionality. We report the case of a neglected 17-year-old nonverbal male who received a resection of a GMN engulfing the penis and scrotum with final resected dimensions of 36...
August 14, 2023: Urology
#11
MULTICENTER STUDY
Taleen A MacArthur, Adam M Vogel, Amy E Glasgow, Suzanne Moody, Meera Kotagal, Regan F Williams, Mark L Kayton, Emily C Alberto, Randall S Burd, Thomas J Schroeppel, Joanne E Baerg, Amanda Munoz, William B Rothstein, Laura A Boomer, Eric M Campion, Caitlin Robinson, Rachel M Nygaard, Chad J Richardson, Denise I Garcia, Christian J Streck, Michaela Gaffley, John K Petty, Mark Ryan, Samir Pandya, Robert T Russell, Brian K Yorkgitis, Jennifer Mull, Jeffrey Pence, Matthew T Santore, Denise B Klinkner, Shawn D Safford, Tanya Trevilian, Aaron R Jensen, David P Mooney, Bavana Ketha, Melvin S Dassinger, Anna Goldenberg-Sandau, Richard A Falcone, Stephanie F Polites
OBJECTIVE: This study examined differences in clinical and resuscitation characteristics between injured children with and without severe traumatic brain injury (sTBI) and aimed to identify resuscitation characteristics associated with improved outcomes following sTBI. METHODS: This is a post hoc analysis of a prospective observational study of injured children younger than 18 years (2018-2019) transported from the scene, with elevated shock index pediatric-adjusted on arrival and head Abbreviated Injury Scale score of ≥3...
July 1, 2023: Journal of Trauma and Acute Care Surgery
#12
MULTICENTER STUDY
Shannon L Cramm, Dionne A Graham, Martin L Blakely, Nicole M Chandler, Robert A Cowles, Shaun M Kunisaki, Robert T Russell, Myron Allukian, Jennifer R DeFazio, Cornelia L Griggs, Matthew T Santore, Stefan Scholz, Danielle I Aronowitz, Brendan T Campbell, Devon T Collins, Sarah J Commander, Abigail Engwall-Gill, Joseph R Esparaz, Christina Feng, Claire Gerall, David N Hanna, Olivia A Keane, Abdulraouf Lamoshi, Aaron M Lipskar, Claudia P Orlas Bolanos, Elizabeth Pace, Maia D Regan, Elisabeth T Tracy, Sacha Williams, Lucy Zhang, Shawn J Rangel
BACKGROUND: The objective was to explore the hospital-level relationship between routine pre-discharge WBC utilization (RPD-WBC) and outcomes in children with complicated appendicitis. METHODS: Multicenter analysis of NSQIP-Pediatric data from 14 consortium hospitals augmented with RPD-WBC data. WBC were considered routine if obtained within one day of discharge in children who did not develop an organ space infection (OSI) or fever during the index admission. Hospital-level observed-to-expected ratios (O/E) for 30-day outcomes (antibiotic days, imaging utilization, healthcare days, and OSI) were calculated after adjusting for appendicitis severity and patient characteristics...
June 2023: Journal of Pediatric Surgery
#13
JOURNAL ARTICLE
Olivia A Keane, Shasha Bai, Kristina Cossen, Briana C Patterson, Kara K Prickett, Kurt F Heiss, Matthew T Santore
OBJECTIVES: Transient hypocalcemia is a common complication after pediatric total thyroidectomy, while permanent hypoparathyroidism (PH) is relatively uncommon. To date there is no model to predict which patients will develop PH based on post-operative makers. We aim to identify pediatric patients who are at high risk of PH following thyroidectomy based on 6 h post-operative parathyroid hormone (PTH) value. METHODS: A retrospective review of 122 pediatric patients undergoing total thyroidectomy between 2016 and 2022 following implementation of a multidisciplinary team was performed...
January 11, 2023: Journal of Pediatric Endocrinology & Metabolism: JPEM
#14
JOURNAL ARTICLE
Olivia A Keane, Shasha Bai, Kristina Cossen, Briana C Patterson, Kara K Prickett, Kurt F Heiss, Matthew T Santore
PURPOSE: Pediatric total thyroidectomy is an uncommon procedure. Higher rates of complication are reported for pediatric patients compared to adults which may be secondary to lower case volume. In this study, we examine the effect of a two-surgeon operative approach on outcomes in pediatric total thyroidectomy. METHODS: A retrospective review of 152 pediatric patients undergoing total thyroidectomy at a single institution was performed. A control group of 89 patients, with one attending surgeon present, was compared to a cohort of 63 pediatric patients who underwent total thyroidectomy with two attendings present...
January 2023: International Journal of Pediatric Otorhinolaryngology
#15
JOURNAL ARTICLE
Shannon L Cramm, Nicole M Chandler, Dionne A Graham, Shaun M Kunisaki, Robert T Russell, Martin L Blakely, Aaron M Lipskar, Myron Allukian, Danielle I Aronowitz, Brendan T Campbell, Devon T Collins, Sarah J Commander, Robert A Cowles, Jennifer R DeFazio, Joseph R Esparaz, Christina Feng, Cornelia L Griggs, Richard A Guyer, David N Hanna, Anastasia M Kahan, Olivia A Keane, Abdulraouf Lamoshi, Carla M Lopez, Elizabeth Pace, Maia D Regan, Matthew T Santore, Stefan Scholz, Elisabeth T Tracy, Sacha A Williams, Lucy Zhang, Shawn J Rangel
OBJECTIVE: To evaluate whether redosing antibiotics within an hour of incision is associated with a reduction in incisional surgical site infection (iSSI) in children with appendicitis. SUMMARY OF BACKGROUND DATA: Existing data remain conflicting as to whether children with appendicitis receiving antibiotics at diagnosis benefit from antibiotic redosing prior to incision. METHODS: This was a multicenter retrospective cohort study using data from the Pediatric National Surgical Quality Improvement Program augmented with antibiotic utilization and operative report data obtained though supplemental chart review...
November 1, 2022: Annals of Surgery
#16
JOURNAL ARTICLE
Kristina Cossen, Matthew T Santore, Kara K Prickett, Steven L Goudy, Kurt F Heiss, Kanika Shanker, Adina L Alazraki, Briana C Patterson
Introduction: To illustrate how quality improvement can produce unexpected positive outcomes. Methods: We compared a retrospective review of perioperative management and outcomes of baseline 122 pediatric total thyroidectomies to 121 subsequent total thyroidectomies managed by an Electronic Medical Record protocol in a large, free-standing children's healthcare system. Process measures included serum calcium measurement 6-12 hours postoperatively; parathyroid hormone measurement 6 hours postoperatively; preoperative iodine for Graves disease, and postoperative prophylactic calcium carbonate administration...
May 2022: Pediatric Quality & Safety
#17
MULTICENTER STUDY
Shannon L Cramm, Aaron M Lipskar, Dionne A Graham, Shaun M Kunisaki, Cornelia L Griggs, Myron Allukian, Robert T Russell, Nicole M Chandler, Matthew T Santore, Danielle I Aronowitz, Martin L Blakely, Brendan Campbell, Devon T Collins, Sarah J Commander, Robert A Cowles, Jennifer R DeFazio, Justice C Echols, Joseph R Esparaz, Christina Feng, Richard A Guyer, David N Hanna, Katherine He, Anastasia M Kahan, Olivia A Keane, Abdulraouf Lamoshi, Carla M Lopez, Sean E McLean, Elizabeth Pace, Maia D Regan, Stefan Scholz, Elisabeth T Tracy, Sasha A Williams, Lucy Zhang, Shawn J Rangel
IMPORTANCE: The clinical significance of gangrenous, suppurative, or exudative (GSE) findings is poorly characterized in children with nonperforated appendicitis. OBJECTIVE: To evaluate whether GSE findings in children with nonperforated appendicitis are associated with increased risk of surgical site infections and resource utilization. DESIGN, SETTING, AND PARTICIPANTS: This multicenter cohort study used data from the Appendectomy Targeted Database of the American College of Surgeons Pediatric National Surgical Quality Improvement Program, which were augmented with operative report data obtained by supplemental medical record review...
August 1, 2022: JAMA Surgery
#18
JOURNAL ARTICLE
Benjamin J Hazen, Olivia A Keane, Robert J Vandewalle, Zachary Grady, Martha Wetzel, Joshua J Chern, Matthew T Santore
BACKGROUND: Chance fracture (CFx) with concomitant intra-abdominal injury has variable occurrence rates ranging from 33 to 89%. No single study has compared the incidence of simultaneous abdominal injury between pediatric and adult populations. This study compares the rate of simultaneous intra-abdominal injury and chance fracture in these populations. METHODS: A retrospective review of pediatric and adult patients with chance fracture in comparable pediatric and adult trauma centers was performed...
June 2023: American Surgeon
#19
JOURNAL ARTICLE
Elizabeth M Sinclair, Maneesha Agarwal, Matthew T Santore, Cary G Sauer, Erica L Riedesel
OBJECTIVE: The aims of this study were to characterize the patient population and initial presentation and care of esophageal button battery ingestion and provide descriptive data including factors affecting accurate diagnosis, duration of battery exposure, and battery removal. METHODS: This was a retrospective cohort study from 2007 to 2020 at a single-center, large-volume, urban academic pediatric hospital system. Included participants were children 6 months to 18 years old who underwent removal of an esophageal button battery impaction at our institution...
March 29, 2022: Pediatric Emergency Care
#20
JOURNAL ARTICLE
Brendan P Lovasik, Katherine T Fay, Johanna M Hinman, Keith A Delman, Jahnavi K Srinivasan, Matthew T Santore
OBJECTIVE: Validated assessment of procedural knowledge and skills with formative remediation is a foundational part of achieving surgical competency. High-fidelity simulation programs provide a unique area to assess resident proficiency and independence, as well as to assist in identifying residents in need of further practice. While several studies have validated the use of simulation to attain proficiency of specific technical skills, few have validated remediation pathways for their trainees objectively...
March 25, 2022: American Surgeon
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