Kamal M.F. Itani
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View article: Propensity Score-Weighted Analysis of Postoperative Infection in Patients With and Without Preoperative Urine Culture
Propensity Score-Weighted Analysis of Postoperative Infection in Patients With and Without Preoperative Urine Culture Open
Importance Although recent guidelines recommend against performance of preoperative urine culture before nongenitourinary surgery, many clinicians still order preoperative urine cultures and prescribe antibiotics for treatment of asymptoma…
View article: Six Long-Standing Questions about Antibiotic Prophylaxis in Surgery
Six Long-Standing Questions about Antibiotic Prophylaxis in Surgery Open
Surgical site infections (SSIs) are the most common adverse event occurring in surgical patients. Optimal prevention of SSIs requires the bundled integration of a variety of measures before, during, and after surgery. Surgical antibiotic p…
View article: Estimated Risk of Adverse Surgical Outcomes Among Patients With Recent COVID-19 Infection Using Target Trial Emulation Methods
Estimated Risk of Adverse Surgical Outcomes Among Patients With Recent COVID-19 Infection Using Target Trial Emulation Methods Open
This cohort study emulates a trial within a large national veteran population to assess the risk of adverse postoperative outcomes among patients with recent COVID-19 infection.
View article: Psychosocial Determinants of Readmission After Surgery
Psychosocial Determinants of Readmission After Surgery Open
Background: Quality of life and psychosocial determinants of health, such as health literacy and social support, are associated with increased health care utilization and adverse outcomes in medical populations. However, the effect on surg…
View article: The CONSORT Framework
The CONSORT Framework Open
This Guide to Statistics and Methods provides an overview of the Consolidated Standards of Reporting Trials framework, emphasizes several important considerations when using it, and points out its limitations.
View article: International classification of abdominal wall planes (ICAP) to describe mesh insertion for ventral hernia repair
International classification of abdominal wall planes (ICAP) to describe mesh insertion for ventral hernia repair Open
Background Nomenclature for mesh insertion during ventral hernia repair is inconsistent and confusing. Several terms, including ‘inlay’, ‘sublay’ and ‘underlay’, can refer to the same anatomical planes in the indexed literature. This frust…
View article: Definitions for Loss of Domain: An International Delphi Consensus of Expert Surgeons
Definitions for Loss of Domain: An International Delphi Consensus of Expert Surgeons Open
Background No standardized written or volumetric definition exists for ‘loss of domain’ (LOD). This limits the utility of LOD as a morphological descriptor and as a predictor of peri‐ and postoperative outcomes. Consequently, our aim was t…
View article: Association of Postoperative Infection With Risk of Long-term Infection and Mortality
Association of Postoperative Infection With Risk of Long-term Infection and Mortality Open
At any given point during the follow-up period, patients with 30-day postoperative infection had a 3.2-fold higher risk of 1-year infection and a 1.9-fold higher risk of mortality compared with those who had no 30-day infection. Cost-benef…
View article: Emergency Department Use After Outpatient Surgery Among Dually Enrolled VA and Medicare Patients
Emergency Department Use After Outpatient Surgery Among Dually Enrolled VA and Medicare Patients Open
Background: Emergency department (ED) use following outpatient surgery may be associated with a surgery-related patient safety problem. We characterized ED use within 7 days of general, urology, orthopedic, ear/nose/throat, and podiatry su…
View article: A Longitudinal Study of S. aureus Infection in a National Cohort of Surgical Patients
A Longitudinal Study of S. aureus Infection in a National Cohort of Surgical Patients Open
Background Postoperative infections are a common and often preventable complication of surgery. Staphylococcus aureus is a prevalent organism cultured in these infections and is associated with morbidity, mortality, and increased health ca…
View article: Comparison of a Potential Hospital Quality Metric With Existing Metrics for Surgical Quality–Associated Readmission
Comparison of a Potential Hospital Quality Metric With Existing Metrics for Surgical Quality–Associated Readmission Open
In this study, surgical quality-associated readmissions were more correlated with postdischarge complications at a higher rate than were unplanned readmissions. Thus, a metric based on such readmissions may be a better measure of surgical …
View article: Development of an Adverse Event Surveillance Model for Outpatient Surgery in the Veterans Health Administration
Development of an Adverse Event Surveillance Model for Outpatient Surgery in the Veterans Health Administration Open
Objective Develop and validate a surveillance model to identify outpatient surgical adverse events ( AE s) based on previously developed electronic triggers. Data Sources Veterans Health Administration's Corporate Data Warehouse. Study Des…
View article: Association Between Preoperative Proteinuria and Postoperative Acute Kidney Injury and Readmission
Association Between Preoperative Proteinuria and Postoperative Acute Kidney Injury and Readmission Open
Proteinuria was associated with postoperative AKI and 30-day unplanned readmission independent of preoperative eGFR. Simple urine assessment for proteinuria may identify patients at higher risk of AKI and readmission to guide perioperative…
View article: The Nature and Severity of Adverse Events in Select Outpatient Surgical Procedures in the Veterans Health Administration
The Nature and Severity of Adverse Events in Select Outpatient Surgical Procedures in the Veterans Health Administration Open
Background: Research on adverse events (AEs) in outpatient surgery has been limited. As part of a Veterans Health Administration (VA) project on AE surveillance, we chart-reviewed selected outpatient surgical cases to characterize the natu…
View article: Association of Postoperative Readmissions With Surgical Quality Using a Delphi Consensus Process to Identify Relevant Diagnosis Codes
Association of Postoperative Readmissions With Surgical Quality Using a Delphi Consensus Process to Identify Relevant Diagnosis Codes Open
One-third of postoperative readmissions are unlikely to reflect problems with surgical quality. Future studies should test whether restricting readmissions to those with specific ICD-9 codes might yield a more useful quality measure.
View article: Histotripsy Treatment of <italic>S. Aureus</italic> Biofilms on Surgical Mesh Samples Under Varying Scan Parameters
Histotripsy Treatment of S. Aureus Biofilms on Surgical Mesh Samples Under Varying Scan Parameters Open
Cavitation-based ultrasound histotripsy has shown potential for treating infections on surgical mesh. The goal of this paper was to explore a new scan strategy while assessing the impact of scan speed, scan step size, and the number of cyc…
View article: Factors Associated with Hospital Admission after Outpatient Surgery in the Veterans Health Administration
Factors Associated with Hospital Admission after Outpatient Surgery in the Veterans Health Administration Open
Objective To examine factors associated with 0‐ to 7‐day admission after outpatient surgery in high‐volume specialties: general surgery, orthopedics, urology, ear/nose/throat, and podiatry. Study Design We calculated rates and assessed dia…
View article: Identifying Risks and Opportunities in Outpatient Surgical Patient Safety: A Qualitative Analysis of Veterans Health Administration Staff Perceptions
Identifying Risks and Opportunities in Outpatient Surgical Patient Safety: A Qualitative Analysis of Veterans Health Administration Staff Perceptions Open
Objectives Little is known about patient safety risks in outpatient surgery. Inpatient surgical adverse events (AEs) risk factors include patient- (e.g., advanced age), process- (e.g., inadequate preoperative assessment), or structure-rela…
View article: A Global Declaration on Appropriate Use of Antimicrobial Agents across the Surgical Pathway
A Global Declaration on Appropriate Use of Antimicrobial Agents across the Surgical Pathway Open
This declaration, signed by an interdisciplinary task force of 234 experts from 83 different countries with different backgrounds, highlights the threat posed by antimicrobial resistance and the need for appropriate use of antibiotic agent…
View article: Association Between Preoperative Hemoglobin A<sub>1c</sub>Levels, Postoperative Hyperglycemia, and Readmissions Following Gastrointestinal Surgery
Association Between Preoperative Hemoglobin A<sub>1c</sub>Levels, Postoperative Hyperglycemia, and Readmissions Following Gastrointestinal Surgery Open
Early postoperative hyperglycemia was associated with increased readmission, but elevated preoperative HbA1c was not. A higher preoperative HbA1c was associated with increased postoperative glucose level checks and insulin use, suggesting …
View article: Risk of surgical site infection, acute kidney injury, and Clostridium difficile infection following antibiotic prophylaxis with vancomycin plus a beta-lactam versus either drug alone: A national propensity-score-adjusted retrospective cohort study
Risk of surgical site infection, acute kidney injury, and Clostridium difficile infection following antibiotic prophylaxis with vancomycin plus a beta-lactam versus either drug alone: A national propensity-score-adjusted retrospective cohort study Open
There are benefits but also unintended consequences of antimicrobial and infection prevention strategies aimed at "getting to zero" healthcare-associated infections. In our study, combination prophylaxis was associated with both benefits (…
View article: Histotripsy Treatment of <i>S. Aureus</i> Biofilms on Surgical Mesh Samples Under Varying Pulse Durations
Histotripsy Treatment of <i>S. Aureus</i> Biofilms on Surgical Mesh Samples Under Varying Pulse Durations Open
Prior studies demonstrated that histotripsy generated by high-intensity tone bursts to excite a bubble cloud adjacent to a medical implant can destroy the bacteria biofilm responsible for the infection. The goal of this paper was to treat …
View article: Introduction to the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infections
Introduction to the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infections Open
Surgical site infection (SSI) is a common type of health-care-associated infection (HAI) and adds considerably to the individual, social, and economic costs of surgical treatment. This document serves to introduce the updated Guideline for…