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OBJECTIVE To investigate the association between obesity and perioperative acute kidney injury (AKI), controlling for preoperative kidney dysfunction. BACKGROUND More than 30% of patients older than 60 years are obese and, therefore, at risk for kidney disease. Postoperative AKI is a significant problem. METHODS We performed a matched case-control study(More)
Matching for several nominal covariates with many levels has usually been thought to be difficult because these covariates combine to form an enormous number of interaction categories with few if any people in most such categories. Moreover, because nominal variables are not ordered, there is often no notion of a "close substitute" when an exact match is(More)
BACKGROUND To improve access to breast reconstruction for mastectomy patients, the United States enacted the Women's Health and Cancer Rights Act in January of 1999. The objective of the current study was to evaluate the impact of this legislation on patients with different insurance plans. METHODS Women aged ≥18 years who underwent mastectomy for cancer(More)
BACKGROUND Federal and Pennsylvania state policies instituted in the late 1990s were designed to improve access to postmastectomy breast reconstruction. We sought to evaluate the impact of these policy changes on access to care among racial minorities. METHODS Mastectomy patients ≥18 years old were identified in the Pennsylvania Health Care Cost(More)
BACKGROUND Anastomotic leaks are one of the most important clinical outcomes after colorectal anastomosis. Because of the lack of measurement of this outcome in databases, research has been limited by the need to perform chart review. OBJECTIVE The aim of this study was to evaluate the ability of 2 sources, an administrative database and a clinical(More)
This paper presents a new method for optimal matching in observational studies based on mixed integer programming. Unlike widely used matching methods based on network algorithms, which attempt to achieve covariate balance by minimizing the total sum of distances between treated units and matched controls, this new method achieves covariate balance(More)
Interhospital transfer (IHT) is associated with mortality in medical and mixed intensive care units (ICUs), but few studies have examined this relationship in a surgical ICU (SICU) setting. We hypothesized that IHT is associated with increased mortality in SICU patients relative to ICU patients admitted within the hospital. We reviewed SICU and transfer(More)
OBJECTIVE To study the medical and financial outcomes associated with surgery in elderly obese patients and to ask if obesity itself influences outcomes above and beyond the effects from comorbidities that are known to be associated with obesity. BACKGROUND Obesity is a surgical risk factor not present in Medicare's risk adjustment or payment algorithms,(More)
BACKGROUND The presence of lymph node (LN) metastases in papillary thyroid cancer (PTC) has limited prognostic utility for predicting disease-specific survival. Pathologic features of the LNs beyond their presence and location do not factor into the AJCC staging system. Most LN metastases are microscopic. The natural history of patients with PTC and(More)
AIM The study aimed to evaluate the relationship between insurance status and the management and outcome of acute diverticulitis in a nationally representative sample. METHOD A retrospective cohort analysis of a nationally representative sample of 1 031 665 hospital discharges of patients admitted for acute diverticulitis in the 2006-2009 Nationwide(More)