Full Text Journal Articles by
Author David A Spain

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Practical Computer Vision Application to Compute Total Body Surface Area Burn: Reappraising a Fundamental Burn Injury Formula in the Modern Era.

Jeff Choi, Advait Patil, Edward Vendrow, Gavin Touponse, Layla Aboukhater, Joseph D Forrester, David A Spain,

<h4>Importance</h4>Critical burn management decisions rely on accurate percent total body surface area (%TBSA) burn estimation. Existing %TBSA burn estimation models (eg, Lund-Browder chart and rule of nines) were derived from a linear formula and a limited number of individuals a century ago and do not reflect the range of body ... Read more >>

JAMA Surg (JAMA surgery)
[2021, :]

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Rib Fracture Frailty Index: A risk stratification tool for geriatric patients with multiple rib fractures.

Jeff Choi, Ben J Marafino, Edward B Vendrow, Lakshika Tennakoon, Michael Baiocchi, David A Spain, Joseph D Forrester,

<h4>Background</h4>Rib fractures are consequential injuries for geriatric patients (age, ≥65 years). Although age and injury patterns drive many rib fracture management decisions, the impact of frailty-which baseline conditions affect rib fracture-specific outcomes-remains unclear for geriatric patients. We aimed to develop and validate the Rib Fracture Frailty (RFF) Index, a practical ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2021, 91(6):932-939]

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Trauma and Acute Care Surgery: The Evolution of a Specialty.

J David Richardson, David A Spain, David H Livingston,

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2021, :]

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Financial Burden of Traumatic Injury Amongst the Privately Insured.

Sue J Fu, Katherine Arnow, Amber Trickey, David A Spain, Arden Morris, Lisa Knowlton,

<h4>Objective</h4>We sought to evaluate the overall financial burden associated with traumatic injury amongst patients with private insurance and assess the effect of high deductible plans on out-of-pocket costs.<h4>Summary background data</h4>Traumatic injury can be a source of unexpected financial burden for households. However, the effect of increasing participation in higher cost-sharing ... Read more >>

Ann Surg (Annals of surgery)
[2021, :]

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Outcomes of the First Virtual General Surgery Certifying Exam of the American Board of Surgery.

Herbert Chen, Jennifer F Tseng, Rabih Chaer, David A Spain, John H Stewart, Daniel Dent, Beatriz Ibáñez, Carol L Barry, Andrew T Jones, Jo Buyske,

<h4>Objective</h4>To Study the Outcomes of the First Virtual General Surgery Certifying Exam of the American Board of Surgery.<h4>Summary of background data</h4>The ABS General Surgery CE is normally an in-person oral examination. Due to the COVID-19 outbreak, the ABS was required to reschedule these. After 2 small pilots, the CE's October ... Read more >>

Ann Surg (Annals of surgery)
[2021, 274(3):467-472]

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Evidence-based surgery for laparoscopic appendectomy: A stepwise systematic review.

Kovi E Bessoff, Jeff Choi, Christopher J Wolff, Aditi Kashikar, Garrison M Carlos, Luke Caddell, Rida I Khan, Christopher D Stave, David A Spain, Joseph D Forrester,

<h4>Introduction</h4>Appendectomy is a common emergency surgery performed globally. Despite the frequency of laparoscopic appendectomy, consensus does not exist on the best way to perform each procedural step. We identified literature on key intraoperative steps to inform best technical practice during laparoscopic appendectomy.<h4>Methods</h4>Research questions were framed using the population, indication, comparison, ... Read more >>

Surg Open Sci (Surgery open science)
[2021, 6:29-39]

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Acquisition of Medicaid at the time of injury: An opportunity for sustainable insurance coverage.

Joshua D Jaramillo, Katherine Arnow, Amber W Trickey, Katherine Dickerson, Todd H Wagner, Alex H S Harris, Linda D Tran, Sylvia Bereknyei, Arden M Morris, David A Spain, Lisa Marie Knowlton,

<h4>Introduction</h4>Uninsured trauma patients are at higher risk of mortality, limited access to postdischarge resources, and catastrophic health expenditure. Hospital Presumptive Eligibility (HPE), enacted with the 2014 Affordable Care Act, enables uninsured patients to be screened and acquired emergency Medicaid at the time of hospitalization. We sought to identify factors associated ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2021, 91(2):249-259]

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Citation Inaccuracies in Influential Surgical Journals.

Jeff Choi, Anshal Gupta, Aydin Kaghazchi, Thinzar S Htwe, Michael Baiocchi, David A Spain,

JAMA Surg (JAMA surgery)
[2021, 156(8):791-792]

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Factors Associated With General Surgery Residents' Operative Experience During the COVID-19 Pandemic.

Amanda C Purdy, Christian de Virgilio, Amy H Kaji, Edgar Shields Frey, Steven Lee-Kong, Kenji Inaba, Jeffrey M Gauvin, Angela L Neville, Timothy R Donahue, Brian R Smith, Edgardo S Salcedo, Kristine E Calhoun, V Prasad Poola, Jukes P Namm, David A Spain, Karen J Dickinson, Tiffany Tanner, Mary Wolfe, Farin Amersi,

<h4>Importance</h4>The suspension of elective operations in March 2020 to prepare for the COVID-19 surge posed significant challenges to resident education. To mitigate the potential negative effects of COVID-19 on surgical education, it is important to quantify how the pandemic influenced resident operative volume.<h4>Objective</h4>To examine the association of the pandemic with ... Read more >>

JAMA Surg (JAMA surgery)
[2021, 156(8):767-774]

Cited: 3 times

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Scoping review of traumatic hemothorax: Evidence and knowledge gaps, from diagnosis to chest tube removal.

Jeff Choi, Joshua Villarreal, Wyatt Andersen, Jung Gi Min, Gavin Touponse, Connie Wong, David A Spain, Joseph D Forrester,

<h4>Background</h4>Traumatic hemothorax is a common injury that invites diagnostic and management strategy debates. Evidence-based management has been associated with improved care efficiency. However, the literature abounds with long-debated, re-emerging, and new questions. We aimed to consolidate up-to-date evidence on traumatic hemothoraces, focusing on clinical conundra debated in literature.<h4>Methods</h4>We conducted a ... Read more >>

Surgery (Surgery)
[2021, 170(4):1260-1267]

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COVID-19 Impact on Surgical Resident Education and Coping.

Clare Elizabeth Wise, Sylvia Bereknyei Merrell, Marzena Sasnal, Joseph D Forrester, Mary T Hawn, James N Lau, Dana T Lin, Ingrid S Schmiederer, David A Spain, Aussama K Nassar, Lisa Marie Knowlton,

<h4>Background</h4>Healthcare systems and surgical residency training programs have been significantly affected by the novel coronavirus disease 2019 (COVID-19) pandemic. A shelter-in-place and social distancing mandate went into effect in our county on March 16, 2020, considerably altering clinical and educational operations. Along with the suspension of elective procedures, resident academic ... Read more >>

J Surg Res (The Journal of surgical research)
[2021, 264:534-543]

Cited: 2 times

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Concomitant Sternal Fractures: Harbinger of Worse Pulmonary Complications and Mortality in Patients With Rib Fractures.

Jeff Choi, Bianca Mulaney, Beatrice Sun, Richard Trimble, Lakshika Tennakoon, David A Spain, Joseph D Forrester,

<h4>Background</h4>Sternal and rib fractures are common concomitant injuries. However, the impact of concurrent sternal fractures on clinical outcomes of patients with rib fractures is unclear. We aimed to unveil the pulmonary morbidity and mortality impact of concomitant sternal fractures among patients with rib fractures.<h4>Methods</h4>We identified adult patients admitted with traumatic ... Read more >>

Am Surg (The American surgeon)
[2021, :3134821991978]

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Nationwide cost-effectiveness analysis of surgical stabilization of rib fractures by flail chest status and age groups.

Jeff Choi, Bianca Mulaney, Wasin Laohavinij, Richard Trimble, Lakshika Tennakoon, David A Spain, Joshua A Salomon, Jeremy D Goldhaber-Fiebert, Joseph D Forrester,

<h4>Background</h4>Surgical stabilization of rib fracture (SSRF) is increasingly used to manage patients with rib fractures. Benefits of performing SSRF appear variable, and the procedure is costly, necessitating cost-effectiveness analysis for distinct subgroups. We aimed to assess the cost-effectiveness of SSRF versus nonoperative management among patients with rib fractures younger than ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2021, 90(3):451-458]

Cited: 0 times

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Heterogeneity in managing rib fractures across non-trauma and level I, II, and III trauma centers.

Jeff Choi, Aydin Kaghazchi, Katherine L Dickerson, Lakshika Tennakoon, David A Spain, Joseph D Forrester,

<h4>Background</h4>We aimed to elucidate management patterns and outcomes of high-risk patients with rib fractures (elderly or flail chest) across non-trauma and trauma centers. We hypothesized highest-capacity (level I) centers would have best outcomes for high-risk patients.<h4>Methods</h4>We queried the 2016 National Emergency Department Sample to identify adults presenting with rib fractures. ... Read more >>

Am J Surg (American journal of surgery)
[2021, 222(4):849-854]

Cited: 1 time

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Outcomes after Surgery among Patients Diagnosed with One or More Multi-Drug-Resistant Organisms.

Anshal Gupta, Lakshika Tennakoon, David A Spain, Joseph D Forrester,

<b><i>Background:</i></b> Infections with multi-drug-resistant organisms (MDROs) may be difficult to treat and prolong patient hospitalization and recovery. Multiple MDRO coinfections may increase the complexity of clinical management. However, association between multiple MDROs and outcomes of patients who undergo surgery is unknown. <b><i>Patients and Methods:</i></b> We performed a retrospective, cross-sectional analysis ... Read more >>

Surg Infect (Larchmt) (Surgical infections)
[2021, 22(7):722-729]

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A Review of "Will Future Surgeons Be Interested in Trauma Care? Results of a Resident Survey" (1992).

David A Spain,

Am Surg (The American surgeon)
[2021, 87(2):191-194]

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Recurrent small bowel obstruction with intraluminal structures.

Beatrice J Sun, Kimberly E Kopecky, Patricia Garcia, David A Spain,

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2021, 90(1):e13-e15]

Cited: 0 times

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Prospective study of short-term quality-of-life after traumatic rib fractures.

Jeff Choi, Suleman Khan, Nicholas A Hakes, Garrison Carlos, Ryan Seltzer, Joshua D Jaramillo, David A Spain,

<h4>Background</h4>Postdischarge convalescence after traumatic rib fractures remains unclear. We hypothesized that patients with rib fractures, even as an isolated injury, have associated poor quality of life (QoL) after discharge.<h4>Methods</h4>We prospectively enrolled adult patients at our level I trauma center with rib fractures between July 2019 and January 2020. We assessed ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2021, 90(1):73-78]

Cited: 0 times

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A multi-institutional study assessing general surgery faculty teaching evaluations.

Adam D Shellito, Christian de Virgilio, Amy H Kaji, Darrel W Harrington, Jamie M Robertson, Nicole K Zern, David A Spain, Karen J Dickinson, Douglas S Smink, Nancy L Cho, Timothy Donahue, Cary B Aarons, Jukes P Namm, Farin Amersi, Tiffany N Tanner, Edgar Shields Frey, Benjamin T Jarman, Brian R Smith, Jeffrey M Gauvin, Karen J Brasel, Edgardo S Salcedo, Kenric Murayama, V Prasad Poola, Ebondo Mpinga, Kenji Inaba, Kristine E Calhoun,

<h4>Background</h4>Resident evaluation of faculty teaching is an important metric in general surgery training, however considerable variability in faculty teaching evaluation (FE) instruments exists.<h4>Study design</h4>Twenty-two general surgery programs provided their FE and program demographics. Three clinical education experts performed blinded assessment of FEs, assessing adherence 2018 ACGME common program standards and ... Read more >>

Am J Surg (American journal of surgery)
[2021, 222(2):334-340]

Cited: 0 times

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Prospectively Assigned AAST Grade versus Modified Hinchey Class and Acute Diverticulitis Outcomes.

Jeff Choi, Kovi Bessoff, Rebecca Bromley-Dulfano, Zelin Li, Anshal Gupta, Kathryn Taylor, Harsh Wadhwa, Ryan Seltzer, David A Spain, Lisa M Knowlton,

<h4>Background</h4>The American Association for the Surgery of Trauma (AAST) recently developed a classification system to standardize outcomes analyses for several emergency general surgery conditions. To highlight this system's full potential, we conducted a study integrating prospective AAST grade assignment within the electronic medical record.<h4>Methods</h4>Our institution integrated AAST grade assignment into ... Read more >>

J Surg Res (The Journal of surgical research)
[2021, 259:555-561]

Cited: 0 times

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Modified percutaneous tracheostomy in patients with COVID-19.

Beatrice J Sun, Christopher J Wolff, Hannah M Bechtold, Dwayne Free, Javier Lorenzo, Patrick R Minot, Paul G Maggio, David A Spain, Thomas G Weiser, Joseph D Forrester,

<h4>Background</h4>Patients hospitalized with COVID-19 are at risk of developing hypoxic respiratory failure and often require prolonged mechanical ventilation. Indication and timing to perform tracheostomy is controversial in patients with COVID-19.<h4>Methods</h4>This was a single-institution retrospective review of tracheostomies performed on patients admitted for COVID-19 between April 8, 2020 and August 1, ... Read more >>

Trauma Surg Acute Care Open (Trauma surgery & acute care open)
[2020, 5(1):e000625]

Cited: 2 times

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Surgical Stabilization of Rib Fracture to Mitigate Pulmonary Complication and Mortality: A Systematic Review and Bayesian Meta-Analysis.

Jeff Choi, Giselle I Gomez, Aydin Kaghazchi, John A Borghi, David A Spain, Joseph D Forrester,

J Am Coll Surg (Journal of the American College of Surgeons)
[2021, 232(2):211-219.e2]

Cited: 1 time

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Hospital Readmission After Climbing-Related Injury in the United States.

Joseph D Forrester, Kristin A Hunter, Lakshika Tennakoon, David A Spain,

INTRODUCTION:Rock climbing and mountaineering may result in injury requiring hospital admission. Readmission frequency after climbing-related injury is unknown. The aim of this study was to assess readmission frequency, morbidity, and mortality after admission for climbing-related injury. METHODS:We performed a retrospective analysis of the 2012 to 2014 national readmission database, a ... Read more >>

Wilderness Environ Med (Wilderness & environmental medicine)
[2020, 31(3):298-302]

Cited: 0 times

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Using a virtual platform for personal protective equipment education and training.

Aussama K Nassar, Dana T Lin, David A Spain, Lisa M Knowlton,

Med Educ (Medical education)
[2020, 54(11):1071-1072]

Cited: 1 time

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Pain Scores in Geriatric vs Nongeriatric Patients With Rib Fractures.

Jeff Choi, Suleman Khan, Kirellos Zamary, Lakshika Tennakoon, David A Spain,

JAMA Surg (JAMA surgery)
[2020, 155(9):889-891]

Cited: 1 time

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