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Your search keyword '"HAWKINS, ALEXANDER T."' showing total 160 results
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13. The Association Between Solid Organ Transplant and Recurrence of Acute Diverticulitis: A National Assessment.

Author

Harrison, Noah J., Samuels, Lauren R., Dusetzina, Stacie B., Alexopoulos, Sophoclis P., Ziogas, Ioannis A., and Hawkins, Alexander T.

Abstract

Objective: The aim of this study was to compare rates and severity of recurrent acute diverticulitis in patients with and without solid organ transplant. Background: Immunocompromised solid organ transplant recipients have been considered higher risk for both recurrence and severity of acute diverticulitis. Current guidelines recommend an individualized approach for colectomy in these patients, but these are based on singlecenter data. Methods: We identified patients with acute diverticulitis using the Merative MarketScan commercial claims data from 2014 to 2020. Patients were classified by history of solid organ transplant. The primary outcome was recurrence of acute diverticulitis with an associated antibiotic prescription =60 days from the initial episode. Secondary outcomes included hospitalization, colectomy, and ostomy in patients with recurrence. Analyses used inverse probability weighting to adjust for imbalances in covariates. Results: Of 170,697 patients with evidence of acute diverticulitis, 442 (0.2%) had a history of solid organ transplantation. In the weighted cohort, among people who had not been censored at 1 year (n= 515), 112 (22%; 95% CI: 20%-25%) experienced a recurrence within the first year. Solid organ transplantation was not significantly associated with a risk of recurrence (hazard ratio=1.19; 95% CI: 0.94-1.50). There was also no statistically significant difference in the hospitalization rate for recurrent diverticulitis. Restricting the analysis to hospitalized recurrences, there was no statistically significant difference observed in either length of stay or discharge status. Conclusions: In this national analysis of commercially insured patients with acute diverticulitis we found no statistically significant differences in recurrence between those with and without a history of solid organ transplant. We do not support an aggressive colectomy strategy based on concern for increased recurrence rate and severity in a solid organ transplant population. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Diverticulitis: An Update From the Age Old Paradigm

Author

Hawkins, Alexander T., Wise, Paul E., Chan, Tiffany, Lee, Janet T., Glyn, Tamara, Wood, Verity, Eglinton, Timothy, Frizelle, Frank, Khan, Adil, Hall, Jason, Ilyas, M.I. Mohammed, Michailidou, Maria, Nfonsam, Valentine N., Cowan, Michelle L., Williams, Jennifer, Steele, Scott R., Alavi, Karim, Ellis, C. Tyler, Collins, Danielle, Winter, Des C., Zaghiyan, Karen, Gallo, Gaetano, Carvello, Michele, Spinelli, Antonino, and Lightner, Amy L.

Published
2020
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28. Short‐course radiation with consolidation chemotherapy does not increase operative morbidity compared to long‐course chemoradiation: A retrospective study of the US rectal cancer consortium.

Author

Bauer, Philip S., Gamboa, Adriana C., Otegbeye, Ebunoluwa E., Chapman, William C., Rivard, Samantha, Regenbogen, Scott, Mohammed, Maryam, Holder‐Murray, Jennifer, Wiseman, Jason T., Ejaz, Aslam, Edwards‐Hollingsworth, Kamren, Hawkins, Alexander T., Hunt, Steven R., Balch, Glen, and Silviera, Matthew L.

Published
2024
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32. A randomized trial of a specialist palliative care intervention for patients undergoing surgery for cancer: rationale and design of the Surgery for Cancer with Option of Palliative Care Expert (SCOPE) Trial

Author

Shinall, Jr, Myrick C., Hoskins, Aimee, Hawkins, Alexander T., Bailey, Christina, Brown, Alaina, Agarwal, Rajiv, Duggan, Maria C., Beskow, Laura M., Periyakoil, Vyjeyanthi S., Penson, David F., Jarrett, Ryan T., Chandrasekhar, Rameela, and Ely, E. Wesley

Published
2019
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38. Effects of Specialist Palliative Care for Patients Undergoing Major Abdominal Surgery for Cancer: A Randomized Clinical Trial.

Author

Shinall Jr, Myrick C., Martin, Sara F., Karlekar, Mohana, Hoskins, Aimee, Morgan, Ellis, Kiehl, Amy, Bryant, Patsy, Orun, Onur M., Raman, Rameela, Tillman, Benjamin F., Hawkins, Alexander T., Brown, Alaina J., Bailey, Christina E., Idrees, Kamran, Chang, Sam S., Smith Jr, Joseph A., Tan, Marcus C. B., Magge, Deepa, Penson, David, and Ely, E. Wesley

Published
2023
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46. Practical Considerations of Perioperative Assessment and Optimization in Major Colorectal Surgery.

Author

Hawkins, Alexander T. and McEvoy, Matthew D.

Abstract

Successful outcomes after colorectal surgery result not only from technique in the operating room, but also from optimization of the patient prior to surgery. This article will discuss the role of preoperative assessment and optimization in the colorectal surgery patient. Through discussion of the various clinical models, readers will understand the range of options available for optimization. This study will also present information on how to design a preoperative clinic and the barriers to success. [ABSTRACT FROM AUTHOR]

Published
2023
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47. Shared Decision-Making in General Surgery: Prospective Comparison of Telemedicine vs In-Person Visits.

Author

Hawkins, Alexander T., Ueland, Thomas, Aher, Chetan, Geiger, Timothy M., Spann, Matthew D., Horst, Sara N., Schafer, Isabella V., Fei Ye, Run Fan, and Sharp, Kenneth W.

Subjects
*MEDICAL consultation, *SCIENTIFIC observation, *CONFIDENCE intervals, *OPERATIVE surgery, *RESEARCH methodology, *PATIENT satisfaction, *REGRESSION analysis, *DECISION making, *QUESTIONNAIRES, *MEDICAL referrals, *DESCRIPTIVE statistics, *MEDICAL appointments, *ODDS ratio, *THEMATIC analysis, *LOGISTIC regression analysis, *DATA analysis software, *TELEMEDICINE, *LONGITUDINAL method
Abstract

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has accelerated a shift toward virtual telemedicine appointments with surgeons. While this form of healthcare delivery has potential benefits for both patients and surgeons, the quality of these interactions remains largely unstudied. We hypothesize that telemedicine visits are associated with lower quality of shared decision-making. STUDY DESIGN: We performed a mixed-methods, prospective, observational cohort trial. All patients presenting for a first-time visit at general surgery clinics between May 2021 and June 2022 were included. Patients were categorized by type of visit: in-person vs telemedicine. The primary outcome was the level of shared decision-making as captured by top box scores of the Collabo-RATE measure. Secondary outcomes included quality of shared decision-making as captured by the 9-item Shared Decision-Making Questionnaire and satisfaction with consultation survey. An adjusted analysis was performed accounting for potential confounders. A qualitative analysis of open-ended questions for both patients and practitioners was performed. RESULTS: During a 13-month study period, 387 patients were enrolled, of which 301 (77.8%) underwent in-person visits and 86 (22.2%) underwent telemedicine visits. The groups were similar in age, sex, employment, education, and generic quality-of-life scores. In an adjusted analysis, a visit type of telemedicine was not associated with either the Collabo-RATE top box score (odds ratio 1.27; 95% CI 0.74 to 2.20) or 9-item Shared Decision-Making Questionnaire (β -0.60; p = 0.76). Similarly, there was no difference in other outcomes. Themes from qualitative patient and surgeon responses included physical presence, time investment, appropriateness for visit purpose, technical difficulties, and communication quality CONCLUSIONS: In this large, prospective study, there does not appear to be a difference in quality of shared decision making in patients undergoing in-person vs telemedicine appointments. [ABSTRACT FROM AUTHOR]

Published
2023
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