{"title":"Evaluation of Emergency Department Utilization Within 30 Days of Same-Day Gynecologic Surgery at a Mid-Atlantic Teaching Hospital","authors":"A. Snyder, Sushma Ahmad, S. Shobeiri, J. Alshiek","doi":"10.1089/gyn.2023.0003","DOIUrl":"https://doi.org/10.1089/gyn.2023.0003","url":null,"abstract":"","PeriodicalId":44791,"journal":{"name":"JOURNAL OF GYNECOLOGIC SURGERY","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45785271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. McClurg, R. Silverstein, K. Moore, M. Fliss, M. Louie
Objective: The effects of demographic and socioeconomic characteristics on delay of minimally invasive gynecologic surgery (MIGS) before and during the COVID-19 pandemic were studied. The primary outcome was interval between first MIGS appointment and date of surgery. Materials and Methods: This retrospective cohort study used electronic medical record data of a historical cohort who had benign MIGS in 2014-2016 (n = 370) and a cohort in 2020 during the COVID pandemic (n = 249). Included procedures were laparoscopic hysterectomy, myomectomy, adnexal surgery, or endometriosis excision. Patient demographics (race, ethnicity, age, marital status, language, insurance, and socioeconomic factors) were evaluated for associations with surgery delay (> 90 days from initial consultation to operating room date). Results: Median time to surgery was 21 days faster during the pandemic. In the historical cohort, 61% patients waited >90 days, and in the pandemic cohort, 47% patients waited >90 days. In the pandemic cohort, race and primary language were new factors associated with surgery delays. During the pandemic, a greater proportion of patients having surgery delays were Black or other races, compared to White, and a greater proportion did not speak English. After adjusting for referral indications, in multivariable logistic regression, patients who reported Other race had 3 times the odds of surgery delay, compared to White patients. Black patients had higher odds of surgery delay, although this estimate was less precise. Patients with a non-English primary language had >4 times the odds of surgery delay. Ethnicity, insurance and employment status, median household income, neighborhood segregation, and distance to hospital were not associated with surgery delay. Telemedicine accounted for 71% of visits in the pandemic cohort and was associated with a significant decrease in surgery delays with a median wait time of 87 days for patients seen via telemedicine, compared to 101 days for patients seen in-person. A higher proportion of patients using telemedicine were White and spoke English. Hispanic/Latino ethnicity, non-English primary language, and unemployment were associated with in-person versus telemedicine visits. Visit type was not correlated with insurance status, median household income, neighborhood segregation, and distance from the hospital. A risk score was calculated to summarize the estimated effect of intersectionality of multiple identities;multiple minority characteristics were correlated with surgery delays. Time to benign MIGS decreased from historical baselines during the pandemic, indicating improved access to surgical care. This benefit did not apply equally. Disproportionately, White patients who spoke English had no delays and used telemedicine;racial minority patients who did not speak English had greater odds of surgery delays and in-person appointments. Conclusions: Telemedicine can improve access to both MIGS care and surgical out
{"title":"Socioeconomic Factors Associated with Delay of Minimally Invasive Benign Gynecologic Surgery and Impact of the COVID-19 Pandemic","authors":"A. McClurg, R. Silverstein, K. Moore, M. Fliss, M. Louie","doi":"10.1089/gyn.2023.0006","DOIUrl":"https://doi.org/10.1089/gyn.2023.0006","url":null,"abstract":"Objective: The effects of demographic and socioeconomic characteristics on delay of minimally invasive gynecologic surgery (MIGS) before and during the COVID-19 pandemic were studied. The primary outcome was interval between first MIGS appointment and date of surgery. Materials and Methods: This retrospective cohort study used electronic medical record data of a historical cohort who had benign MIGS in 2014-2016 (n = 370) and a cohort in 2020 during the COVID pandemic (n = 249). Included procedures were laparoscopic hysterectomy, myomectomy, adnexal surgery, or endometriosis excision. Patient demographics (race, ethnicity, age, marital status, language, insurance, and socioeconomic factors) were evaluated for associations with surgery delay (> 90 days from initial consultation to operating room date). Results: Median time to surgery was 21 days faster during the pandemic. In the historical cohort, 61% patients waited >90 days, and in the pandemic cohort, 47% patients waited >90 days. In the pandemic cohort, race and primary language were new factors associated with surgery delays. During the pandemic, a greater proportion of patients having surgery delays were Black or other races, compared to White, and a greater proportion did not speak English. After adjusting for referral indications, in multivariable logistic regression, patients who reported Other race had 3 times the odds of surgery delay, compared to White patients. Black patients had higher odds of surgery delay, although this estimate was less precise. Patients with a non-English primary language had >4 times the odds of surgery delay. Ethnicity, insurance and employment status, median household income, neighborhood segregation, and distance to hospital were not associated with surgery delay. Telemedicine accounted for 71% of visits in the pandemic cohort and was associated with a significant decrease in surgery delays with a median wait time of 87 days for patients seen via telemedicine, compared to 101 days for patients seen in-person. A higher proportion of patients using telemedicine were White and spoke English. Hispanic/Latino ethnicity, non-English primary language, and unemployment were associated with in-person versus telemedicine visits. Visit type was not correlated with insurance status, median household income, neighborhood segregation, and distance from the hospital. A risk score was calculated to summarize the estimated effect of intersectionality of multiple identities;multiple minority characteristics were correlated with surgery delays. Time to benign MIGS decreased from historical baselines during the pandemic, indicating improved access to surgical care. This benefit did not apply equally. Disproportionately, White patients who spoke English had no delays and used telemedicine;racial minority patients who did not speak English had greater odds of surgery delays and in-person appointments. Conclusions: Telemedicine can improve access to both MIGS care and surgical out","PeriodicalId":44791,"journal":{"name":"JOURNAL OF GYNECOLOGIC SURGERY","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42986346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adverse Events When Using Advanced Sealing Devices During Vaginal Hysterectomy: An Analysis of the Manufacturer and User Facility Device Experience (MAUDE) Database","authors":"Prottusha Sarkar, Lulu Yu, P. Urbina, M. Milad","doi":"10.1089/gyn.2022.0116","DOIUrl":"https://doi.org/10.1089/gyn.2022.0116","url":null,"abstract":"","PeriodicalId":44791,"journal":{"name":"JOURNAL OF GYNECOLOGIC SURGERY","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48158039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Identification of 3 Subtypes of Isolated Fallopian Tube Torsion in 19 Laparoscopically Confirmed Cases: Case Series and Literature Review","authors":"A. Takeda, W. Koike","doi":"10.1089/gyn.2022.0111","DOIUrl":"https://doi.org/10.1089/gyn.2022.0111","url":null,"abstract":"","PeriodicalId":44791,"journal":{"name":"JOURNAL OF GYNECOLOGIC SURGERY","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48566350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Surgical Management of Fecal Incontinence: A Historical Perspective","authors":"Simone Fertel, K. Propst","doi":"10.1089/gyn.2023.0002","DOIUrl":"https://doi.org/10.1089/gyn.2023.0002","url":null,"abstract":"","PeriodicalId":44791,"journal":{"name":"JOURNAL OF GYNECOLOGIC SURGERY","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42404819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Disease, a Syndrome, or Both?","authors":"M. Hoffman","doi":"10.1089/gyn.2023.0025","DOIUrl":"https://doi.org/10.1089/gyn.2023.0025","url":null,"abstract":"","PeriodicalId":44791,"journal":{"name":"JOURNAL OF GYNECOLOGIC SURGERY","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49012782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Simrit K. Warring, D. Narasimhulu, Amanika Kumar, C. Langstraat, Amy L. Weaver, M. McGree, W. Cliby
{"title":"Next Steps Toward Reducing Surgical Morbidity After Complex Cytoreductive Surgery in Fit Surgical Patients","authors":"Simrit K. Warring, D. Narasimhulu, Amanika Kumar, C. Langstraat, Amy L. Weaver, M. McGree, W. Cliby","doi":"10.1089/gyn.2022.0114","DOIUrl":"https://doi.org/10.1089/gyn.2022.0114","url":null,"abstract":"","PeriodicalId":44791,"journal":{"name":"JOURNAL OF GYNECOLOGIC SURGERY","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43240635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rimpi Singla, V. Suri, Snigdha Veeramalla, N. Shafiq, M. Rohilla, J. Kalra
{"title":"Ensuring Compliance with Surgical Antimicrobial Prophylaxis Policy in High-Volume Resource-Limited Settings: Integrated Measures from Inception to Audit","authors":"Rimpi Singla, V. Suri, Snigdha Veeramalla, N. Shafiq, M. Rohilla, J. Kalra","doi":"10.1089/gyn.2022.0103","DOIUrl":"https://doi.org/10.1089/gyn.2022.0103","url":null,"abstract":"","PeriodicalId":44791,"journal":{"name":"JOURNAL OF GYNECOLOGIC SURGERY","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43242198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nodular Adenomyosis of the Fallopian Tube","authors":"R. Kauffman, A.G. Alfaro","doi":"10.1089/gyn.2023.0005","DOIUrl":"https://doi.org/10.1089/gyn.2023.0005","url":null,"abstract":"","PeriodicalId":44791,"journal":{"name":"JOURNAL OF GYNECOLOGIC SURGERY","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43694552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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