Joshua Philip Parreco

Joshua Philip Parreco
Memorial Healthcare System · Department of Trauma Critical Care Surgery

MD

About

105
Publications
4,623
Reads
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483
Citations
Additional affiliations
August 2019 - February 2021
Lawnwood Regional Medical Center
Position
  • Trauma Critical Care Surgeon
August 2018 - August 2019
University of Miami Miller School of Medicine
Position
  • Fellow
July 2013 - June 2018
University of Miami
Position
  • General Surgery Resident
Education
July 2009 - May 2013
University of Miami Miller School of Medicine
Field of study

Publications

Publications (105)
Article
Purpose: The purpose of this study was to compare machine learning techniques for predicting central line-associated bloodstream infection (CLABSI). Materials and methods: The Multiparameter Intelligent Monitoring in Intensive Care III database was queried for all ICU admissions. The variables included six different severities of illness scores...
Article
Full-text available
Hospitalization for violent trauma costs as much as $8.5 billion per year in the United States, and reinjury rates are as high as 40%.¹ Most trauma reinjury studies include data from a single center. However, nearly 60% of reinjured patients present to a different hospital, making prediction of reinjury difficult.¹,2 Machine learning allows compute...
Article
Full-text available
Objective: To compare the risk factors and costs associated with readmission after firearm injury nationally, including different hospitals. Background: No national studies capture readmission to different hospitals after firearm injury. Methods: The 2013 to 2014 Nationwide Readmissions Database was queried for patients admitted after firearm...
Article
Full-text available
Background: Most prior studies of readmission after trauma have been limited to single institutions while multi-institutional studies have been limited to single states and an inability to distinguish between elective and nonelective readmissions. The purpose of this study was to identify the risk factors and costs associated with nonelective read...
Article
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Background: A significant proportion of postoperative readmission occurs at a different hospital and is thus missed by current benchmarking. There are no national studies tracking readmission at different hospitals after colorectal surgery. This study aimed to determine the national burden of postoperative colorectal readmission, including readmis...
Article
Introduction: Diverticular disease is one of the most common gastrointestinal diseases that require hospital admission. This study aims to identify trends in prior hospital admissions for patients that ultimately require a Hartmann's procedure for complicated diverticulitis. Methods: The Nationwide Readmissions Database for 2010-2014 was queried...
Article
Purpose Surgical management of pediatric ovarian torsion includes total oophorectomy (TO) or ovarian preservation surgery (OPS). This study sought to identify factors contributing to surgical management and readmission outcomes for ovarian torsion. Methods The Nationwide Readmission Database from 2010-2014 was used to identify patients < 18 years...
Article
Purpose: Pediatric patients with Crohn's disease often require colectomies. The laparoscopic approach is considered safe, but there is little national data on outcomes and readmissions in this population. Methods: The Nationwide Readmissions Database was queried from 2010-2014 for patients ≤ 18 years who underwent colectomy for Crohn's disease duri...
Article
Background This study aims to compare the morbidity of open versus laparoscopic colectomy or proctocolectomy for pediatric patients with ulcerative colitis (UC) using national readmission outcomes. Materials and Methods The 2010-2014 Nationwide Readmissions Database was used to identify patients ≤ 18 years (excluding newborns) who underwent colect...
Article
Purpose Pyloromyotomy for hypertrophic pyloric stenosis (HPS) is one of the most common non-elective operations performed in the neonatal period. This project aims to explore outcomes of pyloromyotomy and compare differences between laparoscopic versus open pyloromyotomies in newborns diagnosed with HPS. Methods The Nationwide Readmissions Databas...
Article
Purpose: Fundoplications are a common operation in the pediatric population. This study aims to explore outcomes comparing laparoscopic versus open operative techniques. Methods: From 2010 to 2014 the Nationwide Readmissions Database was used to identify patients aged 0-18 years who underwent a fundoplication. Propensity score matched analysis was...
Article
Background: There are few nationwide studies comparing outcomes of open, laparoscopic (LAP), and percutaneous endoscopic (PEG) gastrostomy tube (GT) placement in the pediatric population. Materials and Methods: The Nationwide Readmissions Database from 2010 to 2014 was used to identify patients ≤18 years (excluding newborns) who underwent GT placem...
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Objective: To quantify the proportion of postpartum VTE readmissions, including those that occur at different hospitals from index admission, and describe risk factors for this outcome. Design: Retrospective observational study. Setting: United States hospitals included in the Nationwide Readmissions Database. Sample: A total of 3,719,238 pa...
Article
Background Laparoscopic Ladd's procedure has been proven safe and effective for the treatment of malrotation. However, the nationwide utilization and outcomes of elective Ladd's procedure are largely unknown. Methods The Nationwide Readmissions Database from 2010-2014 was used to identify patients 0-18 years (excluding newborns) with malrotation w...
Article
Background: Randomized controlled trials (RCTs) are generally regarded as the gold standard for demonstrating causality because they effectively mitigate bias from both known and unknown confounders. However, conducting an RCT is not always feasible because of logistical and ethical considerations. This is especially true when evaluating surgical i...
Article
Background: There are no national studies of nonelective readmissions after emergency general surgery (EGS) diagnoses that track non-index hospital readmission. We sought to determine the rate of overall and non-index hospital readmissions at 30 and 90 days after discharge for EGS diagnoses, hypothesizing a significant portion would be to non-inde...
Preprint
Full-text available
Background Of the few studies comparing simultaneous versus staged resection of primary colorectal cancer and synchronous liver metastases, most are limited to resections performed at the same facility. This study was performed to compare outcomes of simultaneous versus staged resection in these patients, including resections performed at a differe...
Article
Objective: Inferior vena cava (IVC) injuries have a high mortality rate that may be related to the location of injury and type of repair. Previous studies have been either single center series or database studies lacking granular detail. These have reported conflicting results. We aimed to perform a systematic review and meta-analysis of published...
Article
Background The dogma of early inguinal hernia repair in infants, especially those born prematurely, has dominated clinical practice owing to reports of a high frequency of incarceration and significant complications associated with untreated inguinal hernias. We aim to evaluate the frequency of complications after discharge with delayed surgery for...
Article
Background The purpose of this study was to identify the pattern of injuries that relates to abuse and neglect in children with burn injuries. Methods The Nationwide Readmissions Database for 2010-2014 was queried for all patients aged less than 18 y admitted with burn injuries. The primary outcome was child maltreatment identified at the index ad...
Article
Background Kasai portoenterostomy (KPE) remains the first-line operation for patients with biliary atresia (BA), but ultimately fails in up to 60% of cases. This study sought to identify factors contributing to hospital readmission and early liver transplant. Methods The Nationwide Readmissions Database from 2010 to 2014 was used to identify patie...
Article
Purpose Congenital diaphragmatic hernia (CDH) is a congenital anomaly associated with lifelong multisystem morbidity. This study sought to identify factors contributing to hospital readmission after CDH repair. Methods The Nationwide Readmissions Database from 2010 to 2014 was used to identify patients with CDH who underwent surgical repair. Prima...
Article
Background: Parathyroidectomy is frequently performed as ambulatory surgery. This study seeks to characterize the socioeconomic factors that may impact the patient selection for outpatient parathyroidectomy. Methods: The 2016 Florida State Inpatient Database (SID) and the 2016 Florida State Ambulatory Surgery Database (SASD) were queried for all...
Article
Background: Prior studies of venous thromboembolism (VTE) after emergency general surgery (EGS) are not nationally representative nor do they fully capture readmissions to different hospitals. We hypothesized that different-hospital readmission accounted for a significant number of readmissions with VTE after EGS and that predictive factors would...
Article
Introduction: The incidence and significance of hyperparathyroidism in patients after bariatric surgery have been established to some degree; however, the impact it has on the national healthcare system has not. We sought to assess the risk of readmission and related comorbidities in this patient population. Methods: The Healthcare Cost and Util...
Article
Objectives Historically, carotid procedures incur a readmission rate of approximately 6%, however, these studies are not nationally representative and are limited to tracking only the index hospitals. We sought to to evaluate a nationally representative database for readmission rates (including different hospitals) after both CEA and CAS, and deter...
Article
Full-text available
Introduction Repeated pediatric assault should be a never event. The purpose of this study was to evaluate the readmission and reinjury patterns in pediatric victims of assault including readmissions to different hospitals across the US. Methods The 2010–2014 Nationwide Readmissions Database was queried for all nonelective admissions for patients...
Article
Background: Previous studies have shown that a notable portion of patients who are readmitted for reinjury after penetrating trauma present to a different hospital. The purpose of this study was to identify the risk factors for reinjury after penetrating trauma including reinjury admissions to different hospitals. Methods: The 2010-2014 Nationwi...
Article
Introduction: The efficacy of vitamin C (VitC) and thiamine (THMN) in patients admitted to the intensive care unit (ICU) with sepsis is unclear. The purpose of this study was to evaluate the effect of VitC and THMN on mortality and lactate clearance in ICU patients. We hypothesized that survival and lactate clearance would be improved when treated...
Article
Purpose: The purpose of this study is to identify determinants of mortality and hospital readmission in infants born with esophageal atresia ± tracheoesophageal fistula. Methods: The Nationwide Readmissions Database (2010-2014) was queried for newborns with a diagnosis of esophageal atresia. Outcomes included mortality and readmissions at 30-day...
Article
Background/Purpose Recurrent intussusception following successful non-operative reduction has previously been reported with a frequency of 8–12% based on data from individual institutions. Meanwhile, the timing of discharge after successful reduction continues to be debated. Here, we evaluate readmissions for recurrent intussusception in young chil...
Article
Purpose: No nationwide studies on hospital readmissions exist for children who have undergone pull-through operations for Hirschsprung disease. The study aim is to identify determinants of postoperative discharge outcomes and hospital readmissions in children with Hirschsprung disease. Methods: The Nationwide Readmissions Database for 2010-2014...
Article
Purpose: Pediatric firearm injury is a national crisis that inflicts significant trauma. No studies have captured risk factors for readmissions after firearm injury, including cost analysis. Methods: Nationwide Readmissions Database (2010-2014) was queried for patients <18 years admitted after acute firearm injury. Outcomes included mortality, l...
Article
Background: The efficacy of oral chlorhexidine (oCHG) for decontamination in intensive care unit (ICU) patients is controversial. The purpose of this study was to evaluate the effect of oCHG decontamination on the incidence of pneumonia, sepsis, and death in ICU patients. Methods: The Philips eICU database version 2.0 was queried for patients admi...
Article
Background: As nonoperative management (NOM) of blunt splenic injury (BSI) increases, understanding risks, especially infectious complications, becomes more important. There are no national studies on BSI outcomes that track readmissions across hospitals. Prior studies demonstrate that infection is a major cause of readmission after trauma and tha...
Article
Purpose: Child abuse is a national, often hidden, epidemic. The study objective was to determine at-risk populations that have been previously hospitalized prior to their admission for child abuse. Methods: The Nationwide Readmissions Database (NRD) was queried for all children hospitalized for abuse. Outcomes were previous admissions and diagno...
Article
Background: The Advanced Trauma Life Support (ATLS) shock classification has been accepted as the conceptual framework for clinicians caring for trauma patients. We sought to validate its ability to predict mortality, blood transfusion, and urgent intervention. Materials and methods: We performed a retrospective review of trauma patients using t...
Article
Full-text available
The safety of hepatectomy continues to improve and it holds a key role in the management of benign and malignant hepatic lesions. Laparoscopic and robotic approaches to hepatectomy are increasingly utilized. The purpose of this study was to compare outcomes and costs of laparoscopic and robotic vs. open approaches to hepatectomy and to determine th...
Article
Prior studies have used vital signs and laboratory measurements with conventional modeling techniques to predict acute kidney injury (AKI). The purpose of this study was to use the trend in vital signs and laboratory measurements with machine learning algorithms for predicting AKI in ICU patients. The eICU Collaborative Research Database was querie...
Article
The purpose of this study was to identify the risk factors for hospital readmission for child maltreatment after trauma, including admissions across different hospitals nationwide. The Nationwide Readmissions Database for 2010-2014 was queried for all patients younger than 18 years admitted for trauma. The primary outcome was readmission for child...
Article
Background: Hospital readmissions with 30 days after vascular surgical interventions have been associated with increased morbidity, mortality, and cost. Readmission rates, now a Centers for Medicare and Medicaid Services quality measure, have been studied in databases that have excluded certain payer types and states and have not accounted for rea...
Article
Full-text available
Up to one in three readmissions occur at a different hospital and are thus missed by current quality metrics. There are no national studies examining 30-day readmission, including to different hospitals, after umbilical hernia repair (UHR). We tested the hypothesis that a large proportion were readmitted to a different hospital, that risk factors f...
Article
Full-text available
Objective: Some drivers involved in motor vehicle crashes across the United States may be identified as at risk of subsequent injury by a similar mechanism. The purpose of this study was to perform a national review of the risk factors for hospitalization for a new injury due to a subsequent motor vehicle crash. It was hypothesized that presenting...
Article
Introduction: Hospital readmissions are tied to financial penalties and thus, significantly influence healthcare policy. Many current studies on readmissions lack national representation by not tracking readmissions across hospitals. The recently released Nationwide Readmission Database (NRD) is one of the most comprehensive national sources of re...
Article
Full-text available
Background: Trauma patients are at increased risk for venous thromboembolism (VTE). One in four trauma readmissions occur at a different hospital. There are no national studies measuring readmissions to different hospitals with VTE following trauma. Thus, the true national burden in trauma patients readmitted with VTE is unknown and can provide a...
Article
Full-text available
The purpose of this study was to use natural language processing of physician documentation to predict mortality in patients admitted to the surgical intensive care unit (SICU). The Multiparameter Intelligent Monitoring in Intensive Care III database was used to obtain SICU stays with six different severity of illness scores. Natural language proce...
Article
Full-text available
Background A significant proportion of readmissions occur at a different hospital than the index admission, and are thus missed by current quality metrics. No study has examined all-hospital adult 30-day readmission rates, including to different hospitals, following burn injury across the US. The purpose of this study was to evaluate nationwide rea...
Article
Introduction: Hospital readmissions are not only associated with increased mortality, morbidity and costs but also, with current healthcare reform, tied to significant financial and administrative penalties. Some studies show that patients undergoing vascular surgery may have higher than average readmission rates. The recently released Nationwide...
Article
Introduction Most trauma surgeons assume that serum creatinine (SCr) reflects glomerular filtration rate (GFR). However, new evidence suggests augmented renal clearance (ARC= creatinine clearance (CLCr) >130 ml/min) occurs in up to 60% of critically ill patients. ARC is associated with subtherapeutic drug concentrations, may lead to adverse clinica...
Article
Full-text available
Introduction The purpose of this study was to identify risk factors and costs associated with readmission after burn injury across the United States. Methods The 2010–2014 Nationwide Readmissions Database was queried for patients admitted for burn. Multivariate logistic regression identified risk factors for 30-day readmission at index and differe...
Article
Full-text available
Introduction Artificial intelligence has proven to be useful in a wide range of medical applications. The purpose of this study was to use artificial intelligence, through supervised machine learning, to predict sepsis in patients with burn injuries. Methods Burn-injured patients were identified from the 2010–2014 Nationwide Readmissions Database....
Article
Purpose: Parathyroidectomy is one of the most common procedures performed in the United States, and are increasingly being performed safely in the outpatient setting. However, complications from surgery can be life-threatening, and thus an understanding of who may be at risk is essential. We analyzed and compared the risk factors for patients read...
Article
Finkelstein P, Kichler K, Parreco J, Lopez-Viego M. Successful Whipple Procedure after Ivor-Lewis Esophagectomy with Right Gastroepiploic and Common Hepatic Artery Anastomosis. ACS Case Reviews in Surgery. 2018;1(5):15-18.