Scott Strassels

Scott Strassels
Atrium Health · Pharmacy

PharmD, PhD

About

137
Publications
19,290
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5,199
Citations

Publications

Publications (137)
Article
Background: Necrotizing soft tissue infections (NSTIs) are severe, rapidly spreading infections with high morbidity and mortality. Attempts to identify risk factors for mortality and morbidity have produced variable results. We hope to determine which factors across the NSTI population impact mortality, morbidities, and discharge disposition. Patie...
Article
Background Timely identification and management of sepsis in surgical patients is crucial, and transfer status may delay optimal treatment of these patients. The objective of this study was to compare in-house and 90-day mortality between patients primarily admitted or transferred into the surgical ICU (SICU) at a tertiary referral center. Materia...
Article
Pain is common in patients with cancer seeking emergency department (ED) care. Fifty percent of ED patients with cancer present with pain and 39% report pain at final ED pain assessment. Thus, ED practitioners seemingly remain challenged to manage pain in this population. Such findings support calls encouraging safe, effective, and timely pain mana...
Article
Background: Assess the relationship between availability of round-the-clock (RTC) in-house intensivists and patient outcomes in people who underwent surgery for a life-threatening emergency general surgery (LT-EGS) disease such as necrotizing soft-tissue infection, ischemic enteritis, perforated viscus, and toxic colitis. Methods: Data on hospit...
Article
Background Patients presenting with acute abdominal pain often undergo a computed tomography (CT) scan as part of their diagnostic workup. We investigated the relationship between availability, timeliness, and interpretation of CT imaging and outcomes for life-threatening intra-abdominal diseases or “acute abdomen,” in older Americans. Methods Dat...
Article
Background: Neoplasm-related pain is often suboptimally treated, contributing to avoidable suffering and increased medical resource use and costs. We hypothesized that dementia may contribute to increased resource use and costs in patients hospitalized for neoplasm-related pain in the United States. Aims: To examine how persons with cancer and d...
Article
Background Necrotizing soft-tissue infections (NSTIs) encompass a group of severe, life-threatening diseases with high morbidity and mortality. Evidence suggests advanced age is associated with worse outcomes. To date, no large data sets exist describing outcomes in older individuals, and risk factor identification is lacking. Methods Retrospectiv...
Article
Background Emergency general surgery has higher adverse outcomes than elective surgery. Patients leaving the hospital against medical advice (AMA) have a greater risk for readmission and complications. We sought to identify clinical and demographic characteristics along with hospital factors associated with leaving AMA after EGS operations. Method...
Article
Full-text available
Background: Acute Care Surgery (ACS) was developed as a structured, team-based approach to providing round-the-clock emergency general surgery (EGS) care for adult patients needing treatment for diseases such as cholecystitis, gastrointestinal perforation, and necrotizing fasciitis. Lacking any prior evidence on optimizing outcomes for EGS patient...
Article
Background: Cholecystectomy is considered a low-risk procedure with proven safety in many high-risk patient populations. However, the risk of cholecystectomy in patients with active cancer has not been established. Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database was queried to identify...
Article
Purpose We examined differences in critical care structures and processes between hospitals with Acute Care Surgery (ACS) versus general surgeon on call (GSOC) models for emergency general surgery (EGS) care. Methods 2811 EGS-capable hospitals were surveyed to examine structures and processes including critical care domains and ACS implementation....
Article
Background Initiation of parenteral nutrition (PN) after a period of starvation can be complicated by refeeding syndrome (RFS). RFSs is associated with electrolyte abnormalities including hypomagnesemia, hyponatremia, and most commonly hypophosphatemia. Risk factors associated with the development of RFS include recent weight loss, low BMI, and ele...
Article
Background In response to duty hour restrictions, hospitals expanded residency programs and added advanced practice providers (APPs). We sought to determine if type of clinical support was associated with emergency general surgery (EGS) outcomes. Methods As part of our 2015 survey of acute care hospitals, we asked hospitals whether residents and A...
Article
Full-text available
Clinical empathy is the ability to understand the patient's experience, communicate that understanding, and act on it. There is evidence that patient and physician benefits are associated with more empathic communications. These include higher patient and physician satisfaction, improved quality of life, and decreased professional burnout for physi...
Article
Background Small bowel obstruction (SBO) no longer mandates urgent surgical evaluation raising the question of the role of operating room (OR) access on SBO outcomes.Methods Data from our 2015 survey on emergency general surgery (EGS) practices, including queries on OR availability and surgical staffing, were anonymously linked to adult SBO patient...
Article
BACKGROUND CONTEXT Obese patients, particularly those with a body mass index (BMI) ≥35 kg/m², pose a major challenge for a spine surgeon. Though obesity has previously been shown to be linked with adverse outcomes following elective spine surgical procedures, the impact of prior bariatric surgery on altering postoperative outcomes following electiv...
Article
To the Editor Dr Sun and colleagues¹ performed a large database analysis of 66 430 overlapping surgical procedures. However, the challenges of large database studies include insufficiently granular data that may affect interpretation of the results.
Article
Objectives: To examine loss of community-dwelling status 9 months after hospitalization for high-acuity emergency general surgery (HA-EGS) disease among older Americans. Design: Retrospective analysis of claims data. Setting: US communities with Medicare beneficiaries. Participants: Medicare beneficiaries age 65 years or older hospitalized u...
Article
Background: In parallel to women entering general surgery training, acute care surgery (ACS) has been developing as a team-based approach to emergency general surgery (EGS). We sought to examine predictors of women surgeons in EGS generally, and ACS particularly. Methods: From our national survey, we determined the proportion of women surgeons w...
Article
Background: Emergency general surgery can have a profound impact on the functional status of even previously independent patients. The role and influence of discharging a patient to a skilled nursing facility, however, remains largely unknown. Methods: We queried the American College of Surgeons National Surgical Quality Improvement Program for...
Article
Introduction: Timely access to the operating room (OR) for emergency general surgery (EGS) diseases is key to optimizing outcomes. We conducted a national survey on EGS structures and processes to examine if implementation of acute care surgery (ACS) would improve OR accessibility compared to a traditional general surgeon on call (GSOC) approach....
Article
Background: Few diseases truly require emergency surgery today. We investigated the relationship between access to OR and outcomes for patients with life-threatening emergency general surgery (LT-EGS) diseases at US hospitals. Methods: In 2015, we surveyed 2,811 US hospitals on EGS practices, including how OR access is assured (e.g., OR staffing...
Article
Full-text available
Purpose Despite the rise in opioid-related hospitalizations, there has been little research regarding opioid-related healthcare utilization. The objective of this study was to estimate the mean adjusted hospital costs, payments, and length of stay (LOS) for opioid-related visits for the nation and each of the nine US census regions. Methods An obs...
Article
Introduction: The provision of safe, effective, cost-efficient perioperative inpatient acute pain management is an important concern among clinicians and administrators within healthcare institutions. Overreliance on opioid monotherapy in this setting continues to present health risks for patients and increase healthcare costs resulting from preve...
Article
Introduction: Recovery from orthopedic surgery is oriented towards restoring functional health outcomes while reducing hospital length of stay (LOS) and medical expenditures. Optimal pain management is a key to reaching these objectives. We sought to compare orthopedic surgery patients who received combination intravenous (IV) acetaminophen and IV...
Article
Full-text available
Unlabelled: Most patients who undergo surgical procedures experience acute postoperative pain, but evidence suggests that less than half report adequate postoperative pain relief. Many preoperative, intraoperative, and postoperative interventions and management strategies are available for reducing and managing postoperative pain. The American Pai...
Article
Objectives: Severe pain after joint replacement surgeries is common and is usually managed by opioid analgesics. We described joint replacement surgery patients who received prescriptions for long-acting opioids (LAOs) and compared their health care utilization and costs with postsurgical patients who did not receive LAO prescriptions. Materials...
Article
Objective: Equianalgesic conversion methods are commonly used to switch patients from one opioid to another due to suboptimal pain relief or adverse events. There is no universally accepted opioid conversion method, however, and there is often significant variability between conversion resources. As a result, patients are at risk for undertreated...
Article
Full-text available
Enriched enrolment, randomised withdrawal (EERW) pain trials select, before randomisation, patients who respond by demonstrating a predetermined degree of pain relief and acceptance of adverse events. There is uncertainty over the value of this design. We report a systematic review of EERW trials in chronic noncancer pain together with a critical a...
Article
Full-text available
Reason for withdrawal from publication This review is out of date, although it is correct at the date of publication. The review may be misleading as new studies could alter the original conclusions. All previous versions of the review can be found in the ‘Other versions’ tab. A new author team intends to develop four new reviews on this topic, whi...
Article
Full-text available
Enriched-enrolment randomised-withdrawal (EERW) pain trials select, before randomisation, patients who respond by demonstrating a predetermined degree of pain relief and acceptance of adverse events. There is uncertainty over the value of this design. We report a systematic review of EERW trials in chronic non-cancer pain together with a critical a...
Article
There is no question that pain of all types is common and that the resulting epidemiologic, economic, and human burden is substantial. In 2011, the Institute of Medicine estimated that 100 million American adults are affected by chronic pain of any type and that associated costs (including lost productivity) are as high as $635 billion [1]. Pain is...
Article
Background: Pain is very common in patients with cancer. Opioid analgesics, including codeine, play a significant role in major guidelines on the management of cancer pain, particularly for mild to moderate pain. Codeine is widely available and inexpensive, which may make it a good choice, especially in low-resource settings. Its use is controvers...
Article
Objectives: To examine situations that prompt pharmacists to access a prescription drug monitoring program (PDMP) database and management of opioid abuse/addiction; assess pharmacists' actions when abuse is suspected; describe pharmacists' tasks when dispensing controlled substance prescriptions (CSPs); and their continuing pharmacy education (CPE...
Article
This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the analgesic efficacy and adverse event profile of meperidine for moderate to severe postoperative pain in adults and to directly or indirectly compare its effectiveness with other analgesics used in this setting.
Chapter
Opioid analgesics occupy a unique position in modern medicine. They are indispensable tools for the treatment of many types of moderate to severe pain, but are also the focus of intense attention and criticism in the biomedical literature, lay press, and media. This chapter discusses the epidemiology of painful conditions and diseases, as well as o...
Article
Full-text available
ABSTRACT The economic burden of prescription opioid abuse is substantial; however, no study has estimated the monetary burden of hospital services (emergency department [ED] and inpatient) using a single, nationally representative database. We sought to estimate total and average (adjusted for demographic and clinical factors) charges billed for op...
Article
Prescription drug monitoring programs (PDMPs) are state-operated electronic databases that contain patients' controlled drug histories. Most states provide these data to pharmacists via online web portals to combat prescription drug abuse and diversion. The objectives of this study were to: 1) explore the theory of planned behavior's (TPB) utility...
Article
This is the protocol for a review and there is no abstract. The objectives are as follows: To determine the efficacy and safety of codeine used alone or in combination with paracetamol for relieving cancer pain.
Article
Full-text available
Objective The objective of this project was to develop core competencies in pain assessment and management for prelicensure health professional education. Such core pain competencies common to all prelicensure health professionals have not been previously reported. Methods An interprofessional executive committee led a consensus-building process t...
Article
Epidural steroid injections (ESI) are the most commonly performed pain procedures. Despite numerous studies, controversy continues to surround their effectiveness. The purpose of this study is to determine whether a standard, clinical local anesthetic injection can predict outcomes for ESI. In this multicenter study, 103 patients received two ESI 2...
Article
Evidence-based medicine is often seen as something dry, formal, and statistical, often used to justify a proscriptive approach to medicine. A more attractive approach is to use our understanding of those aspects of studies that can mislead us to identify the evidence we can trust. Evidence can, and probably should, be based on patient-centred outco...
Article
Objectives: Diagnostic medial branch blocks (MBB) are considered the reference standard for diagnosing facetogenic pain and selecting patients for radiofrequency (RF) denervation. Great controversy exists regarding the ideal cutoff for designating a block as positive. The purpose of this study is to determine the optimal pain relief threshold for...
Article
Pain and symptoms related to palliative care (pain and palliative care [PPC]) are often undertreated. This is largely owing to the complexity in the provision of care and the potential discrepancy in education among the various health care professionals required to deliver care. Pharmacists are frequently involved in the care of PPC patients, altho...
Article
Prescription monitoring programs for controlled substances are increasingly common. Pitfalls and opportunities resulting from the data generated by these programs are discussed.
Article
Adherence to oral antidiabetic (OAD) medications is essential in achieving glycemic control and slowing the progression of diabeties-related complications such as neuropathic pain. OAD medication adherence has been suboptimal and adding neuropathic pain medications may negatively affect adherence. However, little is known about adherence to neuropa...
Article
Little has been done in assessing adherence to oral antidiabetic (OAD) medications in the pediatric population presenting with type 2 diabetes. This study provided information on adherence rates in the Texas Medicaid pediatric population with type 2 diabetes, which is rare in the literature. The knowledge of adherence rates in the pediatric populat...
Article
Studies have shown that radiologic imaging does not improve outcomes in most patients with back pain, though guidelines endorse it before epidural steroid injections (ESIs). The objective of this study was to determine whether magnetic resonance imaging (MRI) improves outcomes or affects decision making in patients with lumbosacral radiculopathy re...
Article
Radiofrequency facet denervation is one of the most frequently performed procedures for chronic low back pain. Although sensory stimulation is generally used as a surrogate measure to denote sufficient proximity of the electrode to the nerve, no study has examined whether stimulation threshold influences outcome. We prospectively recorded data in 6...
Article
Full-text available
Nonmilitary personnel play an increasingly critical role in modern wars. Stark differences exist between the demographic characteristics, training and missions of military and nonmilitary members. We examined the differences in types of injury and rates of returning to duty among nonmilitary and military personnel participating in military operatio...
Article
Symptom burden at the end of life is incompletely understood. To estimate the natural history of constipation and the relation of clinical and demographic characteristics to moderate or severe constipation among persons who received hospice care in the United States starting in 2005. Data were obtained from a national provider of hospice pharmacy s...
Article
Unlabelled: Quality improvement (QI) is a compilation of methods adapted from psychology, statistics, and operations research to identify factors that contribute to poor treatment outcomes and to design solutions for improvement. Valid and reliable measurement is essential to QI using rigorously developed and tested instruments. The purpose of thi...
Article
Among patients presenting with axial low back pain, facet arthropathy accounts for approximately 10-15% of cases. Facet interventions are the second most frequently performed procedures in pain clinics across the United States. Currently, there are no uniformly accepted criteria regarding how best to select patients for radiofrequency denervation....
Conference Paper
Objectives: The Strategic Planning Summit for the Advancement of Pain and Palliative Care Pharmacy was convened to identify opportunities to improve the education of pharmacists on this topic at all facets of their professional career (i.e. professional degree program, post-graduate training, continuing education endeavors, and credentialing). Sp...
Article
Anticipation of the types of injuries that occur in modern warfare is essential to plan operations and maintain a healthy military. We aimed to identify the diagnoses that result in most medical evacuations, and ascertain which demographic and clinical variables were associated with return to duty. Demographic and clinical data were prospectively o...
Article
This commentary refutes published assertions that opioid use is inherently dangerous and to be discouraged. A reasoned case for risk-to-benefit considerations is presented. Data from federal reporting systems are placed in perspective. The importance of using opioids rationally in pain management is supported.
Article
Neck pain is a frequent cause of disability, with facet joint arthropathy accounting for a large percentage of cases. The diagnosis of cervical facet joint pain is usually made with diagnostic blocks of the nerves that innervate them. Yet, medial branch blocks are associated with a high false-positive rate. One hypothesized cause of inaccurate diag...
Article
To determine the out-of-pocket prices of common opioid analgesics by medication, drug coverage, region, and year. Retrospective cohort study using 1999-2004 data from the Medical Expenditure Panel Survey and the Medicare Current Beneficiary Survey. U.S. civilian noninstitutionalized population. Adults not enrolled in Medicaid who filled prescriptio...
Article
Full-text available
Prescription opioid abuse and its associated costs are a problem in the United States, with significant epidemiologic and economic consequences. The breadth and depth of these consequences are not fully understood at present. To summarize published, English-language biomedical evidence pertaining to the epidemiology and costs of prescription opioid...
Article
Edited by Fitzhugh Mullan, Ellen Ficklen, and Kyna Rubin Published by The Johns Hopkins University Press, Baltimore, MD 21218-4363. 2006. 293 p. Price $40.00. A friend is fighting cancer for the third time. He is a father of three young children, a husband, and a patient; most of all, he is a
Article
Hospices provide end-of-life care for heart failure (HF) patients, but hospice is underused for these patients, and its use has not been well described. We examined hospice use among 11,754 HF and 31,228 cancer patients. These patients were either discharged from hospice or died while in hospice between January 1, 2004, and June 30, 2005. The perce...
Article
Sacroiliac (SI) joint pain is a challenging condition characterized by limited treatment options. Recently, numerous studies have reported excellent intermediate-term outcomes after lateral-branch radiofrequency (RF) denervation, but these studies are characterized by wide variability in technique, selection criteria, and patient characteristics. T...
Article
Full-text available
To determine whether fluoroscopic guidance improves outcomes of injections for greater trochanteric pain syndrome. Multicentre double blind randomised controlled study. Three academic and military treatment facilities in the United States and Germany. 65 patients with a clinical diagnosis of greater trochanteric pain syndrome. Injections of cortico...