Robin L Kruse's research while affiliated with Columbia College Missouri and other places

Publications (180)

Article
Introduction Failure to Rescue (FTR), defined as mortality following a complication of care, is an important indicator of hospital care quality. Understanding risk factors associated with FTR in the elective Abdominal Aortic Aneurysm (AAA) population may help surgeons prevent operative mortality. Methods Elective open AAA repairs (2008-2018) were...
Article
Objective Transition from the hospital to an outpatient setting is a multifaceted process requiring coordination among a variety of services and providers to ensure a high-quality discharge. Vascular surgery patients comprise a complex population that experiences high unplanned readmission rates. We performed a qualitative study to identify themes...
Article
Facebook® is a popular platform for older adults, especially as they try to stay in contact with their family around the country. It is also a popular platform for hosting online support groups. The readily available, socially acceptable, and free platform holds many advantages not only for older adults but also for nurse researchers designing and...
Article
Full-text available
Background: Identifying individual and neighborhood-level factors associated with worsening cardiometabolic risks despite clinic-based care coordination may help identify candidates for supplementary team-based care. Methods: Secondary data analysis of data from a two-year nurse-led care coordination program cohort of Medicare, Medicaid, dual-el...
Article
Objectives Fenestrated endovascular aneurysm repair (FEVAR) has emerged as a minimally invasive alternative for repairing complex abdominal aortic aneurysms (AAA). Comparisons of outcomes for FEVAR and traditional endovascular aneurysm repair (EVAR) are limited. We evaluated outcomes following elective endovascular AAA repair with FEVAR or EVAR. M...
Article
Objective Elective abdominal aortic aneurysm (AAA) repair in patients who carry a diagnosis of cancer is controversial. This study aims to evaluate in-hospital outcomes of patients undergoing aneurysm repair in the setting of a cancer diagnosis. Methods Inpatients (2008-2018) undergoing elective AAA repair were selected from Cerner Health Facts® d...
Article
Objectives Limited data exist evaluating pre-operative hemoglobin A1c (HbA1c) in patients undergoing vascular procedures for peripheral arterial disease (PAD). This study evaluated the relationship of preoperative HbA1c on outcomes after open and endovascular lower extremity (LE) vascular procedures for PAD. Methods We selected patients with PAD a...
Preprint
Full-text available
Background: Identifying clinical, sociodemographic, and neighborhood-level risk factors associated with less improvement or worsening cardiometabolic measures despite access to a clinic-based care coordination program may help identify candidates that need additional disease management support outside clinic walls. Methods: Secondary data analysis...
Article
Background: Understanding challenges of family caregivers within specific palliative care contexts is needed. Objective: To describe the challenges of family caregivers of patients with cancer who receive outpatient palliative care. Methods: We summarized the most common and most challenging problems for 80 family caregivers of cancer patients re...
Preprint
Introduction: Identifying individual and neighborhood-level factors associated with less improvement or worsening cardiometabolic measures in participants of clinic-based interventions may help identify candidates for supplementary community-based interventions. Methods: Study design: Secondary data analysis of data from care coordination program c...
Article
Objectives Endovascular aneurysm repair (EVAR) has emerged as a less invasive alternative to open repair for ruptured Abdominal Aortic Aneurysms (rAAA), but comparisons to traditional open rAAA repair and late complications leading to readmission are limited. Materials and Methods Hospitalizations for patients undergoing repair for rAAA were selec...
Article
The rise of hydraulic fracturing and unconventional oil and gas (UOG) exploration in the United States has increased public concerns for water contamination induced from hydraulic fracturing fluids and associated wastewater spills. Herein, we collected surface and groundwater samples across Garfield County, Colorado, a drilling-dense region, and me...
Article
Frailty has been associated with poor postoperative outcomes. This study evaluated the 5-factor modified frailty index (mFI-5) to assess complications, mortality, discharge disposition, and readmission in patients undergoing lower extremity (LE) bypass for critical limb ischemia (CLI).The National Surgical Quality Improvement Program vascular modul...
Article
Objective: We present the protocol of a study aiming to examine the efficacy of a technologically-mediated storytelling intervention called Caregiver Speaks in reducing distress and grief intensity experienced by active and bereaved hospice family caregivers of persons living with dementia (PLWD). Design: The study is a mixed-method, 2-group, ra...
Article
Background and Objectives Many family members struggle to negotiate their aging relative’s care with nursing home staff, potentially leading to depression and other negative outcomes for residents’ families. This pilot study tested an intervention designed to empower residents’ family members to attend and participate in nursing home care plan meet...
Article
Objective The current study evaluated all-cause 30-day readmissions after carotid endarterectomy. Methods Patients undergoing carotid endarterectomy were selected from the Cerner Health Facts® database using ICD-9-CM procedure codes from their index admission. Readmission within 30 days of discharge was determined. Chi-square analysis determined c...
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Full-text available
OBJECTIVES/GOALS: We examined how individual characteristics and characteristics of the socioeconomic and built environment were associated with care coordination’s effect on cardiovascular disease (CVD) risks to identify geographic areas that may benefit from supplementary clinic-community linkages. METHODS/STUDY POPULATION: We analyzed data with...
Article
Objective Low albumin has been associated with poor outcome, including death, in surgical patients. The mechanistic relationship, however, is more complex than simply nutritional. As studies are scant in the vascular population, we sought to examine the association of low albumin with outcomes in patients undergoing open and endovascular lower extr...
Article
Background and objective: Procedural skills assessment is critical in residency training. The Council of Academic Family Medicine recommends the Procedural Competency Assessment Tool (PCAT) for assessing procedure competence of family medicine residents. We sought to evaluate the reliability of the PCAT and to better identify its strengths and lim...
Article
Objective Peripheral artery disease (PAD) has been shown to affect health status and quality of life, however, the disability associated by specific anatomic level of disease is unknown. We evaluated patients presenting with claudication by anatomic level and utilized the Peripheral Artery Questionnaire (PAQ), a PAD-specific validated tool, to quan...
Article
Objective: Neutrophil-lymphocyte ratio (NLR) has been associated with inferior outcomes after lower extremity interventions. NLR has been associated with systemic inflammation and atherosclerotic burden. We examined NLR, severity of peripheral artery disease (PAD), and outcomes after endovascular or open surgical procedures. Methods: Inpatients...
Article
Data are lacking regarding real-time prediction of postoperative complications after elective aneurysm repair. The neutrophil-to-lymphocyte ratio (NLR) has been evaluated as a predictor of outcomes after cardiac and infrapopliteal interventions and is associated with poor outcomes for critical limb ischemia. We examined NLR and outcomes after abdom...
Article
Objective There are limited data evaluating the impact of postoperative hyperglycemia in patients undergoing vascular procedures. This study evaluated the relationship between suboptimal glucose control and adverse outcomes after carotid artery stenting and carotid endarterectomy. Methods Patients admitted for elective carotid procedures were sele...
Article
Context: Family caregivers play a vital role in managing the pain of hospice patients with cancer; however, caregivers' knowledge of pain management principles and experiences as pain managers vary widely. Differences in cultural values and access to resources suggest that rural and urban hospice family caregivers may differ with regard to their p...
Article
Context: There is a need for brief measurement instruments which do not cause burden to hospice caregivers. The Caregiver Quality of Life Index (CQLI) has been used in several studies but assessment of its psychometric properties has been minimal. The CQLI-R (revised) instrument was found to have equivalent properties but also has had minimal test...
Article
Context: Age-adjusted death rates for heart disease are higher in rural areas than in urban areas. Lay advisors could potentially facilitate improvement in cardiovascular health outcomes. The aim of this systematic review and meta-analysis is to estimate lay advisor intervention effects on cardiovascular health metrics in rural populations. Evide...
Article
Background: We conducted a retrospective cohort study of thirty-day readmission after abdominal aortic aneurysm (AAA) repair. Patients and methods: Inpatients (2009-2016) undergoing elective AAA repair were selected from the multicenter Cerner Health Facts® database using ICD-9 procedure codes. We identified characteristics associated with 30-day r...
Article
Background We aimed to find the best predictive model for 14-day mortality in antibiotic-treated nursing home residents with dementia and pneumonia by first applying an existing model to the recent PneuMonitor study. Second, we evaluated whether model performance improved by revising variables or adding variables related to recent changes in the ca...
Article
Background and objectives: Parenting during residency is increasingly common, and resident parents face unique demands on their time and emotional and cognitive resources. Physicians at all levels of training perceive negative impacts of parenting on career and family life. Surveys of program directors (PDs) in other specialties reveal concern abo...
Article
Objective: We evaluated the association between postoperative hyperglycemia and outcomes after abdominal aortic aneurysm (AAA) repair. Methods: We used diagnosis and procedure codes (International Classification of Diseases, Ninth Revision, Clinical Modification) to identify patients who underwent open or endovascular repair of a nonruptured AAA...
Article
Objective: To evaluate the ability to perform activities of daily living (ADLs) in patients who required nursing home (NH) care after radical cystectomy (RC), as this surgery can impair patients' ability to perform ADLs in the post-operative period. Methods: Patients undergoing RC were identified in a novel database of patients with at least 2 N...
Article
Background: Childhood obesity in the United States is a critical public health issue. Although multiple child and parental factors are associated with childhood obesity, few models evaluate how socioeconomic status influences these risk factors. We aimed to create a model to examine how socioeconomic status modifies risk factors for child obesity....
Article
Background and objectives: Procedural training is integral to family medicine residencies. Although accreditation bodies require that family medicine residency programs train residents in procedures relevant to their practices, there are no standards defining the scope of family medicine. We compared the perceived importance of 31 procedures by fa...
Article
Background: Understanding risk factors associated with readmission after lower extremity amputation may indicate targets for reducing readmission. Objective: This study evaluated factors associated with all-cause 30-day readmission after lower extremity amputation procedures. Design: Retrospective cohort study. Setting: Inpatient PATIENTS: A...
Article
Background: Race has been associated with inferior outcomes after multiple procedures, but the association of socioeconomic status with procedures for cerebrovascular disease is not well established. Materials and methods: Elective carotid artery stenting (CAS) and carotid endarterectomy (CEA) procedures were identified in the National Inpatient...
Article
Background This study evaluated risk factors associated with 30-day readmission after open and endovascular lower extremity revascularization. Methods Patients admitted with peripheral artery disease and lower extremity procedures were selected from national electronic medical record data, Cerner Health Facts® (2008–2014). Thirty-day readmission w...
Data
Multivariable conditional logistic regression of risk factors for endometrial cancer, including age at menarche and number of live births. (DOCX)
Data
Multivariable conditional logistic regression of risk factors for endometrial cancer, including unadjusted cadmium concentration and creatinine concentration. (DOCX)
Data
Multivariable conditional logistic regression of risk factors for endometrial cancer, including weight at least 50 pounds above ideal weight in the model. (DOCX)
Data
Multivariable conditional logistic regression of risk factors for endometrial cancer, excluding premenopausal women from the analysis. (DOCX)
Article
Full-text available
Estrogen-mimicking chemicals, such as cadmium, may be associated with increased susceptibility to hormone-dependent cancers, though supporting data are sparse, particularly for endometrial cancer. The Health and Environmental Exposure Research (HEER) study worked with the Arkansas Central Cancer Registry, Iowa Cancer Registry and Missouri Cancer Re...
Data
Multivariable conditional logistic regression of risk factors for endometrial cancer, excluding current smoking status from model. (DOCX)
Article
Research has shown that family caregivers often become socially isolated as they experience the burdens associated with caring for their loved one. The 24 hour nature of caregiving prohibits attendance at traditional support groups. Various small intervention studies across disease categories (Alzheimer’s, cancer, stroke, etc.) have tested Internet...
Article
Full-text available
This study investigates an information retrieval tool embedded in an electronic health record (EHR). 1-Search provides a single search for retrieving information from a variety of content sources. 1-Search's usefulness and impact were determined by measuring the extent of physicians' information needs, pre- and post-implementation user satisfaction...
Article
Objective: The effect of postoperative hyperglycemia in patients undergoing open and endovascular procedures on the lower extremities has not been fully characterized with regard to associated admission diagnoses, hospital complications, mortality, and 30-day readmission. This study evaluated the relationship of postoperative hyperglycemia on outc...
Article
Introduction: Family caregivers are socially isolated and burdened as they care for their loved one, often for many years. Internet support groups can address some of the barriers related to the social isolation, self-efficacy, and burden experienced during caregiving by connecting individuals with similar problems to one another. The purpose of t...
Article
Background: Lowering the 30-d re-admission rate after vascular surgery offers the potential to improve healthcare quality. This study evaluated re-admission associated with infections after open and endovascular lower extremity (LE) procedures for peripheral artery disease (PAD). Methods: Patients admitted for elective LE procedures for PAD were...
Article
Background and objectives: Little information is available on what competencies family medicine program directors expect of incoming residents and whether those incoming residents can deliver on such expectations. Our aim was to determine whether there is a common set of skills that both family medicine clerkship directors and program directors ag...
Article
Objective: To evaluate whether a model that was previously developed to predict 14-day mortality for nursing home residents with dementia and lower respiratory tract infection who received antibiotics could be applied to residents who were not treated with antibiotics. Specifically, in this same data set, to update the model using recalibration me...
Article
Background and objective: Untrained family caregivers struggle with complicated medical management regimens for hospice patients. An intervention was tested to improve caregiver's perception of pain management and patient's pain. Design, setting, and participants: The intervention was tested with a 2-group (usual care vs intervention) randomized...
Article
Conducting prospective studies in hospices can be difficult. We conducted a systematic review to find randomized trials that have been conducted in US hospices and to review them for quality and potential bias. Ten studies met our inclusion criteria; a wide variety of outcomes were studied. Most of the studies had at least moderate risk of bias due...
Article
Full-text available
Context: Family caregivers play a central role in the care of those in hospice care. Little is known about the social support networks for those providing this day-to-day care without training. Objectives: The purpose of this study was to explore changes in family and friend social networks among hospice caregivers over the course of the hospice...
Article
Although many trials have evaluated abdominal aortic aneurysm (AAA) repair, the impact of these procedures on the functional status of frail elderly patients is not well-described. The effects of elective open AAA repair (OAR) and endovascular AAA repair (EVAR) and comorbidities were evaluated for their impact on functional trajectories after disch...
Article
Although the benefits of exercise are well known, rates of exercise among residents are much lower than those of attendings or medical students. Little is known about the barriers that prevent residents from exercising regularly. This mixed methodology study identifies and compares these barriers for resident and attending physicians practicing in...
Article
Cilostazol, an antiplatelet agent with vasodilating properties, has not been well evaluated in conjunction lower extremity revascularization (LER). We evaluated the association between cilostazol and limb salvage after endovascular or open surgery for LER. Patients aged ≥65 years undergoing LER were identified from 2007 to 2008 Medicare Provider An...
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Full-text available
Objective: Even though more than 25% of Americans die in nursing homes, end-of-life care has consistently been found to be less than adequate in this setting. Even for those residents on hospice, end-of-life care has been found to be problematic. This study had 2 research questions; (1) How do family members of hospice nursing home residents diffe...
Article
Objective Assess the association between caregiver supervision and acute unintentional injury in young children; evaluate whether lower levels of supervision result in more severe injury. Methods A case cross-over study was conducted. Parents of children aged ≤4 years whose injuries required emergency department (ED sample) treatment or admission t...
Article
Objective: This study examined the prevalence of clinically significant anxiety among informal hospice caregivers and identified the characteristics of caregivers who experienced anxiety of this severity. Method: An exploratory secondary data analysis pooled from three separate studies of informal hospice caregivers (N = 433) was conducted. Rese...
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Full-text available
Objective: We evaluated rates and identified predictors of readmission in the Medicare population after carotid endarterectomy (CEA) compared to carotid artery stenting (CAS). Methods: MedPAR data (2005-2009) were used to select patients who underwent CEA or CAS (utilizing International Classification of Diseases, Ninth Revision, Clinical Modifi...
Article
The ability of nursing home residents to function independently is associated with their quality of life. The impact of amputations on functional status in this population remains unclear. This analysis evaluated the effect of amputations-transmetatarsal (TM), below-knee (BK), and above-knee (AK)-on the ability of residents to perform self-care act...
Article
Objective: Patient self-management support may be augmented by using home-based technologies that generate data points that providers can potentially use to make more timely changes in the patients' care. The purpose of this study was to evaluate the effectiveness of short-term targeted use of remote data transmission on treatment outcomes in pati...
Article
Background: Collective caregiving, performed by caregivers working in pairs (informal primary and secondary caregivers working together), is common in the hospice setting. Research suggests that caregiving pairs may experience different caregiver outcomes. However, little is known about how caregiving pairs differ from solo caregivers (informal pr...