{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:33:53Z","timestamp":1792787633025,"version":"4.5.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T00:00:00Z","timestamp":1716249600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100001502","name":"Blue Cross Blue Shield of Michigan Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001502","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Blue Care Network Collaborative Quality Initiatives"},{"DOI":"10.13039\/100009931","name":"Michigan Department of Health and Human Services","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009931","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Optimization of antibiotic stewardship requires determining appropriate antibiotic treatment and duration of use. Our current method of identifying infectious complications alone does not attempt to measure the resources actually utilized to treat infections in patients. We sought to develop a method accounting for treatment of infections and length of antibiotic administration to allow benchmarking of trauma hospitals with regard to days of antibiotic use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using trauma quality collaborative data from 35 American College of Surgeons (ACS)-verified level I and level II trauma centers between November 1, 2020, and January 31, 2023, a two-part model was created to account for (1) the odds of any antibiotic use, using logistic regression; and (2) the duration of usage, using negative binomial distribution. We adjusted for injury severity, presence\/type of infection (eg, ventilator-acquired pneumonia), infectious complications, and comorbid conditions. We performed observed-to-expected adjustments to calculate each center\u2019s risk-adjusted antibiotic days, bootstrapped Observed\/Expected (O\/E) ratios to create confidence intervals, and flagged potential high or low outliers as hospitals whose confidence intervals lay above or below the overall mean.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean antibiotic treatment days was 1.98\u00b0days with a total of 88,403 treatment days. A wide variation existed in risk-adjusted antibiotic treatment days (.76\u00b0days to 2.69\u00b0days). Several hospitals were identified as low (9 centers) or high (6 centers) outliers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There exists a wide variation in the duration of risk-adjusted antibiotic use amongst trauma centers. Further study is needed to address the underlying cause of variation and for improved antibiotic stewardship.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348241256070","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T05:52:33Z","timestamp":1716270753000},"page":"2814-2823","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Calculation and Feedback of Risk-Adjusted Antibiotic Days as a Process Measure in a Statewide Trauma Collaborative"],"prefix":"10.1177","volume":"90","author":[{"given":"Naveen F.","family":"Sangji","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Michigan, Ann Arbor, MI, USA"},{"name":"Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA"},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1677-2887","authenticated-orcid":false,"given":"Jacob M.","family":"Dougherty","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Michigan, Ann Arbor, MI, USA"},{"name":"Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Tignanelli","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Minnesota, Minneapolis, MN, USA"},{"name":"Center for Learning Health Systems Science, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannan A.","family":"Maqsood","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Michigan, Ann Arbor, MI, USA"},{"name":"Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne H.","family":"Cain-Nielsen","sequence":"additional","affiliation":[{"name":"Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryant W.","family":"Oliphant","sequence":"additional","affiliation":[{"name":"Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA"},{"name":"Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark R.","family":"Hemmila","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Michigan, Ann Arbor, MI, USA"},{"name":"Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA"},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,5,21]]},"reference":[{"key":"bibr1-00031348241256070","doi-asserted-by":"publisher","DOI":"10.1177\/2042098614554919"},{"key":"bibr2-00031348241256070","unstructured":"Antibiotic Stewardship policies & procedures, Michigan Department of Health and Human Services\n                      . 2023. Available at: https:\/\/www.michigan.gov\/mdhhs\/-\/media\/Project\/Websites\/mdhhs\/HAI-SHARP\/Symposium-2022\/LTC-AMS-policy.pdf (accessed on May 17, 2024)."},{"key":"bibr3-00031348241256070","unstructured":"Antimicrobial Stewardship Pharmacy Practice Guidelines 2023. Available at: https:\/\/www.michiganpharmacists.org\/practice-resources\/pharmacy-practice-guidance\/antimicrobial-stewardship (May 17, 2024)."},{"key":"bibr4-00031348241256070","doi-asserted-by":"publisher","DOI":"10.1542\/pir.2020-000885"},{"key":"bibr5-00031348241256070","doi-asserted-by":"publisher","DOI":"10.1177\/0009922819870248"},{"key":"bibr6-00031348241256070","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/8140429"},{"key":"bibr7-00031348241256070","doi-asserted-by":"publisher","DOI":"10.1111\/ajr.12979"},{"key":"bibr8-00031348241256070","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2017.07.017"},{"key":"bibr9-00031348241256070","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2018.01.002"},{"key":"bibr10-00031348241256070","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001401"},{"key":"bibr11-00031348241256070","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002579"},{"key":"bibr12-00031348241256070","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2022.05.028"},{"key":"bibr13-00031348241256070","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab842"},{"key":"bibr14-00031348241256070","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2018.96"},{"key":"bibr15-00031348241256070","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2021.379"},{"key":"bibr16-00031348241256070","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2020-000448"},{"key":"bibr17-00031348241256070","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2016.205"},{"key":"bibr18-00031348241256070","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e318241e553"},{"key":"bibr19-00031348241256070","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2017.1153"},{"key":"bibr20-00031348241256070","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-019-0471-0"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348241256070","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348241256070","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348241256070","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:40:20Z","timestamp":1777380020000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348241256070"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,21]]},"references-count":20,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1177\/00031348241256070"],"URL":"https:\/\/doi.org\/10.1177\/00031348241256070","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,21]]}}}