{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:41:13Z","timestamp":1777448473250,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,6,21]],"date-time":"2025-06-21T00:00:00Z","timestamp":1750464000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A growing body of work has considered the significance of patients\u2019 psychosocial support and surrounding socioeconomic milieu on surgical outcomes. The presence of such psychosocial risk factors (PSRFs) may define both access to and engagement with care, particularly for access-sensitive conditions, such as colon resection. Yet, the impact of PSRF on outcomes following colectomy remains to be delineated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We queried the Nationwide Readmissions Database for all adults undergoing elective\/emergent colectomy for benign neoplasms, colon cancer, diverticular disease, or inflammatory bowel disease from 2016 to 2022. The presence of PSRF across 5 domains (low-income or uninsured status, substance use, psychiatric disease, and cognitive limitations) was identified using validated administrative codes. Patients with \u22651 PSRF comprised the\n                      <jats:italic>At-Risk<\/jats:italic>\n                      cohort (others:\n                      <jats:italic>Not-At-Risk<\/jats:italic>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among \u223c1,130,803 records, 497,336 (44.0%) had \u22651 documented PSRF. The\n                      <jats:italic>At-Risk<\/jats:italic>\n                      cohort was younger and of greater comorbidity burden, and more frequently underwent open resection at non-metropolitan centers. Following comprehensive risk adjustment, the presence of PSRF remained associated with greater likelihood of in-hospital mortality (AOR 1.17, CI 1.11-1.22) and any major complication (AOR 1.09, CI 1.07-1.11), as well as non-home discharge (AOR 1.41, CI 1.37-1.44) and non-elective readmission within 30 days (AOR 1.10, CI 1.08-1.12). These associations persisted when evaluating only patients treated at high colectomy volume hospitals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In this national study, the presence of PSRF was associated with significantly inferior outcomes following colectomy. Notably, this association was not mitigated by care at high volume hospitals. Psychosocial risk factors should be considered as part of risk stratification and care optimization efforts across institutions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348251353072","type":"journal-article","created":{"date-parts":[[2025,6,21]],"date-time":"2025-06-21T03:59:28Z","timestamp":1750478368000},"page":"1704-1713","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Psychosocial Risk Factors on Acute Clinical Outcomes Following Colectomy: A National Perspective"],"prefix":"10.1177","volume":"91","author":[{"given":"Sara","family":"Sakowitz","sequence":"first","affiliation":[{"name":"CORELAB, Department of Surgery, University of California, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Syed Shahyan","family":"Bakhtiyar","sequence":"additional","affiliation":[{"name":"CORELAB, Department of Surgery, University of California, Los Angeles, CA, USA"},{"name":"Department of Surgery, University of Colorado, Aurora, CO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konmal","family":"Ali","sequence":"additional","affiliation":[{"name":"CORELAB, Department of Surgery, University of California, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amulya","family":"Vadlakonda","sequence":"additional","affiliation":[{"name":"CORELAB, Department of Surgery, University of California, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Balian","sequence":"additional","affiliation":[{"name":"CORELAB, Department of Surgery, University of California, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0373-0784","authenticated-orcid":false,"given":"Hanjoo","family":"Lee","sequence":"additional","affiliation":[{"name":"CORELAB, Department of Surgery, University of California, Los Angeles, CA, USA"},{"name":"Division of Colon &amp; Rectal Surgery, Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4705-0262","authenticated-orcid":false,"given":"Peyman","family":"Benharash","sequence":"additional","affiliation":[{"name":"CORELAB, Department of Surgery, University of California, Los Angeles, CA, USA"},{"name":"Department of Surgery, University of California, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,6,21]]},"reference":[{"key":"e_1_3_3_2_2","volume-title":"Characteristics of Operating Room Procedures in U.S. Hospitals, 2011 - Statistical Brief #170","author":"Weiss AJ","year":"2014","unstructured":"Weiss AJ, Elixhauser A, Andrews RM. Characteristics of Operating Room Procedures in U.S. Hospitals, 2011 - Statistical Brief #170. Agency for Healthcare Research and Quality; 2014. https:\/\/hcup-us.ahrq.gov\/reports\/statbriefs\/sb170-Operating-Room-Procedures-United-States-2011.jsp. Accessed February 1, 2025."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2024.03.036"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000580"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-018-07136-3"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-017-1654-x"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002745"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2022.08.014"},{"key":"e_1_3_3_9_2","unstructured":"Healthcare cost and utilization project. NRD overview. https:\/\/www.hcup-us.ahrq.gov\/nrdoverview.jsp. 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