Research Overviews

Y-Graft by Scott Weldon (320x240)
credit: Scott WeldonY-graft aortic repair

Dr. Coselli Leads Multicenter International Study of Aortic Valve Operative Outcomes in Marfan Patients

Department vice chair and chief of the Division of Cardiothoracic Surgery, Joseph S. Coselli, M.D., is the principal investigator and head of the Data Coordination Center and Surgical Core of a large international study entitled, “Aortic Valve Operative Outcomes in Marfan Patients.” The study is supported by the Marfan Foundation, Baylor College of Medicine, Stanford University, and other participating institutions. This multi-center study is being conducted at 25 international sites, including centers in the United States, Germany, Argentina, Canada, and the Netherlands.

The goals of the Aortic Valve Operative Outcomes in Marfan Patients study are to evaluate and compare the operative outcomes of aortic valve-replacing and aortic valve-sparing surgical interventions in patients with Marfan syndrome. It will assess the prognostic factors that have an impact on operation outcome. For more information, see here.

Dr. Kougias Leading National Transfusion Triggers Trial

Panagiotis Kougias, M.D., M.Sc., associate professor in the  Division of Vascular Surgery and Endovascular Surgery, is the national PI on a 17-million dollar trial titled “TOP Trial: Transfusion Triggers After Operations in High Cardiac Risk Patients,” funded by the VA Office of Research and Development - Cooperative Studies Program (CSP). The goal of the TOP Trial is to determine whether a liberal transfusion strategy (transfusion trigger at hemoglobin level < 10 gm/dl) in veterans at high cardiac risk who undergo major vascular and general surgery operations is associated with decreased risk of adverse postoperative outcomes compared to a restrictive transfusion strategy (transfusion trigger at hemoglobin level < 7 gm/dl).

Cardiovascular Outcomes for People using Anticoagulation Strategies (COMPASS)

Ramyar Gilani, M.D., assistant professor in the Division of Vascular Surgery and Endovascular Surgery, is the principal investigator of the Baylor College of Medicine site of the COMPASS (Cardiovascular OutcoMes for People Using Anticoagulation StrategieS) (NCT01776424) randomized control trial of Rivaroxaban for the prevention of major cardiovascular events. The purpose of the study is to evaluate whether treatment with rivaroxaban and aspirin or rivaroxaban alone is better than aspirin alone in prevention of heart attacks, stroke or cardiovascular death in patients with coronary or peripheral artery disease.

Post-Operative Outcomes in the VA Improved in the Last 15 Years

Nader Massarweh, M.D., M.P.H, assistant professor in the Division of Surgical Oncology, recently co-authored a study “Post-Operative Outcomes in the VA Have Improved Over the Past 15 Years,” published in JAMA Surgery. The study used data from VASQIP to retrospectively analyze complication and failure rates among 704,901 non-cardiac surgical patients treated in 143 VA hospitals over the past 15 years. This work was supported by the Department of Veterans Affairs, Veterans Health Administration, VA Office of Research and Development, Center for Innovations in Quality, Effectiveness and Safety (IQuEST), and a seed grant from the Michael E. DeBakey VA Medical Center.

Leveraging Mobile Technology to Improve Outcomes in Surgical Care

James W. Suliburk, M.D., associate professor in the Division of General Surgery, is the principal investigator of an ongoing clinical study entitled “Leveraging Mobile Technology to Improve Outcomes in Surgical Care” funded the Moore Foundation Patient and Family Engagement Early Career Investigator Award by the Gordon and Betty Moore Foundation. This research aims to improve patient engagement and self-care through rigorous patient engagement and behavioral psychology interventions.

Using Telemedicine Technology to Improve Quality and Delivery of Community Health Services

In 2014, Baylor St. Luke’s Medical Center launched the telehealth program, Project ECHO (Extension for Community Healthcare Outcomes), with a team of health professionals and partnering primary care providers throughout Texas. Led by medical director Norman L. Sussman, M.D., associate professor in the Division of Abdominal Transplantation, Project ECHO aims to enhance medical resources in communities in Texas that currently lack specialized care. The project’s videoconference outreach model uses multipoint teleconferencing to enable specialists like Dr. Sussman from university medical centers to connect with community providers in a peer-to-peer format, and uses case-based learning to teach providers to deliver state-of-the-art medical care.

Airline Pilots Offer Insight for Quality Improvement in the Operating Room

Based on the Department of Surgery’s highly successful grand rounds meetings with members of the American Airlines Flight Academy, we recently launched our AAiR (Aviation Applications In SuRgery) program to improve our performances as a department. The program is being led by S. Rob Todd, M.D., professor and chief of the Section of Acute Care Surgery in the Division of General Surgery. First up: Samir S. Awad, M.D., M.P.H., professor in the Division of General Surgery and vice-chair for surgical quality and safety, is leading the use of an online error self-reporting system, available to all department members to alert each other to potential clinical quality improvement (CQI) opportunities. The goal of the system is to help establish an open, engaged culture and to enhance the situational awareness, self-awareness and leadership skills among the faculty, clinical staff and trainees of the department, leading to optimal performance and ultimately improved patient outcomes.

Resident Research Accomplishments

Research Track general surgery resident, Elaine Vo, M.D., received a Surgical Infection Society (SIS) Clinical Research Training Fellowship to pursue her project, “Use of a Preoperative Decontamination Protocol to Reduce Surgical Site Infection Rate Among Patients Undergoing Elective Oncologic Resections.” She was presented this award at the 36th Annual SIS Meeting in Palm Beach, Florida, in 2016. Dr. Vo is mentored by Samir S. Awad, M.D., M.P.H., professor in the Division of General Surgery and vice chair for surgical quality and safety in the Department of Surgery.

Research Track general surgery resident, Meredith Mason, M.D., received a CPRIT Training Grant for her research proposal “The Impact of Institutional National Quality Forum Quality Metric Performance on Short and Long-term Outcomes in Colon Cancer.” The objectives of her project are to evaluate and understand trends in national hospital performance on NQF quality metrics in colon cancer, to determine the extent to which these metrics correlate with one another, and to analyze how hospital performance on these metrics affects short-term surgical outcomes as well as overall survival. Dr. Mason is mentored by Nader Massarweh, M.D., M.P.H, assistant professor in the Division of Surgical Oncology, and David H. Berger, M.D., M.H.C.M, professor and director of surgical quality in the Division of General Surgery.

Research by Disease

Cardiac Disease

Dr. Coselli Leads Multicenter International Study of Aortic Valve Operative Outcomes in Marfan Patients

Our department vice chair and chief of the Division of Cardiothoracic Surgery, Joseph S. Coselli, M.D., is the principal investigator and head of the Data Coordination Center and Surgical Core of a large international study entitled, “Aortic Valve Operative Outcomes in Marfan Patients,” supported by the Marfan Foundation, Baylor College of Medicine, Stanford University, and other participating institutions. This multicenter study is being conducted at 25 international sites, including centers in the United States, Germany, Argentina, Canada, and the Netherlands.

The goals of the Aortic Valve Operative Outcomes in Marfan Patients study are to evaluate and compare the operative outcomes of aortic valve-replacing and aortic valve-sparing surgical interventions in patients with Marfan syndrome. It will assess the prognostic factors that have an impact on operation outcome. 

Vascular Disease

Dr. Kougias Leading National Transfusion Triggers Trial

Panagiotis Kougias, M.D., M.Sc., associate professor in the Division of Vascular Surgery and Endovascular Therapy, is the national PI on a 17-million dollar trial titled “TOP Trial: Transfusion Triggers After Operations in High Cardiac Risk Patients,” funded by the VA Office of Research and Development - Cooperative Studies Program (CSP). The goal of the TOP Trial is to determine whether a liberal transfusion strategy (transfusion trigger at hemoglobin level < 10 gm/dl) in veterans at high cardiac risk who undergo major vascular and general surgery operations is associated with decreased risk of adverse postoperative outcomes compared to a restrictive transfusion strategy (transfusion trigger at hemoglobin level < 7 gm/dl).

Cardiovascular Outcomes for People using Anticoagulation Strategies (COMPASS)

Ramyar Gilani, M.D., assistant professor in the Division of Vascular Surgery and Endovascular Surgery, is the principal investigator of the Baylor College of Medicine site of the COMPASS (Cardiovascular OutcoMes for People Using Anticoagulation StrategieS) (NCT01776424) randomized control trial of Rivaroxaban for the prevention of major cardiovascular events. The purpose of the study is to evaluate whether treatment with rivaroxaban and aspirin or rivaroxaban alone is better than aspirin alone in prevention of heart attacks, stroke or cardiovascular death in patients with coronary or peripheral artery disease.

Gastrointestinal Cancer

Resident Research Accomplishments

Research Track general surgery resident, Elaine Vo, M.D., received a Surgical Infection Society (SIS) Clinical Research Training Fellowship to pursue her project, “Use of a Preoperative Decontamination Protocol to Reduce Surgical Site Infection Rate Among Patients Undergoing Elective Oncologic Resections.” She was presented this award at the 36th Annual SIS Meeting in Palm Beach, Florida, in 2016. Dr. Vo is mentored by Samir S. Awad, M.D., M.P.H., professor in the Division of General Surgery and vice chair for surgical quality and safety in the Department of Surgery.

Research Track general surgery resident, Meredith Mason, M.D., received a CPRIT Training Grant for her research proposal “The Impact of Institutional National Quality Forum Quality Metric Performance on Short and Long-term Outcomes in Colon Cancer.” The objectives of her project are to evaluate and understand trends in national hospital performance on NQF quality metrics in colon cancer, to determine the extent to which these metrics correlate with one another, and to analyze how hospital performance on these metrics affects short-term surgical outcomes as well as overall survival. Dr. Mason is mentored by Nader Massarweh, M.D., M.P.H, assistant professor in the Division of Surgical Oncology, and David H. Berger, M.D., M.H.C.M, professor and director of surgical quality in the Division of General Surgery.

Liver Disease

Using Telemedicine Technology to Improve Quality and Delivery of Community Health Services

In 2014, Baylor St. Luke’s Medical Center launched the telehealth program Project ECHO (Extension for Community Healthcare Outcomes) with a team of health professionals and partnering primary care providers throughout Texas. Led by medical director Norman L. Sussman, M.D., associate professor in the Division of Abdominal Transplantation, Project ECHO aims to enhance medical resources in communities in Texas that currently lack specialized care. The project’s videoconference outreach model uses multipoint teleconferencing to enable specialists like Dr. Sussman from university medical centers to connect with community providers in a peer-to-peer format, and uses case-based learning to teach providers to deliver state-of-the-art medical care.