Publications by authors named "Kaitlin Woods"

7 Publications

  • Page 1 of 1

Anesthetic choice for arteriovenous access creation: A National Anesthesia Clinical Outcomes Registry analysis.

J Vasc Access 2021 Sep 21:11297298211045495. Epub 2021 Sep 21.

Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology, West Virginia University, Morgantown, WV, USA.

Background: We sought to evaluate differences in primary anesthetic type used in arteriovenous access creation with the hypothesis that administration of regional anesthesia and monitored anesthesia care (MAC) with local anesthesia as the primary anesthetic has increased over time.

Methods: National Anesthesia Clinical Outcomes Registry data were retrospectively evaluated. Covariates were selected a priori within multivariate models to determine predictors of anesthetic type in adults who underwent elective arteriovenous access creation between 2010 and 2018.

Results: A total of 144,392 patients met criteria; 90,741 (62.8%) received general anesthesia. The use of regional anesthesia and MAC decreased over time (8.0%-6.8%, 36.8%-27.8%, respectively; both  < 0.0001). Patients who underwent regional anesthesia were more likely to have ASA physical status >III and to reside in rural areas (52.3% and 12.9%, respectively; both  < 0.0001). Patients who underwent MAC were more likely to be older, male, receive care outside the South, and reside in urban areas (median age 65, 56.8%, 68.1%, and 70.8%, respectively; all  < 0.0001). Multivariate analysis revealed that being male, having an ASA physical status >III, and each 5-year increase in age resulted in increased odds of receiving alternatives to general anesthesia (regional anesthesia adjusted odds ratios (AORs) 1.06, 1.12, and 1.26, MAC AORs 1.09, 1.2, and 1.1, respectively; all  < 0.0001). Treatment in the Midwest, South, or West was associated with decreased odds of receiving alternatives to general anesthesia compared to the Northeast (regional anesthesia AORs 0.28, 0.38, and 0.03, all  < 0.0001; MAC 0.76, 0.13, and 0.43, respectively; all  < 0.05).

Conclusions: Use of regional anesthesia and MAC with local anesthesia for arteriovenous access creation has decreased over time with general anesthesia remaining the primary anesthetic type. Anesthetic choice, however, varies with patient characteristics and geography.
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http://dx.doi.org/10.1177/11297298211045495DOI Listing
September 2021

Staffing in a Level 1 Trauma Center: Quantifying Capacity for Preparedness.

Disaster Med Public Health Prep 2021 Sep 15:1-7. Epub 2021 Sep 15.

Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology, West Virginia University, Morgantown, West Virginia, USA.

Objective: We sought to determine who is involved in the care of a trauma patient.

Methods: We recorded hospital personnel involved in 24 adult Priority 1 trauma patient admissions for 12 h or until patient demise. Hospital personnel were delineated by professional background and role.

Results: We cataloged 19 males and 5 females with a median age of 50-y-old (interquartile range [IQR], 35.5-67.5). The average number of hospital personnel involved was 79.71 (standard deviation, 17.62; standard error 3.6). A median of 51.2% (IQR, 43.4%-59.8%) of personnel were first involved within hour 1. More personnel were involved in direct versus indirect care (median 54.5 [IQR, 47.5-67.0] vs 25.0 [IQR, 22.0-30.5]; P < 0.0001). Median number of health-care professionals and auxiliary staff were 74.5 (IQR, 63.5-90.5) and 6.0 (IQR, 5.0-7.0), respectively. More personnel were first involved in hospital locations external to the emergency department (median, 53.0 [IQR, 41.5-63.0] vs 27.5 [IQR, 24.0-30.0]; P < 0.0001). No differences existed in total personnel by Injury Severity Score (P = 0.1266), day (P = 0.7270), or time of admission (P = 0.2098).

Conclusions: A large number of hospital personnel with varying job responsibilities respond to severe trauma. These data may guide hospital staffing and disaster preparedness policies.
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http://dx.doi.org/10.1017/dmp.2021.269DOI Listing
September 2021

Commentary: Extracorporeal membrane oxygenation (ECMO) and coronavirus disease 2019 (COVID-19): Beyond the brink of a pandemic.

JTCVS Open 2021 Mar 16;5:171-172. Epub 2020 Dec 16.

Division of Cardiac Anesthesia, WVU Heart and Vascular Institute, West Virginia University, Morgantown, WVa.

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http://dx.doi.org/10.1016/j.xjon.2020.12.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7833281PMC
March 2021

Anesthetic Choice for Atrial Fibrillation Ablation: A National Anesthesia Clinical Outcomes Registry Analysis.

J Cardiothorac Vasc Anesth 2021 09 5;35(9):2600-2606. Epub 2021 Jan 5.

Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology, West Virginia University, Morgantown, WV. Electronic address:

Objective: The authors evaluated the type of anesthesia administered in atrial fibrillation ablation, hypothesizing that monitored anesthesia care is used less frequently than general anesthesia.

Design: A retrospective study.

Setting: National Anesthesia Clinical Outcomes Registry data, which are multi-institutional from across the United States.

Participants: Adult patients who underwent elective atrial fibrillation ablation between 2013 and 2018.

Interventions: None.

Measurements And Main Results: National Anesthesia Clinical Outcomes Registry data were evaluated, and covariates were selected a priori within multivariate models to assess for predictors of anesthetic type. A total of 54,321 patients underwent atrial fibrillation ablation; 3,251 (6.0%) received monitored anesthesia care. Patients who received monitored anesthesia care were more likely to be >80 years old (12.4% v 4.9%; p < 0.0001), female (36.1% v 34.3%; p < 0.0001), have American Society of Anesthesiologists physical status >III (17.28% v 10.48%; p < 0.0001), and reside in urban areas (62.23% v 53.37%; p < 0.0001). They received care in the Northeast (17.6% v 10.1%; p < 0.0001) at low-volume centers (median 224 v 284 procedures; p < 0.0001). Multivariate analysis revealed that each five-year increase in age, being female, and having an American Society of Anesthesiologists physical status >III resulted in a 7% (p < 0.0001), 9% (p = 0.032), and 200% (p < 0.0001) increased odds of receiving monitored anesthesia care, respectively. Requiring additional ablation of atria or of a second arrhythmia and residing outside the Northeast resulted in a decreased odds of monitored anesthesia care (adjusted odds ratio 0.24 [p=0.002] and < 0.5 [p < 0.03], respectively). For each 50 cases performed annually at a center, the odds decreased by 5% (p = 0.005).

Conclusions: General anesthesia is the most common type of anesthesia administered for atrial fibrillation ablation. The type of anesthesia administered, however, varies with patient, procedural, and hospital characteristics.
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http://dx.doi.org/10.1053/j.jvca.2020.12.046DOI Listing
September 2021

Coronary Artery Bypass Grafting in a Patient with Dextrocardia with Situs Inversus.

Case Rep Anesthesiol 2020 14;2020:8885881. Epub 2020 Dec 14.

Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology, West Virginia University, Morgantown, WV, USA.

Dextrocardia involves embryologic malformations leading to a right hemithorax heart with rightward apex. Situs inversus encompasses all viscera in mirrored position. A 76-year-old male with dextrocardia with situs inversus presented for coronary artery bypass grafting due to a non-ST elevation myocardial infarction. Management was altered accordingly. Electrocardiography leads and defibrillator pads were reversed. A left internal jugular vein central venous catheter provided direct access to the right atrium. Transesophageal echocardiography confirmation of aortic and venous cannulation required turning the probe right for the right-sided aorta and left for liver visualization, respectively. Proactive surgical and anesthetic management was imperative for the successful and uneventful outcome for this patient.
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http://dx.doi.org/10.1155/2020/8885881DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752276PMC
December 2020

Vascular Complications Increase Hospital Charges and Mortality in Adult Patients on Extracorporeal Membrane Oxygenation in the United States.

Semin Thorac Cardiovasc Surg 2021 Summer;33(2):397-406. Epub 2020 Sep 23.

Division of Thoracic Surgery, Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia.

Patients on extracorporeal membrane oxygenation (ECMO) who suffer vascular complications frequently accrue additional procedures and costs. We sought to evaluate the effect of ECMO-related vascular complications on hospital charges and in-hospital mortality. Adult discharges involving ECMO from 2004 to 2013 in the National Inpatient Sample were examined. There were 12,636 patients in the cohort. Vascular complications, focusing on arterial complications were identified using ICD-9-CM diagnosis and procedure codes. A multivariable survey linear regression model using median hospital charges was used to model the effect of vascular complications on charges. We used multivariable survey logistic regression to evaluate the effect of vascular complications on in-hospital mortality. Of the 12,636 patients examined, 6467 (51.2%) had ECMO-related vascular complications. Median charges in patients with vascular complications were $ 477,363 (interquartile range: 258,660-875,823) and were $ 282,298 (interquartile range: 130,030-578,027) without vascular complications. On multivariable analysis, patients with vascular complications had 24% higher median charges than patients without vascular complications (Ratio: 1.24; 95% confidence interval [CI]: 1.16-1.33; P < 0.0001) and 34% higher odds of experiencing in-hospital mortality than patients without vascular complications (adjusted odds ratio: 1.34; 95% CI:1.08-1.66; P = 0.009). Vascular complications occur in over half of ECMO patients and are associated with an increased risk of high hospital charges and in-hospital mortality. These findings support the need for identification and modification of risk factors for ECMO-related vascular complications. Furthermore, the standardization of protocols using evidence-based measures to mitigate vascular complications may improve overall ECMO outcomes.
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http://dx.doi.org/10.1053/j.semtcvs.2020.09.025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7985037PMC
July 2021

Variables during swing associated with decreased impact peak and loading rate in running.

J Biomech 2014 Jan 22;47(1):32-8. Epub 2013 Oct 22.

Department of Rehabilitation Sciences, University of Kentucky, Lexington, KY, USA. Electronic address:

When the foot impacts the ground in running, large forces and loading rates can arise that may contribute to the development of overuse injuries. Investigating which biomechanical factors contribute to these impact loads and loading rates in running could assist clinicians in developing strategies to reduce these loads. Therefore, the goals of our work were to determine variables that predict the magnitude of the impact peak and loading rate during running, as well as to investigate how modulation of knee and hip muscle activity affects these variables. Instrumented gait analysis was conducted on 48 healthy subjects running at 3.3m/s on a treadmill. The top four predictors of loading rate and impact peak were determined using a stepwise multiple linear regression model. Forward dynamics was performed using a whole body musculoskeletal model to determine how increased muscle activity of the knee flexors, knee extensors, hip flexors, and hip extensors during swing altered the predictors of loading rate and impact peak. A smaller impact peak was associated with a larger downward acceleration of the foot, a higher positioned foot, and a decreased downward velocity of the shank at mid-swing while a lower loading rate was associated with a higher positioned thigh at mid-swing. Our results suggest that an alternative to forefoot striking may be increased hip flexor activity during swing to alter these mid-swing kinematics and ultimately decrease the leg's velocity at landing. The decreased velocity would decrease the downward momentum of the leg and hence require a smaller force at impact.
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http://dx.doi.org/10.1016/j.jbiomech.2013.10.026DOI Listing
January 2014
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