Scholars@Duke
Marcelo Cerullo

Marcelo Cerullo

House Staff
Surgery

Selected Publications

Market Factors, Not Quality, Influence Reimbursement for Pancreaticoduodenectomy in an Era of Price Transparency.

Journal Article Ann Surg Oncol · November 2024 BACKGROUND: The Centers for Medicare and Medicaid Services (CMS) price transparency rule tries to facilitate cost-conscious decision-making. For surgical services, such as pancreaticoduodenectomy (PD), factors mediating transparency and real-world reimburs ... Full text Link to item Cite

Lung Cancer Screening in Clinical Practice: A 5-Year Review of Frequency and Predictors of Lung Cancer in the Screened Population.

Journal Article J Am Coll Radiol · May 2024 PURPOSE: The aims of this study were to evaluate (1) frequency, type, and lung cancer stage in a clinical lung cancer screening (LCS) population and (2) the association between patient characteristics and Lung CT Screening Reporting & Data System (Lung-RAD ... Full text Link to item Cite

Who Benefits? An Assessment of Resident Benefits at Top 50 Academic Institutions.

Journal Article J Surg Educ · March 2024 OBJECTIVE: Residency serves as a crucial time in the professional and personal development of young physicians. Extensive effort is devoted to the clinical training of residents across the country. However, many residents report concerns with compensation, ... Full text Link to item Cite

Factors Associated with Discharge to Skilled Nursing Facility Following Gunshot Wounds.

Journal Article J Surg Res · February 2024 INTRODUCTION: Firearm injury is a public health crisis. Most victims are minorities in underserved neighborhoods. Measuring firearm injury by mortality underestimates its impact, as most victims survive to discharge. This study was done to determine if rac ... Full text Link to item Cite

Rates of price disclosure associated with the surgical treatment of early-stage breast cancer one year after implementation of federal regulations.

Journal Article Breast cancer research and treatment · January 2024 PurposeMastectomy, breast reconstruction (BR) and breast conserving therapy (BCT) are core components of the treatment paradigm for early-stage disease but are differentially associated with significant financial burdens. Given recent price transp ... Full text Cite

A National Comparison of Volume and Acuity for Adult and Pediatric Trauma: A Trauma Quality Improvement Program Cohort Study.

Journal Article J Surg Res · November 2023 INTRODUCTION: Most injured children receive trauma care outside of a pediatric trauma center. Differences in physiology, dosing, and injury pattern limit extrapolation of adult trauma principles to pediatrics. We compare US trauma center experience with pe ... Full text Link to item Cite

Rural For-Profit Hospitals Are Associated With Higher Commercial Prices for 3 Common Urological Procedures.

Journal Article Urol Pract · November 2023 INTRODUCTION: Rural patients lack access to urological services, and high local prices may dissuade underinsured patients from surgery. We sought to describe commercially insured prices for 3 urological procedures at rural vs metropolitan and for-profit vs ... Full text Link to item Cite

Association Between Hospital Monopoly Status, Patient Socioeconomic Disadvantage, and Total Joint Arthroplasty Price Disclosure.

Journal Article J Am Acad Orthop Surg · October 1, 2023 INTRODUCTION: In recent years, healthcare institutions and regulatory bodies have enacted cost transparency mandates for routine interventions such as total hip arthroplasty and total knee arthroplasty. However, disclosure rates remain low. This study exam ... Full text Open Access Link to item Cite

Commentary: All Grown Up - del Nido Cardioplegia Shows Promise in Complex Adult Aortic Surgery.

Journal Article Seminars in thoracic and cardiovascular surgery · March 2023 Full text Cite

Association of Rural Hospital for-Profit Status With Higher Publicly Reported Prices for the Components of Inpatient Hematuria Evaluation Among Commercially Insured Patients.

Journal Article Urol Pract · March 2023 INTRODUCTION: Rural patients have limited access to urological care and are vulnerable to high local prices. Little is known about price variation for urological conditions. We aimed to compare reported commercial prices for the components of inpatient hem ... Full text Link to item Cite

Surgical Evaluation in Patients Undergoing Radiation Therapy for Early-Stage Lung Cancer.

Journal Article Ann Thorac Surg · February 2023 BACKGROUND: Stereotactic body radiation therapy (SBRT) is used to treat stage I non-small cell lung cancer (NSCLC) in nonsurgical candidates, although guidelines specify that inoperability be determined in multidisciplinary fashion. We characterized NSCLC ... Full text Link to item Cite

Lung cancer screening and prevention

Chapter · January 1, 2023 Lung cancer mortality has been declining since the 1990s largely due to decreases in smoking, yet it remains the leading cause of cancer mortality in the United States. While effective screening tests have been available for the three other cancers with hi ... Full text Cite

Improved survival and higher rates of surgical resection associated with hepatocellular carcinoma in children as compared to young adults.

Journal Article Int J Cancer · December 15, 2022 Hepatocellular adenocarcinoma (HCC) is the second most common primary hepatic malignancy in children with a 5-year overall survival of 30%. Few studies have examined the similarities and differences between pediatric and adult HCC. This article aims to exa ... Full text Link to item Cite

Tumor Size, Histology, and Survival After Stereotactic Ablative Radiotherapy and Sublobar Resection in Node-negative Non-small Cell Lung Cancer.

Journal Article Ann Surg · December 1, 2022 BACKGROUND: Although SABR is increasingly emerging as an alternative to surgery for node-negative non-small cell lung cancer, there is poor understanding of patients who may most benefit SABR compared to surgery. OBJECTIVE: This study examined the relation ... Full text Link to item Cite

Association Between Cancer Center Accreditation and Compliance With Price Disclosure of Common Oncologic Surgical Procedures.

Journal Article J Natl Compr Canc Netw · November 2022 BACKGROUND: Cancer center accreditation status is predicated on several factors that measure high-value healthcare. However, price transparency, which is critical in healthcare decisions, is not a quality measure included for accreditation. We reported the ... Full text Link to item Cite

Factors Associated with Surgical Cost Disclosure Non-Compliance

Conference Journal of the American College of Surgeons · November 2022 Full text Cite

Do You Get What You Pay For? The Relationship of Price and Quality in Hospital Provided Procedures.

Journal Article The Journal of surgical research · October 2022 IntroductionStarting in 2021, Centers for Medicare and Medicaid Services required hospitals to provide pricing information to allow consumers to compare prices. Patients perceived that the quality of these services also impacts decision-making. Th ... Full text Cite

Surgical resection is associated with improved long-term survival of patients with resectable pancreatic head cancer compared to multiagent chemotherapy.

Journal Article HPB (Oxford) · July 2022 BACKGROUND: Standard of care for resectable pancreatic cancer is a combination of surgical resection (SR) and multiagent chemotherapy (MCT). We aim to determine whether SR or MCT is associated with superior survival for patients receiving only single-modal ... Full text Link to item Cite

Financial Impacts And Operational Implications Of Private Equity Acquisition Of US Hospitals.

Journal Article Health affairs (Project Hope) · April 2022 Although private equity acquisition of short-term acute care hospitals purportedly improves efficiency and cost-effectiveness, financial performance after acquisition remains unexamined. We compared changes in the financial performance of 176 hospitals acq ... Full text Cite

Association Between Hospital Private Equity Acquisition and Outcomes of Acute Medical Conditions Among Medicare Beneficiaries.

Journal Article JAMA network open · April 2022 ImportanceAs private equity (PE) acquisitions of short-term acute care hospitals (ACHs) continue, their impact on the care of medically vulnerable older adults remains largely unexplored.ObjectiveTo investigate the association between PE ... Full text Cite

Commentary: Cutoffs and Tradeoffs: Predicting Prolonged Length of Stay After Routine Cardiac Surgery.

Journal Article Seminars in thoracic and cardiovascular surgery · March 2022 Full text Cite

Empiric nasogastric decompression after pancreaticoduodenectomy is not necessary.

Journal Article HPB (Oxford) · December 2021 BACKGROUND: The aim of the present study was to evaluate the impact of routine NGT decompression after PD on postoperative outcomes in the era of an enhanced recovery after surgery (ERAS) protocol. MATERIALS AND METHODS: A retrospective review of all patie ... Full text Link to item Cite

Private Equity Acquisition And Responsiveness To Service-Line Profitability At Short-Term Acute Care Hospitals.

Journal Article Health affairs (Project Hope) · November 2021 As private equity firms continue to increase their ownership stake in various health care sectors in the US, questions arise about potential impacts on the organization and delivery of care. Using a difference-in-differences approach, we investigated chang ... Full text Cite

Hepatic vascular malignancies in children are associated with increased rates of surgical resection and improved overall survival compared with adults.

Journal Article Pediatr Blood Cancer · May 2021 BACKGROUND: Hepatic vascular malignancies (HVMs) are rare malignancies, with no standardized treatment regimens. The most common HVMs, angiosarcoma and malignant epithelioid hemangioendothelioma (EHE), are often grouped together in the literature complicat ... Full text Link to item Cite

Private Equity Investments In Health Care: An Overview Of Hospital And Health System Leveraged Buyouts, 2003-17.

Journal Article Health affairs (Project Hope) · May 2021 Private equity firms have increased their participation in the US health care system, raising questions about incentive alignment and downstream effects on patients. However, there is a lack of systematic characterization of private equity acquisition of s ... Full text Cite

Donor-Recipient Height Mismatch Is Associated With Decreased Survival in Pediatric-to-Adult Liver Transplant Recipients.

Journal Article Liver Transpl · February 2021 Liver grafts from pediatric donors represent a small fraction of grafts transplanted into adult recipients, and their use in adults requires special consideration of donor size to prevent perioperative complications. In the past, graft weight or volume rat ... Full text Link to item Cite

Validation of the 8th Edition American Joint Commission on Cancer (AJCC) Gallbladder Cancer Staging System: Prognostic Discrimination and Identification of Key Predictive Factors.

Journal Article Cancers (Basel) · February 1, 2021 The scope of our study was to compare the predictive ability of American Joint Committee on Cancer (AJCC) 7th and 8th edition in gallbladder carcinoma (GBC) patients, investigate the effect of AJCC 8th nodal status on the survival, and identify risk factor ... Full text Link to item Cite

Development and Performance of a Clinical Decision Support Tool to Inform Resource Utilization for Elective Operations.

Journal Article JAMA Netw Open · November 2, 2020 IMPORTANCE: Hospitals ceased most elective procedures during the height of coronavirus disease 2019 (COVID-19) infections. As hospitals begin to recommence elective procedures, it is necessary to have a means to assess how resource intensive a given case m ... Full text Link to item Cite

Routine Intensive Care Unit Admission Following Liver Resection: What Is the Value Proposition?

Journal Article Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · November 2020 IntroductionThe value of routine ICU admission after elective surgery has been debated due to the lack of robust evidence supporting its benefit, as well as the increased incurred costs. We sought to analyze outcomes of patients undergoing hepatec ... Full text Cite

Improved overall survival is still observed in patients receiving delayed adjuvant chemotherapy after pancreaticoduodenectomy for pancreatic adenocarcinoma.

Journal Article HPB (Oxford) · November 2020 BACKGROUND: Adjuvant chemotherapy (AC) is associated with improved survival following resection of pancreatic adenocarcinoma but is frequently delayed or deferred due to perioperative complications or patient deconditioning. The aim of this study was to as ... Full text Link to item Cite

Defining a textbook surgical outcome for patients undergoing surgical resection of intermediate and high-grade soft tissue sarcomas of the extremities.

Journal Article J Surg Oncol · October 2020 BACKGROUND: Quality measures for the surgical management soft tissue sarcoma of the extremity are limited. The purpose of this study was to define a textbook surgical outcome (TO) for soft tissue sarcoma of the extremities (STS-E) and to examine its associ ... Full text Link to item Cite

Assessing post-discharge costs of hepatopancreatic surgery: an evaluation of Medicare expenditure.

Journal Article Surgery · June 2020 BackgroundThe true cost of liver and pancreatic surgery may not be completely ascertained by examining costs associated solely with the index hospitalization. We sought to assess post-discharge costs related to liver and pancreatic surgery after t ... Full text Cite

Textbook Outcomes Among Patients Undergoing Retroperitoneal Sarcoma Resection.

Journal Article Anticancer Res · April 2020 BACKGROUND/AIM: Recently, the concept of textbook outcome (TO) has emerged as a novel effort to develop a benchmark that reflects multiple domains of quality. The aims of the current study were to define TO for retroperitoneal sarcoma (RPS), evaluate the r ... Full text Link to item Cite

Trauma Bay Disposition of Infants and Young Children With Mild Traumatic Brain Injury and Positive Head Imaging.

Journal Article Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · November 2019 ObjectivesTo describe the disposition of infants and young children with isolated mild traumatic brain injury and neuroimaging findings evaluated at a level 1 pediatric trauma center, and identify factors associated with their need for ICU admissi ... Full text Cite

Is Bigger Better?: The Effect of Hospital Consolidation on Index Hospitalization Costs and Outcomes Among Privately Insured Recipients of Immediate Breast Reconstruction.

Journal Article Annals of surgery · October 2019 ObjectivesTo examine the relationship between hospital market competition and inpatient costs, procedural markup, inpatient complications, and length of stay among privately insured patients undergoing immediate reconstruction after mastectomy. Full text Cite

Routine ICU Admission after Hepatectomy for Cancer Does Not Decrease Rates of Failureto-Rescue

Conference JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS · October 1, 2019 Link to item Cite

Implementation of a Blood Management Program at a Tertiary Care Hospital: Effect on Transfusion Practices and Clinical Outcomes Among Patients Undergoing Surgery.

Journal Article Annals of surgery · June 2019 BackgroundPatient blood management (PBM) programs represent a perioperative bundle of care that aim to reduce or eliminate unnecessary transfusions.ObjectiveTo evaluate the impact of a PBM program on transfusion practices and clinical out ... Full text Cite

Routine intensive care unit admission among patients undergoing major pancreatic surgery for cancer: No effect on failure to rescue.

Journal Article Surgery · April 2019 BackgroundAn understanding of the overall routine intensive care unit utilization, and characterization of the factors associated with a routine intensive care unit stay, may help identify ways to decrease overutilization of this resource after pa ... Full text Cite

Laparoscopic synchronous resection of colorectal cancer and liver metastases: A systematic review.

Journal Article Journal of surgical oncology · January 2019 While colorectal and hepatic resections are commonly performed through a laparoscopic approach, the safety and feasibility of total laparoscopic synchronous resections (LSR) of colorectal liver metastasis (CRLM) have not been established. In this systemati ... Full text Cite

The relationship of hospital market concentration, costs, and quality for major surgical procedures.

Journal Article American journal of surgery · December 2018 BackgroundOur objective was to determine the association between indicators of surgical quality - incidence of major complications and failure-to-rescue - and hospital market concentration in light of differences in costs of care.MethodsP ... Full text Cite

Predicting the Risk of Readmission From Dehydration After Ileostomy Formation: The Dehydration Readmission After Ileostomy Prediction Score.

Journal Article Diseases of the colon and rectum · December 2018 BackgroundAll-cause readmission rates in patients undergoing ileostomy formation are as high as 20% to 30%. Dehydration is a leading cause. No predictive model for dehydration readmission has been described.ObjectiveThe purpose of this st ... Full text Cite

Effect of Regional Hospital Market Competition on Use Patterns of Free Flap Breast Reconstruction.

Journal Article Plastic and reconstructive surgery · December 2018 BackgroundMarket competition is believed to promote patient access and health care delivery. The authors examined the relationship between market competition and use of surgical services for cancer, using free flap immediate breast reconstruction ... Full text Cite

Reliability of Glasgow Coma Score in pediatric trauma patients.

Journal Article Journal of pediatric surgery · September 2018 BackgroundDiscordant assessments of Glasgow Coma Score (GCS) following trauma can result in inappropriate triage. This study sought to determine the reliability of prehospital GCS compared to emergency department (ED) GCS.MethodsWe conduc ... Full text Cite

Variation in markup of general surgical procedures by hospital market concentration.

Journal Article American journal of surgery · April 2018 BackgroundIncreasing hospital market concentration (with concomitantly decreasing hospital market competition) may be associated with rising hospital prices. Hospital markup - the relative increase in price over costs - has been associated with gr ... Full text Cite

The Effect of Frailty Index on Early Outcomes after Combined Colorectal and Liver Resections.

Journal Article Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · April 2018 BackgroundAlthough previous studies have examined frailty as a potential predictor of adverse surgical outcomes, little is reported on its application. We sought to assess the impact of the 5-item modified frailty index (mFI) on morbidity in patie ... Full text Cite

Assessing the Financial Burden Associated With Treatment Options for Resectable Pancreatic Cancer.

Journal Article Annals of surgery · March 2018 ObjectiveThe aim of this study is to assess the financial burden associated with treatment options for resectable pancreatic cancer.BackgroundAs the volume of cancer care increases in the United States, there is growing interest among bot ... Full text Cite

Self-Directed Interactive Video-Based Instruction Versus Instructor-Led Teaching for Myanmar House Surgeons: A Randomized, Noninferiority Trial.

Journal Article Journal of surgical education · January 2018 ObjectiveTo compare self-directed interactive video-based instruction (IVBI) with instructor-led teaching in the acquisition of basic surgical skills by House Surgeons at University of Medicine 1, Yangon.DesignA prospective, 1:1 randomize ... Full text Cite

Defining payments associated with the treatment of colorectal cancer.

Journal Article The Journal of surgical research · December 2017 BackgroundWhile bundled payments aim to reduce variations in health care spending across the continuum of care, data reporting on variations in payments for privately insured patients undergoing treatment for colon cancer (CC) are lacking. The cur ... Full text Cite

Effect of surgeon "experience" with laparoscopy on postoperative outcomes after colorectal surgery.

Journal Article Surgery · October 2017 BackgroundAlthough the relationship between laparoscopic surgery and improved clinical outcomes has been well established across a variety of procedures, the effect of operative experience with laparoscopic surgery remains less defined. The presen ... Full text Cite

Association of Hospital Market Concentration With Costs of Complex Hepatopancreaticobiliary Surgery.

Journal Article JAMA surgery · September 2017 ImportanceTrade-offs involved with market competition, overall costs to payers and consumers, and quality of care have not been well defined. Less competition within any given market may enable provider-driven increases in charges.Objective Full text Cite

Hospital Volume and the Costs Associated with Surgery for Pancreatic Cancer.

Journal Article Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · September 2017 BackgroundData evaluating the financial implications of volume-based referral are lacking. This study sought to compare in-hospital costs for pancreatic surgery by annual hospital volume.MethodsEleven thousand and eighty-one patients aged ... Full text Cite

Impact of Angiotensin Receptor Blocker Use on Overall Survival Among Patients Undergoing Resection for Pancreatic Cancer.

Journal Article World journal of surgery · September 2017 BackgroundPancreatic cancer has higher concentrations of angiotensin II compared with other cancers. This study sought to assess the effect of angiotensin II receptor blockers (ARBs) on survival of patients undergoing resection using a large, nati ... Full text Cite

Physiologic correlates of intraoperative blood transfusion among patients undergoing major gastrointestinal operations.

Journal Article Surgery · August 2017 BackgroundGuidelines for transfusion focus on nadir levels of hemoglobin. Hemoglobin triggers may not be helpful, however, in defining appropriate intraoperative use of packed red blood cells. We sought to define the use of intraoperative packed r ... Full text Cite

Frailty as a Risk Predictor of Morbidity and Mortality Following Liver Surgery.

Journal Article Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · May 2017 BackgroundGiven the increasing number of elderly and comorbid patients undergoing surgery, there is increased interest in preoperatively identifying patients at high risk of morbidity and mortality following liver resection. We sought to develop a ... Full text Cite

Readmission after major surgery: effect of the postdischarge environment.

Journal Article The Journal of surgical research · October 2016 BackgroundAlthough uncoordinated postdischarge care has been associated with poor clinical outcomes, the effect of discharge to a low healthcare resource area (LHRA) on readmission remains undetermined. We sought to assess how the quality of disch ... Full text Cite

Metformin Use Is Associated with Improved Survival in Patients Undergoing Resection for Pancreatic Cancer.

Journal Article Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · September 2016 Preclinical evidence has demonstrated anti-tumorigenic effects of metformin. The effects of metformin following pancreatic cancer, however, remain undefined. We sought to assess the association between metformin use and survival using a large, nationally r ... Full text Cite

Awareness of racial/ethnic disparities in surgical outcomes and care: factors affecting acknowledgment and action.

Journal Article American journal of surgery · July 2016 BackgroundStudies have demonstrated racial/ethnic disparities in surgical outcomes and care. Surgeon awareness and its association with institutional action remain unclear. The study sought to assess surgeons' awareness of racial/ethnic disparitie ... Full text Cite