John F. Pearson

All Publications

• Bayesian Analysis of Postoperative Complication Risk Associated With Preoperative Exposure to Fine Particulate Matter: A Single-Center Cohort Study. Acta anaesthesiologica Scandinavica Pearson, J. F., Jacobson, C. K., Riss, C. S., Strickland, M. J., Lee, L., Wan, N., Benney, T. M., Pace, N. L., Goodrich, B. K., Gabry, J. S., Pham, J. V., Kartchner, C. K., Wood, J. A., Andreae, M. H. 2026; 70 (6): e70235

  Abstract

  Air pollution, especially particle pollution, is increasingly recognized as a potential perioperative risk factor, yet modeling environmental exposures in surgical cohorts remains methodologically underdeveloped. We demonstrate a Bayesian hierarchical framework to quantify probabilistic associations between preoperative fine particulate matter (PM2.5) exposure and postoperative complications, highlighting its interpretability and flexibility for clinical environmental epidemiology.We conducted a single center, retrospective cohort study using data from 49,615 surgical patients in Utah who underwent elective surgical procedures from 2016 to 2018. Patients' addresses were geocoded and linked to daily Census-tract level PM2.5 estimates. The exposure variable was defined as the maximum PM2.5 concentrations in the 7 days prior to surgery. The binary outcome was a composite of postoperative complications: pneumonia, surgical site infection, urinary tract infection, sepsis, stroke, myocardial infarction, or thromboembolic event. A hierarchical Bayesians regression model with weakly informative priors was used adjusting for age, sex, season, neighborhood disadvantage, and the Elixhauser index of comorbidities with census tract as a group (random) effect. We present posterior estimates with credible intervals, highlight model transparency and sensitivity, and discuss contrasts with standard frequentist methods.Postoperative complications were associated in a dose-dependent manner with higher concentrations of PM2.5 exposure. We found a relative increase of 8.2% in the odds of complications (OR = 1.082) for every 10.ug/m3 increase in the highest single-day 24-h PM2.5 exposure during the 7 days prior to surgery. For an increase in PM2.5 from 1 to 30 ug/m3, the odds of complication rose to over 27% (95% CI: 4%-55%). The results were robust across prior choices and model specifications. We report full posterior distributions and highlight advantages of Bayesian modeling for uncertainty quantification and clinical interpretability.This case study demonstrates the application of hierarchical Bayesian modeling to quantify the probabilistic associations between preoperative PM2.5 exposure and postoperative complications, highlighting transparent risk estimation and uncertainty characterization that may inform the design of future multicenter perioperative environmental studies.Using Bayesian statistical analysis, the authors demonstrate a dose-dependent risk for postoperative complications in patients exposed to air polluted with fine particulate matter with a size of less than 2.5 μm.

  View details for DOI 10.1111/aas.70235

  View details for PubMedID 42036603

  View details for PubMedCentralID PMC13111187

• The effect of hospital-level fine particulate matter exposure on surgical complications. Anaesthesia Pearson, J. F., Riss, C. S., Colquhoun, D. A., Zhang, Y., Strickland, M. J. 2026

  View details for DOI 10.1111/anae.70207

  View details for PubMedID 41852084

• Disparities in Antiemetic Prophylaxis Care Processes Predicted by Patient Neighborhood: Retrospective Cohort and Geospatial Analysis. JMIR public health and surveillance Han, J., Wan, N., Jacobson, C. K., Pace, N. L., Kartchner, C. K., Hohl, A., Schonberger, R. B., Colquhoun, D. A., Dutton, R. P., Andreae, M., Pearson, J. F. 2026; 12: e69133

  Abstract

  Background: Social determinants of health continue to drive persistent disparities in perioperative care. Our team has previously demonstrated racial and socioeconomic disparities in perioperative processes, notably in the administration of antiemetic prophylaxis, in several large perioperative registries. Given how neighborhoods are socially segregated in the United States, we examined geospatial clustering of perioperative antiemetic disparities.Objective: The study aimed to determine whether disparities in perioperative antiemetic prophylaxis exhibit geographic clustering based on neighborhood-level disadvantage and whether patients from disadvantaged communities are more likely to be undertreated after adjusting for individual postoperative nausea and vomiting risk.Methods: We conducted a retrospective cohort study of anesthetic records from the University of Utah Hospital involving 19,477 patients who met the inclusion criteria. We geocoded patient home addresses and combined them with the census block group-level neighborhood disadvantage, a composite index from the National Neighborhood Data Archive. We stratified our patients by antiemetic risk score and calculated the number of antiemetic interventions. We used Poisson spatial scan statistics, implemented in SaTScan (Information Management Services, Inc), to detect geographic clusters of undertreatment.Results: We identified 1 significant cluster (P<.001) of undertreated perioperative antiemetic prophylaxis cases. The relative risk of the whole cluster was 1.44, implying that patients within the cluster were 1.44 times more likely to receive fewer antiemetics after controlling for antiemetic risk. Patients from more disadvantaged neighborhoods were more likely to receive below-median antiemetic prophylaxis after controlling for risk.Conclusions: To our knowledge, this is the first geospatial cluster analysis of perioperative process disparities; we leveraged innovative geostatistical methods and identified a spatially defined, geographic cluster of patients whose home address census-tract level neighborhood deprivation index predicted disparities in risk-adjusted antiemetic prophylaxis.

  View details for DOI 10.2196/69133

  View details for PubMedID 41734334

• Modified full-face snorkel masks as reusable personal protective equipment for hospital personnel. PloS one Kroo, L., Kothari, A., Hannebelle, M., Herring, G., Pollina, T., Chang, R., Peralta, D., Banavar, S. P., Flaum, E., Soto-Montoya, H., Li, H., Combes, K., Pan, E., Vu, K., Yen, K., Dale, J., Kolbay, P., Ellgas, S., Konte, R., Hajian, R., Zhong, G., Jacobs, N., Jain, A., Kober, F., Ayala, G., Allinne, Q., Cucinelli, N., Kasper, D., Borroni, L., Gerber, P., Venook, R., Baek, P., Arora, N., Wagner, P., Miki, R., Kohn, J., Kohn Bitran, D., Pearson, J., Arias-Arco, B., Larrainzar-Garijo, R., Herrera, C. M., Prakash, M. 2021; 16 (1): e0244422

  Abstract

  Here we adapt and evaluate a full-face snorkel mask for use as personal protective equipment (PPE) for health care workers, who lack appropriate alternatives during the COVID-19 crisis in the spring of 2020. The design (referred to as Pneumask) consists of a custom snorkel-specific adapter that couples the snorkel-port of the mask to a rated filter (either a medical-grade ventilator inline filter or an industrial filter). This design has been tested for the sealing capability of the mask, filter performance, CO2 buildup and clinical usability. These tests found the Pneumask capable of forming a seal that exceeds the standards required for half-face respirators or N95 respirators. Filter testing indicates a range of options with varying performance depending on the quality of filter selected, but with typical filter performance exceeding or comparable to the N95 standard. CO2 buildup was found to be roughly equivalent to levels found in half-face elastomeric respirators in literature. Clinical usability tests indicate sufficient visibility and, while speaking is somewhat muffled, this can be addressed via amplification (Bluetooth voice relay to cell phone speakers through an app) in noisy environments. We present guidance on the assembly, usage (donning and doffing) and decontamination protocols. The benefit of the Pneumask as PPE is that it is reusable for longer periods than typical disposable N95 respirators, as the snorkel mask can withstand rigorous decontamination protocols (that are standard to regular elastomeric respirators). With the dire worldwide shortage of PPE for medical personnel, our conclusions on the performance and efficacy of Pneumask as an N95-alternative technology are cautiously optimistic.

  View details for DOI 10.1371/journal.pone.0244422

  View details for PubMedID 33439902