Kirbi Yelorda, MD, MS

All Publications

• Association of Cumulative Social Risk and Cancer-Specific Survival Among Patients With Advanced Colorectal Cancer. Diseases of the colon and rectum Yelorda, K., Day, H., Arnow, M. K., Fu, S., Kim, S. A., Morris, A. M. 2025

  Abstract

  Socioeconomic disadvantage is widely associated with poor clinical outcomes among patients with colorectal cancer. Interventions to address these pervasive public health problems have had mixed success, potentially related to their development based on aggregated data (e.g., average zip code income) and short-term outcomes, rather than individual level data and meaningful long-term cancer outcomes.To examine associations of individual and cumulative multiple, co-occurring individual-level social risk factors with long-term cancer-specific survival among patients with advanced colorectal cancer.Prospective cohort study.Between 2011-2014, we collaborated with Surveillance, Epidemiology and End Result in Georgia and Detroit to survey patients with Stage III colorectal cancer in the prior year. Cumulative social risk was calculated by summing significant factors associated with colorectal cancer-specific mortality: employment, insurance, health literacy, income, and marital status.Patients with stage III colorectal cancer.Time from diagnosis to cancer-specific mortality, adjusted for age, race, sex, and chemotherapy receipt, with comparisons provided in hazard ratios with 95% confidence intervals.Among 1173 patients, pre-operative unemployment (1.76 [1.30-2.39]), uninsured or Medicaid insurance (1.54 [1.12-2.11]), low health literacy (1.40 [1.00-1.95]), annual income < $50,000 (1.34 [1.01-1.77]) and being unpartnered (1.34 [1.02-1.77]) were associated with higher likelihood of cancer-specific mortality. In cumulative risk analyses, each added social risk was associated with 24% higher adjusted likelihood of cancer-specific mortality (1.24 [1.12-1.37]).This study has limitations inherent to survey research including the potential lack of generalizability and responses subject to recall bias. Additionally, the cross-sectional survey and linked longitudinal clinical data do not allow for determination of causality.Cumulative social risk was associated with long-term cancer-specific survival after treatment for Stage III colorectal cancer. Assessing social risk may help identify patients with colorectal cancer who are at higher risk of mortality to receive support programs designed to mitigate social disadvantage. See Video Abstract.

  View details for DOI 10.1097/DCR.0000000000003851

  View details for PubMedID 40521691

• Resident-Applicant Buddy Program Increases Applicant Interest and Program Transparency. Journal of surgical education Shearer, J., Ngongoni, R. F., Yelorda, K., Nobuhara, C., Lin, D. T., Gahagan, J., Dua, M., Spain, D. A., Liebert, C. A. 2024; 81 (11): 1792-1797

  Abstract

  Resident-Applicant Buddy Programs (RABPs) are a new initiative designed to improve resident recruitment. This study aims to evaluate the impact and perceived value of RABPs and to identify areas for improvement for future recruitment cycles.Anonymous online survey study of RABP participants with mixed-methods approach to evaluate participants' experience and perceived impact of the program. The survey queried demographics, Likert responses, and open-ended responses. Qualitative thematic analysis of open-ended responses was performed with inductive coding in an iterative fashion by 2 raters.This study was conducted at a general surgery residency program at a tertiary academic institution during 2022-2023 recruitment cycle.Of 125 RABP participants (n = 39 residents and n = 86 interviewed applicants), surveys from n = 45 participants (n = 19 residents, 66%; n = 26 applicants, 30%) were completed and analyzed.Applicants were predominantly female (65%) and first-generation physicians (69%). Buddy pairings were 65% gender concordant and 48% race/ethnicity concordant. Many applicants (60%) participated in RABPs at other institutions. Buddies connected for a mean (SD) of 52 (28) minutes. Majority of applicants agreed the program decreased stress/apprehension about interviewing (70%, 4.0 [1.1]), helped understand resident life at the program (91%, 4.3 [1.0]), and increased desire to match in the program (65%, 4.0 [1.1]). Residents agreed they enjoyed participation (89%, 4.5 [0.7]), the program should be continued (100%, 4.8 [0.4]), and desired to participate again (100%, 4.8 [0.4]). Thematic analysis revealed applicants valued the program as an approachable source of information, illumination of program culture, aid in interview preparation, and connection between applicant and program. Applicants appreciated the intentionality of the program to create a RABP.RABP decreased applicants' stress, improved understanding of resident life, and for the majority, increased desire to match at the program. Resident engagement and desire for ongoing participation in the RABP was high. Overall, RABPs can increase applicant interest and program transparency.

  View details for DOI 10.1016/j.jsurg.2024.08.010

  View details for PubMedID 39321695

• Recommendations of the Blue Ribbon Committee II for the Optimization of Surgical Education and Training in the United States: The Surgical Trainee Perspective. Annals of surgery Johnson, W. R., Mainali, B. B., Chen, X., Alobuia, W., Anderson, E. M., Martin, R., Caldwell, K. E., Dawson-Amoah, K., Doyle, K., Ellis, D., Fazzone, B., Ghio, M., Godfrey, C. M., Gomes, C., Hoefer, L., Kearse, L., Niehaus-White, H., Phelps, H., Riner, A. N., Sharon, C., Shin, T. H., Yelorda, K., Coleman, J. R. 2024

  Abstract

  This study aims to appraise recommendations from an expert panel of surgical educators on optimizing surgical education and training in the setting of contemporary challenges.The Blue Ribbon Committee (BRC II), a group of surgical educators, was convened to make recommendations to optimize surgical training considering the current changes in the landscape of surgical education. Surgical trainees were recruited to assess their impressions of the recommendations.A mixed-methods study design was employed, with a survey, followed by focus group interviews. Participating residents and fellows were recruited through a purposeful sampling approach. Descriptive statistics were applied to analyze the survey data, and a thematic data analysis on interview transcripts was employed.The majority of trainee respondents (n=16) thought that all of the subcommittee recommendations should be included in the final BRC II recommendations and paper. According to the interviews, overall, the feedback from the trainees was positive, with particular excitement around work-life integration, education support and faculty development, and funding pitfalls. Some themes about concerns included a lack of clarity about the recommendations, concern about some recommendations being in conflict with one another, and a disconnect between the initial BRC II survey and the subsequent recommendations.The residents gathered for this focus group were encouraged by the thought, effort, and intention that gathered the surgical leaders across the country to make the recommendations. While there were areas the trainees wanted clarity on, the overall opinion was in agreement with the recommendations.

  View details for DOI 10.1097/SLA.0000000000006483

  View details for PubMedID 39109446

• Ventriculoperitoneal shunt migration into an inguinal hernia with subsequent laparoscopic reduction and hernia repair. Trauma surgery & acute care open Lou, V., Yelorda, K., Tung, J. 2022; 7 (1): e000951

  View details for DOI 10.1136/tsaco-2022-000951

  View details for PubMedID 35692610

  View details for PubMedCentralID PMC9134172

• Ventriculoperitoneal shunt migration into an inguinal hernia with subsequentreduction and hernia repair TRAUMA SURGERY & ACUTE CARE OPEN Lou, V., Yelorda, K., Tung, J. 2022; 7 (1)

  View details for DOI 10.1136/tsaco-2022-000951

  View details for Web of Science ID 000802208900001

• Association Between High-Deductible Health Plans and Hernia Acuity. JAMA surgery Yelorda, K., Rose, L., Bundorf, M. K., Muhammad, H. A., Morris, A. M. 2022

  Abstract

  Importance: About half of people younger than 65 years with private insurance are enrolled in a high-deductible health plan (HDHP). While these plans entail substantially higher out-of-pocket costs for patients with chronic medical conditions who require ongoing care, their effect on patients undergoing surgery who require acute care is poorly understood. It is plausible that higher out-of-pocket costs may lead to delays in care and more complex surgical conditions.Objective: To determine the association between enrollment in HDHPs and presentation with incarcerated or strangulated hernia.Design, Setting, and Participants: This retrospective cohort analysis included privately insured patients aged 18 to 63 years from a large commercial insurance claims database who underwent a ventral or groin hernia operation from January 2016 through June 2019 and classified their coverage as either a traditional health plan or an HDHP per the Internal Revenue Service's definition. Multivariable regression, adjusting for demographic and clinical covariates, was used to examine the association between enrollment in an HDHP and the primary outcome of presentation with an incarcerated or strangulated hernia.Exposures: Traditional health plan vs HDHP.Main Outcomes and Measures: Presence of an incarcerated or strangulated hernia per International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnosis codes.Results: Among 83 281 patients (71.9% men and 28.1% women; mean [SD] age, 48.7 [10.9] years) who underwent hernia surgery, 27 477 (33.0%) were enrolled in an HDHP and 21 876 (26.2%) had a hernia that was coded as incarcerated or strangulated. The mean annual deductible was considerably higher for those in the HDHP group than their traditional health plan counterparts (unadjusted mean [SD], $3635 [$2094] vs $705 [$737]; adjusted, -$2931; P<.001). Patients in the HDHP group were more likely to present with an incarcerated or strangulated hernia (adjusted odds ratio, 1.07; 95% CI, 1.03-1.11; P<.001).Conclusions and Relevance: In this cohort study, enrollment in an HDHP was associated with higher odds of presenting with an incarcerated or strangulated hernia, which is more likely to require emergency surgery that precludes medical optimization. These data suggest that, among patients with groin and ventral hernias, enrollment in an HDHP may be associated with delays in surgical care that result in complex disease presentation.

  View details for DOI 10.1001/jamasurg.2021.7567

  View details for PubMedID 35152285

• Analysis of Survival Among Adults With Early-Onset Colorectal Cancer. JAMA network open Yelorda, K. L., Fu, S. J., Owens, D. K. 2021; 4 (6): e2112878

  View details for DOI 10.1001/jamanetworkopen.2021.12878

  View details for PubMedID 34132797

• Self-efficacy Toward a Healthcare Career Among Minority High School Students in a Surgical Pipeline Program: A Mixed Methods Study. Journal of surgical education Yelorda, K., Bidwell, S., Fu, S., Miller, M. O., Merrell, S. B., Koshy, S., Morris, A. M. 2021

  Abstract

  OBJECTIVE: While many barriers to healthcare careers exist for URM students, a strong sense of self-efficacy may help mitigate these obstacles. This study explores how URM high school students describe their academic challenges and compares their descriptions across self-efficacy scores.DESIGN: We conducted a convergent mixed methods study of URM high school students. Students completed a validated self-efficacy questionnaire and participated in semi-structured focus group interviews to discuss their approach to academic challenges, goal setting, and achievement. The primary outcome was academic, social, and emotional self-efficacy, measured using the Self-Efficacy Questionnaire for Children. We separated participants into high and low self-efficacy groups based on scores in each domain. Using thematic analysis, we identified and compared common themes associated with academic challenges and goal setting.SETTING: Surgical exposure pipeline program sponsored by Stanford University Department of Surgery PARTICIPANTS: Low-income, high academic achieving URM high school students interested in science, technology, engineering and mathematics, and/or healthcare careers.RESULTS: Thirty-one high school students completed the focus groups and self-efficacy questionnaire. Most students scored in the high self-efficacy group for at least one domain: 65% for academic self-efficacy, 56% for social self-efficacy, and 19% for emotional self-efficacy. Four emergent themes highlighted participants' perspectives toward educational success: fulfillment in academic challenges, focus on future goals, failing forward, and asking for help. Compared to students with low self-efficacy scores, students in the high-scoring self-efficacy groups more often discussed strategies and concrete behaviors such as the importance of seeking support from teachers and peers and learning from failure.CONCLUSIONS: Students in high self-efficacy groups were more comfortable utilizing approaches that helped them succeed academically. Additional efforts are needed to bolster student self-efficacy, particularly in students from URM backgrounds, to increase diversity in medical schools.

  View details for DOI 10.1016/j.jsurg.2021.04.010

  View details for PubMedID 34011476

• Are Statins Associated With Reduced Risk of Adhesion-Related Complications After Abdominal Surgery? JAMA network open Fu, S., Yelorda, K., Knowlton, L. 2021; 4 (2): e2037296

  View details for DOI 10.1001/jamanetworkopen.2020.37296

  View details for PubMedID 33533927

• BASE Jumping Injuries Presenting to Emergency Departments in the United States: an Assessment of Morbidity, Emergency Department, and Inpatient Costs WILDERNESS & ENVIRONMENTAL MEDICINE Forrester, J. D., Yelorda, K., Tennakoon, L., Spain, D. A., Staudenmayer, K. 2019; 30 (2): 150–54

  View details for DOI 10.1016/j.wem.2019.02.002

  View details for Web of Science ID 000472986100007

• BASE Jumping Injuries Presenting to Emergency Departments in the United States: an Assessment of Morbidity, Emergency Department, and Inpatient Costs. Wilderness & environmental medicine Forrester, J. D., Yelorda, K., Tennakoon, L., Spain, D. A., Staudenmayer, K. 2019

  Abstract

  BACKGROUND: BASE (building, antenna, span, earth) jumping involves jumping from fixed objects with specialized parachutes. BASE jumping is associated with less aerodynamic control and flight stability than skydiving because of the lower altitude of jumps. Injuries and fatalities are often attributed to bad landings and object collision.METHODS: We performed a retrospective analysis of the 2010-2014 National Emergency Department Sample database, a nationally representative sample of all visits to US emergency departments (EDs). BASE jumping-associated injuries were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes [E004.0]. Outcomes evaluated included morbidity, mortality, inpatient admission, and costs. Adjusted analyses accounting for survey methodology were performed.RESULTS: After weighting, 1790 BASE-associated ED presentations were identified with 358±28 injuries annually. A total of 1313 patients (73%) were aged 18 to 44 y, and 1277 (71%) were male. Nine hundred seventy-six (55%) multiple body system injuries and 677 (38%) isolated extremity injuries were reported. There were 1588 (89%) patients discharged home from the ED; only 144 (7%) were admitted as inpatients. On multivariate logistic regression, only anatomic site of injury was associated with inpatient admission (odds ratio=0.6, P<0.001, 95% CI 0.5-0.8). Including ED and inpatient costs, BASE injuries cost the US healthcare system approximately $1.7 million annually. No deaths were identified within the limitations of the survey design.CONCLUSIONS: Although deemed one of the most dangerous extreme sports, many patients with BASE injuries surviving to arrival at definitive medical care do not require inpatient admission.

  View details for PubMedID 31003883

• Development and Implementation of a Hands-on Surgical Pipeline Program for Low-Income High School Students. JAMA network open Bidwell, S. S., Miller, M. O., Lee, E. W., Yelorda, K. n., Koshy, S. n., Hawn, M. n., Morris, A. M. 2019; 2 (8): e199991

  View details for DOI 10.1001/jamanetworkopen.2019.9991

  View details for PubMedID 31441933