Imperial College London

Mr Alex Almoudaris BSc.(Hons.) MBBS DIC PhD FRCS

Faculty of MedicineDepartment of Surgery & Cancer

Honorary Clinical Research Fellow
 
 
 
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Contact

 

+44 (0)20 3312 7651a.almoudaris

 
 
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Location

 

1089Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Publication Type
Year
to

49 results found

Barugola G, Bertocchi E, Leonardi A, Almoudaris AM, Ruffo Get al., 2021, Post surgical rectovaginal fistula: who really benefits from stoma diversion?, Updates in Surgery, Vol: 73, Pages: 165-171, ISSN: 2038-131X

Journal article

Worley G, Almoudaris A, Bassett P, Segal J, Akbar A, Ghosh S, Aylin P, Faiz Oet al., 2020, Colectomy rates for ulcerative colitis in England 2003-2016, ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Vol: 53, Pages: 484-498, ISSN: 0269-2813

Journal article

Burke JR, Downey C, Almoudaris AM, 2020, Failure to Rescue Deteriorating Patients, Journal of Patient Safety, Vol: Publish Ahead of Print, ISSN: 1549-8417

Journal article

Worley G, Almoudaris A, Bassett P, Segal J, Akbar A, Aylin P, Faiz Oet al., 2019, A nationwide cohort study of colectomy rates for ulcerative colitis during the introduction of biologic therapy, Publisher: OXFORD UNIV PRESS, Pages: S65-S66, ISSN: 1873-9946

Conference paper

Celentano V, Smart N, McGrath J, Cahill RA, Spinelli A, Obermair A, Hasegawa H, Lal P, Almoudaris AM, Hitchins CR, Pellino G, Browning MG, Ishida T, Luvisetto F, Cingiloglu P, Gash K, Harries R, Harji D, Di Candido F, Cassinotti E, McDermott FD, Berry JEA, Battersby NJ, Platt E, Campain NJ, Keeler BD, Boni L, Gupta S, Griffith J, Acheson AG, Cecil T, Coleman MGet al., 2018, LAP-VEGaS Practice Guidelines for Reporting of Educational Videos in Laparoscopic Surgery A Joint Trainers and Trainees Consensus Statement, ANNALS OF SURGERY, Vol: 268, Pages: 920-926, ISSN: 0003-4932

Journal article

Burke J, Faiz O, Vincent C, Almoudaris Aet al., 2018, Failure to rescue deteriorating patients; a systematic review of causation and practical intervention strategies in colorectal surgery, International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland, Publisher: WILEY, Pages: 53-53, ISSN: 0007-1323

Conference paper

Manook M, Almoudaris AM, Zosimas D, Hayles K, Hepworth Cet al., 2018, 'Hepworth hitch': parastomal hernia prevention by simple modifications of operative techniques, TECHNIQUES IN COLOPROCTOLOGY, Vol: 22, Pages: 461-463, ISSN: 1123-6337

Journal article

Mcglone ER, Khan OA, Almoudaris AA, Adamo M, Dexter S, Findlay I, Hopkins J, Menon V, Reddy M, Sedman P, Small P, Somers S, Walton P, Welbourn Ret al., 2017, IS PRE-OPERATIVE WEIGHT LOSS ASSOCIATED WITH BETTER LONGER TERM WEIGHT LOSS IN PATIENTS UNDERGOING VERTICAL SLEEVE GASTRECTOMY FOR MORBID OBESITY? Pre-operative management, Publisher: SPRINGER, Pages: 819-819, ISSN: 0960-8923

Conference paper

Pinto A, faiz O, davis R, almoudaris A, vincent Cet al., 2016, Surgical complications and their impact on patients’ psychosocial wellbeing: A systematic review and meta-analysis, BMJ Open, Vol: 6, ISSN: 2044-6055

Objective Surgical complications may affect patients psychologically due to challenges such as prolonged recovery or long-lasting disability. Psychological distress could further delay patients’ recovery as stress delays wound healing and compromises immunity. This review investigates whether surgical complications adversely affect patients’ postoperative well-being and the duration of this impact.Methods The primary data sources were ‘PsychINFO’, ‘EMBASE’ and ‘MEDLINE’ through OvidSP (year 2000 to May 2012). The reference lists of eligible articles were also reviewed. Studies were eligible if they measured the association of complications after major surgery from 4 surgical specialties (ie, cardiac, thoracic, gastrointestinal and vascular) with adult patients’ postoperative psychosocial outcomes using validated tools or psychological assessment. 13 605 articles were identified. 2 researchers independently extracted information from the included articles on study aims, participants’ characteristics, study design, surgical procedures, surgical complications, psychosocial outcomes and findings. The studies were synthesised narratively (ie, using text). Supplementary meta-analyses of the impact of surgical complications on psychosocial outcomes were also conducted.Results 50 studies were included in the narrative synthesis. Two-thirds of the studies found that patients who suffered surgical complications had significantly worse postoperative psychosocial outcomes even after controlling for preoperative psychosocial outcomes, clinical and demographic factors. Half of the studies with significant findings reported significant adverse effects of complications on patient psychosocial outcomes at 12 months (or more) postsurgery. 3 supplementary meta-analyses were completed, 1 on anxiety (including 2 studies) and 2 on physical and mental quality of life (including 3 studies). The latter indicated statistically signi

Journal article

Johnston MJ, Arora S, King D, Bouras G, Almoudaris AM, Davis R, Darzi Aet al., 2015, A systematic review to identify the factors that affect failure to rescue and escalation of care in surgery, Surgery, Vol: 157, Pages: 752-763, ISSN: 0039-6060

BackgroundThe relationship between the ability to recognize and respond to patient deterioration (escalate care) and its role in preventing failure to rescue (FTR; mortality after a surgical complication) has not been explored. The aim of this systematic review was to determine the incidence of, and factors contributing to, FTR and delayed escalation of care for surgical patients.MethodsA search of MEDLINE, EMBASE PsycINFO, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials was conducted to identify articles exploring FTR, escalation of care, and interventions that influence outcomes. Screening of 19,887 citations led to inclusion of 42 articles.ResultsThe reported incidence of FTR varied between 8.0 and 16.9%. FTR was inversely related to hospital volume and nurse staffing levels. Delayed escalation occurred in 20.7–47.1% of patients and was associated with greater mortality rates in 4 studies (P < .05). Causes of delayed escalation included hierarchy and failures in communication. Of five interventional studies, two reported a significant decrease in intensive care admissions (P < .01) after introduction of escalation protocols; only 1 study reported an improvement in mortality.ConclusionThis systematic review explored factors linking FTR and escalation of care in surgery. Important factors that contribute to the avoidance of preventable harm include the recognition and communication of serious deterioration to implement definitive treatment. Targeted interventions aiming to improve these factors may contribute to enhanced patient outcome.

Journal article

Almoudaris AM, Mamidanna R, Faiz O, 2014, Failure to Rescue in Trauma Patients: Operative Interventions Must Be Considered, ANNALS OF SURGERY, Vol: 259, Pages: E85-E85, ISSN: 0003-4932

Journal article

Burns EM, Bottle A, Almoudaris AM, Mamidanna R, Aylin P, Darzi A, Nicholls RJ, Faiz ODet al., 2013, Hierarchical multilevel analysis of increased caseload volume and postoperative outcome after elective colorectal surgery, BRITISH JOURNAL OF SURGERY, Vol: 100, Pages: 1531-U1538, ISSN: 0007-1323

Journal article

Symons NRA, Moorthy K, Almoudaris AM, Bottle A, Aylin P, Vincent CA, Faiz ODet al., 2013, Mortality in high-risk emergency general surgical admissions, BRITISH JOURNAL OF SURGERY, Vol: 100, Pages: 1318-1325, ISSN: 0007-1323

Journal article

Mamidanna R, Almoudaris AM, Bottle A, Aylin P, Faiz O, Hanna GBet al., 2013, National outcomes and uptake of laparoscopic gastrectomy for cancer in England, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol: 27, Pages: 3348-3358, ISSN: 0930-2794

Journal article

Symons NRA, Faiz OD, Moorthy K, Almoudaris AM, Bottle RA, Aylin PP, Vincent CAet al., 2013, The effects of resource availability on mortality for emergency general surgical admissions, 99th Annual Clinical Congress of the American-College-of-Surgeons / 68th Annual Sessions of the Owen H Wangensteen Surgical Forum on Fundamental Surgical Problems, Publisher: ELSEVIER SCIENCE INC, Pages: S109-S109, ISSN: 1072-7515

Conference paper

Bertels J, Almoudaris AM, Cortoos P-J, Jacklin A, Franklin BDet al., 2013, Feedback on prescribing errors to junior doctors: exploring views, problems and preferred methods, INTERNATIONAL JOURNAL OF CLINICAL PHARMACY, Vol: 35, Pages: 332-338, ISSN: 2210-7703

Journal article

Almoudaris AM, Mamidanna R, Bottle A, Aylin P, Vincent C, Faiz O, Hanna GBet al., 2013, Failure to Rescue Patients After Reintervention in Gastroesophageal Cancer Surgery in England, JAMA SURGERY, Vol: 148, Pages: 272-276, ISSN: 2168-6254

Journal article

Symons NRA, Almoudaris AM, Nagpal K, Vincent CA, Moorthy Ket al., 2013, An Observational Study of the Frequency, Severity, and Etiology of Failures in Postoperative Care After Major Elective General Surgery, ANNALS OF SURGERY, Vol: 257, Pages: 1-5, ISSN: 0003-4932

Journal article

Patel VM, Ashrafian H, Almoudaris A, Makanjuola J, Bucciarelli-Ducci C, Darzi A, Athanasiou Tet al., 2013, Measuring academic performance for healthcare researchers with the H index: which search tool should be used?, Medical Principles and Practice, Vol: 22, Pages: 178-183, ISSN: 1011-7571

Objectives: To compare H index scores for healthcare researchers returned by Google Scholar, Web of Science and Scopus databases, and to assess whether a researcher’s age, country of institutional affiliation and physician status influences calculations. Subjects and Methods: One hundred and ninety-five Nobel laureates in Physiology and Medicine from 1901 to 2009 were considered. Year of first and last publications, total publications and citation counts, and the H index for each laureate were calculated from each database. Cronbach’s alpha statistics was used to measure the reliability of H index scores between the databases. Laureate characteristic influence on the H index was analysed using linear regression. Results: There was no concordance between the databases when considering the number of publications and citations count per laureate. The H index was the most reliably calculated bibliometric across the three databases (Cronbach’s alpha = 0.900). All databases returned significantly higher H index scores for younger laureates (p < 0.0001). Google Scholar and Web of Science returned significantly higher H index for physician laureates (p = 0.025 and p = 0.029, respectively). Country of institutional affiliation did not influence the H index in any database. Conclusion: The H index appeared to be the most consistently calculated bibliometric between the databases for Nobel laureates in Physiology and Medicine. Researcher-specific characteristics constituted an important component of objective research assessment. The findings of this study call to question the choice of current and future academic performance databases.

Journal article

Mamidanna R, Eid-Arimoku L, Almoudaris AM, Burns EM, Bottle A, Aylin P, Hanna GB, Faiz Oet al., 2012, Poor 1-Year Survival in Elderly Patients Undergoing Nonelective Colorectal Resection, DISEASES OF THE COLON & RECTUM, Vol: 55, Pages: 788-796, ISSN: 0012-3706

Journal article

Almoudaris AM, Burns E, Bottle A, Aylin P, Darzi A, Vincent Cet al., 2012, Single measures of performance do not reflect overall institutional quality in colorectal cancer surgery, Gut

Objective To evaluate overall performance of English colorectal cancer surgical units identified as outliers for a single quality measure—30 day inhospital mortality.Design 144 542 patients that underwent primary major colorectal cancer resection between 2000/2001 and 2007/2008 in 149 English National Health Service units were included from hospital episodes statistics. Casemix adjusted funnel plots were constructed for 30 day inhospital mortality, length of stay, unplanned readmission within 28 days, reoperation, failure to rescue-surgical (FTR-S) and abdominoperineal excision (APE) rates. Institutional performance was evaluated across all other domains for institutions deemed outliers for 30 day mortality. Outliers were those that lay on or breached 3 SD control limits. ‘Acceptable’ performance was defined if units appeared under the upper 2 SD limit.Results 5 high mortality outlier (HMO) units and 15 low mortality outlier (LMO) units were identified. Of the five HMO units, two were substandard performance outliers (ie, above 3 SD) on another metric (both on high reoperation rates). A further two HMO institutions exceeded the second but not the third SD limits for substandard performance on other outcome metrics. One of the 15 LMO units exceeded 3 SD for substandard performance (APE rate). One LMO institution exceeded the second but not the third SD control limits for high reoperation rates. Institutional mortality correlated with FTR-S and reoperations (R=0.445, p<0.001 and R=0.191, p<0.020 respectively).Conclusions Performance appraisal in colorectal surgery is complex and dependent on stakeholder perspective. Benchmarking units solely on a single performance measure is over simplistic and potentially hazardous. A global appraisal of institutional outcome is required to contextualise performance.

Journal article

Almoudaris, 2011, Imaging of Acute Appendicitis in Adults and Children, Imaging of Acute Appendicitis in Adults and Children, Editors: Keyzer, Gevenois, Keyzer, Gevenois, Keyzer, Gevenois, Publisher: Springer Verlag, Pages: 45-55, ISBN: 9783642178719

Treatment of Appendiceal Perforation Alex M. Almoudaris and Omar Faiz Abstract The treatment of appendiceal perforation is subject to considerable debate in ...

Book chapter

Almoudaris AM, Burns E, Bottle A, Aylin P, Vincent Cet al., 2011, Failure to Rescue- Surgical (FTR-S): Defining an important metric in surgery [invited talk], British Association of Surgical Oncologists (BASO)

Conference paper

Symons, Almoudaris, Nagpal, Vincent, Moorthyet al., 2011, Teamwork and communication failures in post-operative care, American College of Surgeons Clinical Congress

Conference paper

Lauretta A, Almoudaris AM, Jiao LR, 2011, Septic Thrombophlebitis of Portal Vein: Unusual Presentation of Appendicitis, AMERICAN SURGEON, Vol: 77, Pages: E206-E207, ISSN: 0003-1348

Journal article

Andrea L, Almoudaris AM, Jiao L, 2011, Septic Thrombophlebitis of Portal Vein: Unusual Presentation of Appendicitis, American Surgeon

Journal article

Almoudaris AM, Burns E, Bottle A, Aylin P, Vincent C, Faiz Oet al., 2011, How do postoperative mortality ‘outlier’ institutions for colorectal cancer surgery perform on other measures of quality?, European Society of Coloproctologists

Conference paper

Kirresh A, Patel VM, Warren OJ, Ali M, Ashrafian H, Almoudaris AM, Darzi A, Athanasiou Tet al., 2011, A framework to establish a mentoring programme in surgery, LANGENBECKS ARCHIVES OF SURGERY, Vol: 396, Pages: 811-817, ISSN: 1435-2443

Journal article

Almoudaris AM, Burns E, Bottle A, Aylin P, Vincent C, Faiz Oet al., 2011, Failure To Rescue-Surgical (FTR-S): Defining an important metric in surgery, Tripartite Colorectal meeting of the Associations of Coloproctologists of Great Britain & Ireland, United States and Australasia

Conference paper

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