2024
The Impact of Preoperative Spinal Injection Timing on the Postoperative Complications of Lumbar Fusion
Mirpuri P, Khalid S, Colliander R, King P, Tao X, Elsamadicy A, Mehta A, Adogwa O. The Impact of Preoperative Spinal Injection Timing on the Postoperative Complications of Lumbar Fusion. World Neurosurgery 2024, 190: e121-e128. PMID: 39002778, DOI: 10.1016/j.wneu.2024.07.050.Peer-Reviewed Original ResearchTransforaminal lumbar interbody fusionCSF leakSurgical complicationsComplication rateIncidence of CSF leakRate of CSF leakSecondary outcomesRate of surgical complicationsSurgical complication ratePostoperative surgical complicationsSurgical site infectionDay of surgeryLumbar interbody fusionPostoperative complicationsSite infectionWound disruptionPostoperative rateAdult patientsLumbar fusionInterbody fusionIncreased riskPrimary outcomePatientsSurgeryPrimary analysisImpact of a quality improvement initiative and monthly multidisciplinary meetings on outcomes after posterior spinal fusion for adolescent idiopathic scoliosis
Hengartner A, Elsamadicy A, Jonnalagadda A, Craft S, Sherman J, Reeves B, Fernandez T, Hobbs J, Koo A, DiLuna M, Tuason D. Impact of a quality improvement initiative and monthly multidisciplinary meetings on outcomes after posterior spinal fusion for adolescent idiopathic scoliosis. Spine Deformity 2024, 12: 1043-1051. PMID: 38493442, DOI: 10.1007/s43390-024-00859-2.Peer-Reviewed Original ResearchPosterior spinal instrumented fusionPre-QI cohortAdolescent idiopathic scoliosisMultidisciplinary team meetingsProportion of patientsLength of stayPre-QITeam meetingsPost-QIPostoperative complicationsIdiopathic scoliosisQuality improvementQuality improvement initiativesPostoperative ambulationBenefits of enhanced recoveryMethodsThe medical recordsPain control protocolIntraoperative drain placementPosterior spinal fusionSpinal instrumented fusionQI implementationImprovement initiativesPatient careAmbulation statusDrain placement
2023
Racial/Ethnic Disparities Among Patients Undergoing Anterior Cervical Discectomy and Fusion or Posterior Cervical Decompression and Fusion for Cervical Spondylotic Myelopathy: A National Administrative Database Analysis
Elsamadicy A, Sayeed S, Sherman J, Craft S, Reeves B, Hengartner A, Koo A, Larry Lo S, Shin J, Mendel E, Sciubba D. Racial/Ethnic Disparities Among Patients Undergoing Anterior Cervical Discectomy and Fusion or Posterior Cervical Decompression and Fusion for Cervical Spondylotic Myelopathy: A National Administrative Database Analysis. World Neurosurgery 2023, 183: e372-e385. PMID: 38145651, DOI: 10.1016/j.wneu.2023.12.103.Peer-Reviewed Original ResearchCervical spondylotic myelopathyNon-routine dischargeHealthcare resource utilizationExtended hospital LOSHospital LOSWhite patientsHispanic patientsPatient raceNational Inpatient Sample databaseMultivariate logistic regression analysisGreater comorbidity burdenRacial/Ethnic DisparitiesAdministrative database analysisLogistic regression analysisRace/ethnicityACDF cohortComorbidity burdenPostoperative complicationsAdult patientsAdverse eventsPatient demographicsSpondylotic myelopathyIndependent predictorsSurgical outcomesBlack raceEffects of delayed ambulation following posterior spinal fusion for adolescent idiopathic scoliosis: a single institutional study
Hengartner A, David W, Reeves B, Craft S, Boroumand S, Clappier M, Hansen J, Fernandez T, Koo A, Tuason D, DiLuna M, Elsamadicy A. Effects of delayed ambulation following posterior spinal fusion for adolescent idiopathic scoliosis: a single institutional study. Spine Deformity 2023, 11: 1127-1136. PMID: 37093449, DOI: 10.1007/s43390-023-00693-y.Peer-Reviewed Original ResearchConceptsPosterior spinal fusionAdolescent idiopathic scoliosisSpinal fusionPostoperative complicationsRisk factorsIdiopathic scoliosisMultivariate stepwise logistic regressionOral pain medicationTotal hospital lengthTwenty-nine patientsMethodsThe medical recordsSingle institutional studyStepwise logistic regressionMajor academic institutionHospital lengthHospital stayNine patientsPain medicationUnplanned readmissionIntraoperative variablesPatient demographicsPostoperative outcomesRBC transfusionHealthcare utilizationOperative timeAssociation Between Intravenous to Oral Opioid Transition Time and Length of Hospital Stay After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis.
Hengartner A, Havlik J, David W, Reeves B, Freedman I, Sarkozy M, Maloy G, Fernandez T, Craft S, Koo A, Tuason D, DiLuna M, Elsamadicy A. Association Between Intravenous to Oral Opioid Transition Time and Length of Hospital Stay After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis. The International Journal Of Spine Surgery 2023, 17: 468-476. PMID: 37076256, PMCID: PMC10312154, DOI: 10.14444/8448.Peer-Reviewed Original ResearchPosterior spinal fusionAdolescent idiopathic scoliosisExtended LOSSpinal fusionIdiopathic scoliosisMultivariate analysisMultilevel posterior spinal fusionLength of hospitalPostoperative complication rateMajor academic institutionOral opioidsHospital LOSStudy patientsDischarge dispositionHospital lengthPostoperative complicationsPostoperative courseComplication rateIntraoperative variablesLonger LOSPatient demographicsReadmission ratesMedical recordsUnivariate analysisOdds ratioDifferences in Outcomes and Health Care Resource Utilization After Surgical Intervention for Metastatic Spinal Column Tumor in Safety-Net Hospitals
Elsamadicy A, Koo A, David W, Reeves B, Sherman J, Craft S, Hersh A, Duvall J, Lo S, Shin J, Mendel E, Sciubba D. Differences in Outcomes and Health Care Resource Utilization After Surgical Intervention for Metastatic Spinal Column Tumor in Safety-Net Hospitals. Spine 2023, 48: 800-809. PMID: 36972069, DOI: 10.1097/brs.0000000000004643.Peer-Reviewed Original ResearchConceptsSpinal column tumorsSNH statusPostoperative complicationsDischarge dispositionMultivariable analysisTumor surgeryMetastatic spinal tumor surgeryHealth care resource utilizationNationwide Inpatient Sample databaseICD-10-CM codingNonroutine discharge dispositionObservational cohort studySpinal tumor surgerySafety-net hospitalNonroutine dischargeSNH patientsHospital lengthStudy patientsAdult patientsCohort studyIntraoperative variablesExtended LOSIndependent predictorsLonger LOSProlonged hospitalization
2022
Hospital Frailty Risk Score and Healthcare Resource Utilization After Surgery for Primary Spinal Intradural/Cord Tumors
Elsamadicy AA, Koo AB, Reeves BC, Pennington Z, Sarkozy M, Hersh A, Havlik J, Sherman JJZ, Goodwin CR, Kolb L, Laurans M, Lo S, Shin JH, Sciubba DM. Hospital Frailty Risk Score and Healthcare Resource Utilization After Surgery for Primary Spinal Intradural/Cord Tumors. Global Spine Journal 2022, 13: 2074-2084. PMID: 35016582, PMCID: PMC10556884, DOI: 10.1177/21925682211069937.Peer-Reviewed Original ResearchHospital Frailty Risk ScoreNon-routine dischargeFrailty Risk ScoreImpact of frailtyCost of admissionDischarge dispositionFrail cohortPrimary tumorSpinal cordRisk scoreNationwide Inpatient Sample databaseRetrospective cohort studyHealthcare resource utilizationLength of stayPrimary spinal tumorsGreater mean costICD-10 codesICD-10-CM codesLarge national datasetPerioperative complicationsPostoperative complicationsAdult patientsCohort studyLonger LOSPatient characteristics
2021
Comparison of frailty metrics and the Charlson Comorbidity Index for predicting adverse outcomes in patients undergoing surgery for spine metastases.
Hersh AM, Pennington Z, Hung B, Patel J, Goldsborough E, Schilling A, Feghali J, Antar A, Srivastava S, Botros D, Elsamadicy AA, Lo SL, Sciubba DM. Comparison of frailty metrics and the Charlson Comorbidity Index for predicting adverse outcomes in patients undergoing surgery for spine metastases. Journal Of Neurosurgery Spine 2021, 36: 849-857. PMID: 34826820, DOI: 10.3171/2021.8.spine21559.Peer-Reviewed Original ResearchMetastatic spinal tumor frailty indexCharlson Comorbidity IndexLength of stayNonroutine dischargePostoperative complicationsMFI-5Frailty metricsComorbidity indexPostoperative outcomesFrailty indexSpine metastasis patientsAdverse postoperative outcomesPatient demographic characteristicsProspective multicenter cohortHigh complication rateComprehensive cancer centerRobust independent predictorOutcomes of interestMedical comorbiditiesMetastasis surgeryPostoperative morbidityComplication rateMetastasis patientsRetrospective cohortIndependent predictorsEffects of preoperative nutritional status on complications and readmissions after posterior lumbar decompression and fusion for spondylolisthesis: A propensity-score analysis
Elsamadicy AA, Havlik J, Reeves BC, Koo AB, Sherman J, Lo SL, Shin JH, Sciubba DM. Effects of preoperative nutritional status on complications and readmissions after posterior lumbar decompression and fusion for spondylolisthesis: A propensity-score analysis. Clinical Neurology And Neurosurgery 2021, 211: 107017. PMID: 34781222, DOI: 10.1016/j.clineuro.2021.107017.Peer-Reviewed Original ResearchConceptsUnplanned readmissionAdverse eventsSpine surgerySurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseOccurrence of AEsPreoperative serum albumin levelQuality Improvement Program databaseMultivariate logistic regression analysisPosterior lumbar decompressionPreoperative nutritional statusHigh rateImprovement Program databaseRetrospective cohort studySerum albumin levelSignificant independent predictorsEffects of malnutritionLogistic regression analysisPropensity score analysisPropensity-score matchingMalnourished cohortMalnourished patientsPerioperative complicationsPostoperative complicationsLumbar decompressionImpact of race on nonroutine discharge, length of stay, and postoperative complications after surgery for spinal metastases.
Hung B, Pennington Z, Hersh AM, Schilling A, Ehresman J, Patel J, Antar A, Porras JL, Elsamadicy AA, Sciubba DM. Impact of race on nonroutine discharge, length of stay, and postoperative complications after surgery for spinal metastases. Journal Of Neurosurgery Spine 2021, 36: 678-685. PMID: 34740176, DOI: 10.3171/2021.7.spine21287.Peer-Reviewed Original ResearchConceptsLow preoperative KPS scoreNonroutine dischargePreoperative KPS scoreSpinal metastasesInsurance statusPostoperative complicationsKPS scoreIndependent predictorsFunctional statusPreoperative Karnofsky Performance Scale scoreHigher Charlson comorbidity indexSingle comprehensive cancer centerKarnofsky Performance Scale scoreStepwise multivariable logistic regressionFrankel grade ANonhome discharge destinationCharlson Comorbidity IndexPreoperative clinical characteristicsPrimary tumor typeBaseline functional statusMultivariable logistic regressionMarital statusLength of stayPerformance Scale scoreComprehensive cancer centerImpact of race on outcomes and healthcare utilization following spinal fusion for adolescent idiopathic scoliosis
Elsamadicy AA, Koo AB, David WB, Freedman IG, Kundishora AJ, Hong CS, Sarkozy M, Sciubba DM, Kahle KT, DiLuna M. Impact of race on outcomes and healthcare utilization following spinal fusion for adolescent idiopathic scoliosis. Clinical Neurology And Neurosurgery 2021, 206: 106634. PMID: 33979695, DOI: 10.1016/j.clineuro.2021.106634.Peer-Reviewed Original ResearchConceptsPosterior spinal fusionPostoperative complicationsAdolescent idiopathic scoliosisPatient demographicsIdiopathic scoliosisAdolescent patientsSpine surgerySpinal fusionBlack cohortBaseline patient demographicsRate of complicationsMajority of patientsPosterior spine surgeryPosterior spinal surgeryMedian total costBaseline comorbiditiesHospital stayDischarge dispositionInpatient managementPostoperative outcomesBlood transfusionPrimary outcomeFemale patientsHealthcare utilizationHispanic patientsRace Is an Independent Predictor for Nonroutine Discharges After Spine Surgery for Spinal Intradural/Cord Tumors
Elsamadicy AA, Koo AB, David WB, Reeves BC, Freedman IG, Pennington Z, Ehresman J, Kolb L, Laurans M, Shin JH, Sciubba DM. Race Is an Independent Predictor for Nonroutine Discharges After Spine Surgery for Spinal Intradural/Cord Tumors. World Neurosurgery 2021, 151: e707-e717. PMID: 33940256, DOI: 10.1016/j.wneu.2021.04.085.Peer-Reviewed Original ResearchConceptsNonroutine discharge dispositionIndependent predictorsNonroutine dischargeDischarge dispositionCord tumorsAA raceSurgical interventionNational Inpatient Sample databaseMultivariable logistic regression analysisStepwise multivariable logistic regression analysisBackward stepwise multivariable logistic regression analysisAfrican AmericansPostoperative complication rateRetrospective cohort studyClinical Modification diagnosisLength of hospitalizationProcedural Coding SystemLogistic regression analysisHealth care costsRegression analysisMultivariate regression analysisAA/BlackPostoperative complicationsCohort studyComplication rateThe Effects of Pulmonary Risk Factors on Hospital Resource Use After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis Correction
Elsamadicy AA, Freedman IG, Koo AB, David WB, Havlik J, Kundishora AJ, Sciubba DM, Kahle KT, DiLuna M. The Effects of Pulmonary Risk Factors on Hospital Resource Use After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis Correction. World Neurosurgery 2021, 149: e737-e747. PMID: 33548534, DOI: 10.1016/j.wneu.2021.01.109.Peer-Reviewed Original ResearchConceptsPosterior spinal fusionAdolescent idiopathic scoliosisPreoperative pulmonary risk factorsPulmonary risk factorsLonger hospital stayRisk factorsUnplanned readmissionHospital stayDischarge dispositionSpinal fusionNational Surgical Quality Improvement Program Pediatric databaseSurgeons National Surgical Quality Improvement Program Pediatric databaseSignificant independent risk factorsAdolescent idiopathic scoliosis correctionRetrospective cohort studyIndependent risk factorHospital resource useLength of stayIdiopathic scoliosis correctionHigh rateLonger hospitalPostoperative complicationsCohort studyIntraoperative variablesPatient demographicsOctogenarians Are Independently Associated With Extended LOS and Non-Routine Discharge After Elective ACDF for CSM
Elsamadicy AA, Koo AB, Reeves BC, Freedman IG, David WB, Ehresman J, Pennington Z, Laurans M, Kolb L, Sciubba DM. Octogenarians Are Independently Associated With Extended LOS and Non-Routine Discharge After Elective ACDF for CSM. Global Spine Journal 2021, 12: 1792-1803. PMID: 33511889, PMCID: PMC9609534, DOI: 10.1177/2192568221989293.Peer-Reviewed Original ResearchCervical spondylotic myelopathyNon-routine dischargeRetrospective cohort studyExtended LOSElective ACDFCohort studyDischarge dispositionICD-10-CM diagnosisSignificant independent risk factorsNational Inpatient Sample databaseLonger hospital stayIndependent risk factorSignificant independent predictorsYear cohortYear old cohortHospital stayPerioperative complicationsPostoperative complicationsPatient demographicsSpondylotic myelopathyAdult patientsIndependent predictorsRisk factorsACDFAge 80
2020
Impact of Preoperative Anemia on Outcomes After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis
Elsamadicy AA, Freedman IG, Koo AB, David WB, Havlik J, Kundishora AJ, Hong CS, Sciubba DM, Kahle KT, DiLuna M. Impact of Preoperative Anemia on Outcomes After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis. World Neurosurgery 2020, 146: e214-e224. PMID: 33091648, DOI: 10.1016/j.wneu.2020.10.074.Peer-Reviewed Original ResearchConceptsPosterior spinal fusionAdolescent idiopathic scoliosisPreoperative anemiaAnemic cohortHospital stayReadmission ratesIndependent predictorsSpinal fusionIdiopathic scoliosisNational Surgical Quality Improvement Program Pediatric databaseSurgeons National Surgical Quality Improvement Program Pediatric databaseUnplanned reoperation rateLonger hospital stayRetrospective cohort studyThirty-day outcomesLonger operative timeLonger lengthPostoperative complicationsReoperation rateCohort studyDischarge dispositionComplication ratePediatric patientsTransfusion eventsOperative timePredictors of Extended Length of Stay Following Treatment of Unruptured Adult Cerebral Aneurysms: A Study of The National Inpatient Sample
Koo AB, Elsamadicy AA, Lin IH, David WB, Sujijantarat N, Santarosa C, Cord BJ, Zetchi A, Hebert R, Bahrassa F, Malhotra A, Matouk CC. Predictors of Extended Length of Stay Following Treatment of Unruptured Adult Cerebral Aneurysms: A Study of The National Inpatient Sample. Journal Of Stroke And Cerebrovascular Diseases 2020, 29: 105230. PMID: 33066916, DOI: 10.1016/j.jstrokecerebrovasdis.2020.105230.Peer-Reviewed Original ResearchMeSH KeywordsAgedComorbidityDatabases, FactualEndovascular ProceduresFemaleHospital CostsHumansInpatientsIntracranial AneurysmLength of StayMaleMicrosurgeryMiddle AgedOutcome and Process Assessment, Health CarePatient AdmissionPostoperative ComplicationsQuality Indicators, Health CareRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeUnited StatesConceptsLOS cohortExtended LOSMultivariate logistic regressionUnruptured cerebral aneurysmsCerebral aneurysmsPreadmission comorbiditiesInpatient complicationsHospital stayMore patientsOdds ratioUnruptured aneurysmsHealthcare costsMultiple patient-specific factorsLogistic regressionOverall complication rateHospital-level factorsNon-routine dischargePatient-level factorsNational Inpatient SamplePatient-specific factorsOverall healthcare costsChoice of procedureIndex admissionPostoperative complicationsComplication rateScoring System to Triage Patients for Spine Surgery in the Setting of Limited Resources: Application to the Coronavirus Disease 2019 (COVID-19) Pandemic and Beyond
Sciubba DM, Ehresman J, Pennington Z, Lubelski D, Feghali J, Bydon A, Chou D, Elder BD, Elsamadicy AA, Goodwin CR, Goodwin ML, Harrop J, Klineberg EO, Laufer I, Lo SL, Neuman BJ, Passias PG, Protopsaltis T, Shin JH, Theodore N, Witham TF, Benzel EC. Scoring System to Triage Patients for Spine Surgery in the Setting of Limited Resources: Application to the Coronavirus Disease 2019 (COVID-19) Pandemic and Beyond. World Neurosurgery 2020, 140: e373-e380. PMID: 32479913, PMCID: PMC7256646, DOI: 10.1016/j.wneu.2020.05.233.Peer-Reviewed Original ResearchConceptsElective spine surgeryCoronavirus disease 2019 (COVID-19) pandemicDisease 2019 pandemicSpine surgeryScoring systemSurgical casesFellowship-trained spine surgeonsPatient medical comorbiditiesSpine surgery casesLocal disease burdenFinal scoring systemAcademic medical centerElective surgical casesResource-limited settingsWeb-based calculatorHospital courseMedical comorbiditiesPostoperative complicationsDischarge dispositionNeurologic statusDisease burdenSurgery casesMedical CenterSpine surgeonsSpine stabilityAssociated risk factors for extended length of stay following anterior cervical discectomy and fusion for cervical spondylotic myelopathy
Elsamadicy AA, Koo AB, Lee M, David WB, Kundishora AJ, Robert SM, Kuzmik GA, Coutinho PO, Kolb L, Laurans M, Abbed K. Associated risk factors for extended length of stay following anterior cervical discectomy and fusion for cervical spondylotic myelopathy. Clinical Neurology And Neurosurgery 2020, 195: 105883. PMID: 32428797, DOI: 10.1016/j.clineuro.2020.105883.Peer-Reviewed Original ResearchConceptsCervical spondylotic myelopathyHospital-level factorsLOS cohortAnterior cervical discectomyExtended LOSMultivariate logistic regressionSpondylotic myelopathyPostoperative complicationsCervical discectomyBlood transfusionOdds ratioNational Inpatient Sample databaseLogistic regressionFurther investigational studiesOverall complication rateNon-routine dischargeAssociated risk factorsNational cohort studyNumber of complicationsRisk-adjusted LOSGreater overall costsLow socioeconomic statusPaucity of literatureHospital LOSHospital stayRisk Factors Portending Extended Length of Stay After Suboccipital Decompression for Adult Chiari I Malformation
Elsamadicy AA, Koo AB, Lee M, David WB, Kundishora AJ, Freedman IG, Zogg CK, Hong CS, DeSpenza T, Sarkozy M, Kahle KT, DiLuna M. Risk Factors Portending Extended Length of Stay After Suboccipital Decompression for Adult Chiari I Malformation. World Neurosurgery 2020, 138: e515-e522. PMID: 32147550, PMCID: PMC7379177, DOI: 10.1016/j.wneu.2020.02.158.Peer-Reviewed Original ResearchConceptsPatient-level factorsMultivariate logistic regressionExtended LOSLOS cohortSurgical decompressionDecompression surgeryOdds ratioGreater overall complication ratesMultiple patient-level factorsLogistic regressionChiari malformation type IAdult Chiari I malformationPatient's baseline comorbidityOverall complication rateRetrospective cohort studyChiari I malformationRisk-adjusted LOSPostoperative complicationsAdult patientsCohort studyComplication ratePatient demographicsSuboccipital decompressionElectrolyte disordersObstructive hydrocephalusGeographic Variation in Outcomes and Costs After Spinal Fusion for Adolescent Idiopathic Scoliosis
Koo AB, Elsamadicy AA, Kundishora AJ, David WB, Lee M, Hong CS, Lee V, Kahle KT, DiLuna M. Geographic Variation in Outcomes and Costs After Spinal Fusion for Adolescent Idiopathic Scoliosis. World Neurosurgery 2020, 136: e347-e354. PMID: 31917315, DOI: 10.1016/j.wneu.2019.12.175.Peer-Reviewed Original ResearchConceptsAdolescent idiopathic scoliosisLength of surgeryAdolescent patientsSpinal fusionIdiopathic scoliosisMultilevel posterior spinal fusionHealth care resource utilizationGreater complication ratePosterior spinal fusionPosterior spinal surgeryPostoperative complicationsComplication ratePrimary outcomeAIS patientsSpinal surgeryPatientsSurgeryAdmissionRegional variationComplicationsFurther studiesOutcomesCohortScoliosisTotal cost