2024
Impact 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 placementAssociation of Malnutrition with Surgical and Hospital Outcomes after Spine Surgery for Spinal Metastases: A National Surgical Quality Improvement Program Study of 1613 Patients
Elsamadicy A, Havlik J, Reeves B, Sherman J, Craft S, Serrato P, Sayeed S, Koo A, Khalid S, Lo S, Shin J, Mendel E, Sciubba D. Association of Malnutrition with Surgical and Hospital Outcomes after Spine Surgery for Spinal Metastases: A National Surgical Quality Improvement Program Study of 1613 Patients. Journal Of Clinical Medicine 2024, 13: 1542. PMID: 38541767, PMCID: PMC10971134, DOI: 10.3390/jcm13061542.Peer-Reviewed Original ResearchNon-routine dischargeLength of stayImpact of malnutritionSpinal metastasesAdverse eventsMalnourished patientsNourished patientsSurgeons National Surgical Quality Improvement Program databaseSurgical treatment of spinal metastasesNational Surgical Quality Improvement Program databaseTreatment of spinal metastasesNational Surgical Quality Improvement Program studyQuality Improvement Program databaseRisk of postoperative complicationsMultivariate logistic regression analysisMetastatic spinal diseaseHospital length of stayProlonged length of stayAssociation of malnutritionRetrospective cohort studyPostoperative adverse eventsHealthcare resource utilizationAssessed patient demographicsExtradural spinal metastasisBaseline comorbidity burden
2023
Influence of affective disorders on outcomes after suboccipital decompression for adult Chiari I malformation
Sherman J, Sayeed S, Craft S, Reeves B, Hengartner A, Fernandez T, Koo A, DiLuna M, Elsamadicy A. Influence of affective disorders on outcomes after suboccipital decompression for adult Chiari I malformation. Clinical Neurology And Neurosurgery 2023, 236: 108104. PMID: 38171050, DOI: 10.1016/j.clineuro.2023.108104.Peer-Reviewed Original ResearchHealthcare resource utilizationNon-routine dischargeLength of stayChiari I malformationAD cohortSuboccipital decompressionAffective disordersAdverse eventsPatient demographicsPostoperative eventsAdmission costsExtended LOSMean LOSNational Inpatient Sample databaseMultivariate logistic regression analysisAdult Chiari I malformationIncidence of syringomyeliaPerioperative adverse eventsChronic pulmonary diseaseICD-10-CM codesGreater proportionLogistic regression analysisComorbid affective disordersAdult patientsIndependent predictorsPrevalence and Influence of Frailty on Hospital Outcomes After Surgical Resection of Spinal Meningiomas
Elsamadicy A, Koo A, Reeves B, Craft S, Sayeed S, Sherman J, Sarkozy M, Aurich L, Fernandez T, Lo S, Shin J, Sciubba D, Mendel E. Prevalence and Influence of Frailty on Hospital Outcomes After Surgical Resection of Spinal Meningiomas. World Neurosurgery 2023, 173: e121-e131. PMID: 36773810, DOI: 10.1016/j.wneu.2023.02.019.Peer-Reviewed Original ResearchConceptsHospital Frailty Risk ScoreLength of stayHealth care resource utilizationSpinal meningiomasNonroutine dischargeAdverse eventsDischarge dispositionInternational ClassificationExtended LOSMean LOSNational Inpatient Sample databaseFrailty Risk ScoreInfluence of frailtyImpact of frailtyRetrospective cohort studyPerioperative adverse eventsTenth Revision codesClinical Modification codesCost of admissionMultivariate regression analysisHospital outcomesPatient frailtyAdult patientsCohort studyPatient demographics
2022
Impact of Affective Disorders on Inpatient Opioid Consumption and Hospital Outcomes Following Open Posterior Spinal Fusion for Adult Spine Deformity
Elsamadicy A, Sandhu M, Reeves B, Jafar T, Craft S, Sherman J, Hersh A, Koo A, Kolb L, Lo S, Shin J, Mendel E, Sciubba D. Impact of Affective Disorders on Inpatient Opioid Consumption and Hospital Outcomes Following Open Posterior Spinal Fusion for Adult Spine Deformity. World Neurosurgery 2022, 170: e223-e235. PMID: 36332777, DOI: 10.1016/j.wneu.2022.10.114.Peer-Reviewed Original ResearchConceptsInpatient narcotic consumptionInpatient opioid consumptionHealthcare resource utilizationAD cohortAffective disordersNonroutine dischargeOpioid consumptionNarcotic consumptionSpinal fusionAdult spinal deformity surgeryInpatient opioid usePremier Healthcare DatabaseRetrospective cohort studyPosterior spinal fusionLength of staySpinal deformity surgeryAdult spinal deformityAdult spine deformityYears of ageGreater proportionMultivariate regression analysisNon-Hispanic whitesHospital outcomesStudy patientsCohort studyAssessment of Frailty Indices and Charlson Comorbidity Index for Predicting Adverse Outcomes in Patients Undergoing Surgery for Spine Metastases: A National Database Analysis
Elsamadicy AA, Havlik JL, Reeves B, Sherman J, Koo AB, Pennington Z, Hersh AM, Sandhu MRS, Kolb L, Larry Lo SF, Shin JH, Mendel E, Sciubba DM. Assessment of Frailty Indices and Charlson Comorbidity Index for Predicting Adverse Outcomes in Patients Undergoing Surgery for Spine Metastases: A National Database Analysis. World Neurosurgery 2022, 164: e1058-e1070. PMID: 35644519, DOI: 10.1016/j.wneu.2022.05.101.Peer-Reviewed Original ResearchConceptsMetastatic spinal tumor frailty indexCharlson Comorbidity IndexFrailty indexMFI-5Adverse outcomesNonroutine dischargeComorbidity indexUnplanned readmissionAdverse eventsNational Surgical Quality Improvement Program databaseHigher Charlson comorbidity indexQuality Improvement Program databaseMultivariate logistic regression analysisPredicting Adverse OutcomesRetrospective cohort studyImprovement Program databaseNational database analysisLength of stayLogistic regression analysisExtradural spinal metastasisOnly significant predictorAdult patientsCohort studyProlonged lengthIndependent predictorsHigher Hospital Frailty Risk Score is associated with increased complications and healthcare resource utilization after endovascular treatment of ruptured intracranial aneurysms
Koo AB, Elsamadicy AA, Renedo D, Sarkozy M, Sherman J, Reeves BC, Havlik J, Antonios J, Sujijantarat N, Hebert R, Malhotra A, Matouk C. Higher Hospital Frailty Risk Score is associated with increased complications and healthcare resource utilization after endovascular treatment of ruptured intracranial aneurysms. Journal Of NeuroInterventional Surgery 2022, 15: 255-261. PMID: 35292571, PMCID: PMC8931798, DOI: 10.1136/neurintsurg-2021-018484.Peer-Reviewed Original ResearchConceptsHospital Frailty Risk ScoreNon-routine dischargeLength of stayFrailty Risk ScoreHealthcare resource utilizationTotal hospital costsEndovascular treatmentIntracranial aneurysmsAdverse eventsHospital costsRisk scoreHighest Hospital Frailty Risk ScoresMean LOSNational Inpatient Sample databaseMean total hospital costMultivariate logistic regression analysisImpact of frailtyRetrospective cohort studyICD-10-CM codesLogistic regression analysisRegression analysisMultivariate regression analysisCohort studyDischarge dispositionPatient demographicsHospital Frailty Risk Score and healthcare resource utilization after surgery for metastatic spinal column tumors.
Elsamadicy AA, Koo AB, Reeves BC, Pennington Z, Yu J, Goodwin CR, Kolb L, Laurans M, Lo SL, Shin JH, Sciubba DM. Hospital Frailty Risk Score and healthcare resource utilization after surgery for metastatic spinal column tumors. Journal Of Neurosurgery Spine 2022, 37: 241-251. PMID: 35148505, DOI: 10.3171/2022.1.spine21987.Peer-Reviewed Original ResearchHospital Frailty Risk ScoreLength of staySpinal column tumorsFrailty Risk ScoreNonroutine dischargeHospital admissionHigh frailtyIntermediate frailtyDischarge dispositionSpinal tumorsLower frailtyDiagnostic codesRisk scoreHigher total hospital costsMean LOSNational Inpatient Sample databaseMultivariate logistic regression analysisICD-10 diagnostic codesImpact of frailtyRetrospective cohort studyHealthcare resource utilizationProportion of patientsTotal hospital costsProcedural Coding SystemLogistic regression analysisDifferences in Health Care Resource Utilization After Surgery for Metastatic Spinal Column Tumors in Patients with a Concurrent Affective Disorder in the United States
Elsamadicy AA, Koo AB, Sarkozy M, Reeves BC, Pennington Z, Havlik J, Sandhu MR, Hersh A, Patel S, Kolb L, Larry Lo SF, Shin JH, Mendel E, Sciubba DM. Differences in Health Care Resource Utilization After Surgery for Metastatic Spinal Column Tumors in Patients with a Concurrent Affective Disorder in the United States. World Neurosurgery 2022, 161: e252-e267. PMID: 35123021, DOI: 10.1016/j.wneu.2022.01.112.Peer-Reviewed Original ResearchConceptsLength of stayHealth care resource utilizationPostoperative adverse eventsNonroutine dischargeAdverse eventsAffective disordersNational Inpatient Sample databaseMultivariate logistic regression analysisSpinal column metastasesRetrospective cohort studyMetastatic spinal tumorsSpinal column tumorsLogistic regression analysisConcurrent affective disorderGreater total costsRegression analysisMultivariate regression analysisAdult patientsCohort studyDischarge dispositionIntraoperative variablesPatient demographicsHospital admissionIndependent predictorsSpinal metastasesHospital 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 characteristicsGeographic variations in health care resource utilization following elective ACDF for cervical spondylotic myelopathy: A national trend analysis
Koo AB, Elsamadicy AA, Sarkozy M, Pathak N, David WB, Freedman IG, Reeves BC, Sciubba DM, Laurans M, Kolb L. Geographic variations in health care resource utilization following elective ACDF for cervical spondylotic myelopathy: A national trend analysis. North American Spine Society Journal (NASSJ) 2022, 9: 100099. PMID: 35141663, PMCID: PMC8819911, DOI: 10.1016/j.xnsj.2022.100099.Peer-Reviewed Original ResearchCervical spondylotic myelopathyLength of stayElective ACDFSpondylotic myelopathyAdult patientsPatient demographicsComplication rateRegional cohortElective anterior cervical discectomyHealth care resource utilizationNational Inpatient Sample databaseAnterior cervical discectomyMean total costHousehold income quartileHealth care deliveryHealth care expendituresNonroutine dischargePerioperative complicationsCervical discectomyDischarge dispositionFemale patientsElixhauser comorbiditiesSurgery variesPrimary diagnosisHospital costs
2021
Patient- and hospital-related risk factors for non-routine discharge after lumbar decompression and fusion for spondylolisthesis
Elsamadicy AA, Freedman IG, Koo AB, David W, Hengartner AC, Havlik J, Reeves BC, Hersh A, Pennington Z, Kolb L, Laurans M, Shin JH, Sciubba DM. Patient- and hospital-related risk factors for non-routine discharge after lumbar decompression and fusion for spondylolisthesis. Clinical Neurology And Neurosurgery 2021, 209: 106902. PMID: 34481141, DOI: 10.1016/j.clineuro.2021.106902.Peer-Reviewed Original ResearchConceptsNon-routine dischargeDependent functional statusAdverse eventsIndependent predictorsUnplanned readmissionLonger LOSSpinal decompressionLumbar spondylolisthesisFemale sexFunctional statusSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseNon-Hispanic black race/ethnicityHospital-related risk factorsQuality Improvement Program databaseNon-Hispanic black raceICD-9-CM diagnosisBlack race/ethnicityMultivariate logistic regression modelNon-home dischargeHospital-related factorsImprovement Program databaseRetrospective cohort studyLength of stayProcedural Coding SystemCost and Health Care Resource Utilization Differences After Spine Surgery for Bony Spine versus Primary Intradural Spine Tumors
Elsamadicy AA, Koo AB, Reeves BC, Freedman IG, Pennington Z, David WB, Ehresman J, Hengartner A, Laurans M, Kolb L, Shin JH, Sciubba DM. Cost and Health Care Resource Utilization Differences After Spine Surgery for Bony Spine versus Primary Intradural Spine Tumors. World Neurosurgery 2021, 151: e286-e298. PMID: 33866030, DOI: 10.1016/j.wneu.2021.04.015.Peer-Reviewed Original ResearchConceptsLength of stayPrimary intradural spinal tumorsIntradural spinal tumorsSpine tumorsSpine surgeryPerioperative complicationsSpinal tumorsNational Inpatient Sample databaseMultivariable logistic regression analysisStepwise multivariable logistic regression analysisBackward stepwise multivariable logistic regression analysisIntradural spinal neoplasmsIntradural spine tumorsRetrospective cohort studyLogistic regression analysisHealth care resourcesMore comorbiditiesAdult patientsCohort studyDischarge dispositionIntraoperative variablesPatient demographicsComplication rateHospital admissionIndependent predictorsThe 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 demographics
2020
Does neurofibromatosis 1 status impact outcomes for pediatric/young adults undergoing spinal fusion?
Freedman I, Koo A, Yeagle E, Diluna M, Kolb L, Yeung J. Does neurofibromatosis 1 status impact outcomes for pediatric/young adults undergoing spinal fusion? Surgical Neurology International 2020, 11: 60. PMID: 32363055, PMCID: PMC7193189, DOI: 10.25259/sni_39_2020.Peer-Reviewed Original ResearchNeurofibromatosis type 1Adverse postoperative eventsYoung adult patientsAdult patientsPostoperative eventsIndependent predictorsSpine patientsNF1 statusSpinal fusionNonroutine discharge dispositionNonroutine hospital dischargeFurther prospective studiesNationwide Inpatient SampleLength of staySignificant independent predictorsSpinal fusion surgeryYears of agePaucity of dataNonroutine dischargeMore transfusionsDischarge dispositionFusion patientsHospital dischargePerioperative variablesComplication rate