2024
Continuous Adductor Canal Block Compared to Epidural Anesthesia for Total Knee Arthroplasty
Freedman I, Mercier M, Galivanche A, Sandhu M, Hocevar M, Moore H, Grauer J, Rubin L, Li J. Continuous Adductor Canal Block Compared to Epidural Anesthesia for Total Knee Arthroplasty. Journal Of Pain Research 2024, 17: 3729-3740. PMID: 39559456, PMCID: PMC11572497, DOI: 10.2147/jpr.s462079.Peer-Reviewed Original ResearchContinuous adductor canal blockAdductor canal blockEpidural analgesiaEA patientsNon-home dischargeCanal blockMultivariate analysisIncidence of postoperative adverse eventsPostoperative adverse eventsMorphine equivalentsEpidural anesthesiaAdverse eventsRetrospective analysisHospital lengthProlonged LOSLevel IIIPatientsSteroidsTotal knee arthroplastyAdjuvantTKA patientsLogistic regressionDischarge dispositionAnalgesiaKnee arthroplasty
2022
Emergency Department Visits Within 90 Days of Total Ankle Replacement
Ratnasamy PP, Kammien AJ, Gouzoulis MJ, Oh I, Grauer JN. Emergency Department Visits Within 90 Days of Total Ankle Replacement. Foot & Ankle Orthopaedics 2022, 7: 24730114221134255. PMID: 36324696, PMCID: PMC9619275, DOI: 10.1177/24730114221134255.Peer-Reviewed Original ResearchElixhauser Comorbidity IndexSurgical site painRetrospective cohort studyED visitsSite painCohort studyHealth care utilization/costsHigher Elixhauser comorbidity indexPain management pathwayPostoperative ED visitsPostoperative hospital lengthEmergency department visitsDay of surgeryLogistic regression analysisSite of careTotal ankle replacementHealth care costsComorbidity indexHospital lengthED utilizationDepartment visitsPatient factorsPostoperative weekEmergency departmentFemale sexUnicompartmental Knee Arthroplasty in Octogenarians: A National Database Analysis Including Over 700 Octogenarians
Moore HG, Schneble CA, Kahan JB, Grauer JN, Rubin LE. Unicompartmental Knee Arthroplasty in Octogenarians: A National Database Analysis Including Over 700 Octogenarians. Arthroplasty Today 2022, 15: 55-60. PMID: 35399988, PMCID: PMC8991237, DOI: 10.1016/j.artd.2022.02.009.Peer-Reviewed Original ResearchUnicompartmental knee arthroplastyAdverse eventsMedical comorbiditiesKnee arthroplastyNational Surgical Quality Improvement Program databaseLarge national surgical databaseQuality Improvement Program databaseHigher comorbidity burdenMinor adverse eventsPostoperative adverse eventsSerious adverse eventsImprovement Program databaseProlonged hospital stayUrinary tract infectionDay of surgeryNational database analysisNational surgical databaseShort-term mortalityMultivariate regression analysisComorbidity burdenOctogenarian cohortHospital lengthHospital stayNonhome dischargeSelect patients
2021
Ambulatory Single-level Posterior Cervical Foraminotomy for Cervical Radiculopathy
Bovonratwet P, Retzky JS, Chen AZ, Ondeck NT, Samuel AM, Qureshi SA, Grauer JN, Albert TJ. Ambulatory Single-level Posterior Cervical Foraminotomy for Cervical Radiculopathy. Clinical Spine Surgery A Spine Publication 2021, 35: e306-e313. PMID: 34654773, DOI: 10.1097/bsd.0000000000001252.Peer-Reviewed Original ResearchConceptsSingle-level posterior cervical foraminotomyPosterior cervical foraminotomyCervical radiculopathyInpatient proceduresCervical foraminotomyPerioperative complicationsAmbulatory proceduresSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databasePropensity scoreRetrospective cohort comparison studyImprovement Program databaseSurgical site infectionCohort comparison studyHospital lengthPain controlPerioperative outcomesPostoperative complicationsThromboembolic eventsWound complicationsNSQIP databasePatient characteristicsSite infectionIndividual complicationsCenters for Medicare & Medicaid Services' 2018 Removal of Total Knee Arthroplasty From the Inpatient-only List Led to Broad Changes in Hospital Length of Stays
Rankin KA, Freedman IG, Rubin LE, Grauer JN. Centers for Medicare & Medicaid Services' 2018 Removal of Total Knee Arthroplasty From the Inpatient-only List Led to Broad Changes in Hospital Length of Stays. Journal Of The American Academy Of Orthopaedic Surgeons 2021, 29: 1061-1067. PMID: 33960970, DOI: 10.5435/jaaos-d-20-01228.Peer-Reviewed Original ResearchConceptsTotal knee arthroplastyHospital lengthKnee arthroplastyNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseMedicare eligibilityCategorical data comparisonsOverall practice patternsRetrospective cohort studyImprovement Program databaseSame dayRemoval of TKAPearson's chi-squared testChi-squared testMann-Whitney testLOS daysProlonged LOSMost patientsTKA patientsCohort studyMore patientsPractice patternsPatient characterizationProgram databaseActual LOS
2020
Pediatric Supracondylar Humerus Fracture Outcomes by Pediatric and Nonpediatric Orthopedists.
Mets EJ, Grauer JN, McLynn RP, Frumberg DB. Pediatric Supracondylar Humerus Fracture Outcomes by Pediatric and Nonpediatric Orthopedists. Orthopedics 2020, 44: e203-e210. PMID: 33316820, DOI: 10.3928/01477447-20201210-03.Peer-Reviewed Original ResearchConceptsPediatric supracondylar humerus fracturesSupracondylar humerus fracturesHumerus fracturesMultivariate analysisRetrospective comparative cohort analysisLarge national databaseComparative cohort analysisComorbidity burdenHospital lengthPerioperative outcomesAdverse eventsPatient characteristicsPatient factorsFracture outcomesOperative timePatient 1Surgical interventionAdverse outcomesPediatric orthopedistsStudy groupCohort analysisOrthopaedic surgeonsOrthopedistsNational databaseSubspecialty trainingCharacteristics and Predictors of HCAHPS Nonresponse After Spine Surgery.
Malpani R, Adrados M, Mercier MR, McLynn RP, Galivanche AR, Pathak N, Grauer JN. Characteristics and Predictors of HCAHPS Nonresponse After Spine Surgery. Spine 2020, 45: e448-e456. PMID: 31609883, PMCID: PMC7113123, DOI: 10.1097/brs.0000000000003287.Peer-Reviewed Original ResearchConceptsSpine surgery patientsSpine surgeryHCAHPS surveyPerioperative outcomesAdverse eventsPatient characteristicsSurgery patientsSingle institutionMultivariate analysisLonger hospital lengthHigher American SocietyMajor adverse eventsMinor adverse eventsRetrospective cohort studyMinority of patientsPatient satisfaction surveyHospital Consumer AssessmentSatisfaction surveyNonresponder biasHospital lengthPatient demographicsCohort studyHospital readmissionRetrospective analysisBACKGROUND DATAHigh, As Well As Low, Preoperative Platelet Counts Correlate With Adverse Outcomes After Elective Posterior Lumbar Surgery.
Malpani R, Gala RJ, Adrados M, Galivanche AR, Clark MG, Mercier MR, Pathak N, Mets EJ, Grauer JN. High, As Well As Low, Preoperative Platelet Counts Correlate With Adverse Outcomes After Elective Posterior Lumbar Surgery. Spine 2020, 45: 349-356. PMID: 32045405, DOI: 10.1097/brs.0000000000003248.Peer-Reviewed Original ResearchConceptsPosterior lumbar surgeryPreoperative platelet countLow platelet countPlatelet countLumbar surgeryAdverse outcomesAdverse eventsHospital lengthNational Surgical Quality Improvement Program databaseLow preoperative platelet countPreoperative low platelet countQuality Improvement Program databaseHigh platelet groupLonger hospital lengthLumbar surgery patientsPerioperative adverse outcomesMinor adverse eventsPostoperative adverse eventsImprovement Program databaseRetrospective cohort studyHigher platelet countsLarger patient populationPostoperative complicationsCohort studyPlatelet groupSafety and Effectiveness of Antifibrinolytics in Posterior Scoliosis Surgery for Adolescent Idiopathic Scoliosis
Bovonratwet P, Sheha ED, Ondeck NT, Malpani R, Smith BG, Grauer JN. Safety and Effectiveness of Antifibrinolytics in Posterior Scoliosis Surgery for Adolescent Idiopathic Scoliosis. Clinical Spine Surgery A Spine Publication 2020, 33: e26-e32. PMID: 31162181, DOI: 10.1097/bsd.0000000000000836.Peer-Reviewed Original ResearchConceptsAdolescent idiopathic scoliosisPosterior spinal fusionMultilevel posterior spinal fusionIntensive care unitAntifibrinolytic useHospital lengthCare unitTreatment groupsIdiopathic scoliosisOperating roomEffectiveness of antifibrinolyticsNSQIP-Pediatric databasePediatric deformity surgeryPerioperative transfusion ratesVolume of transfusionLonger operative timePosterior scoliosis surgeryLarge national databaseTransfusion reductionPerioperative complicationsPostoperative complicationsTransfusion ratePostoperative outcomesPediatric patientsOperative time
2018
Is Discharge Within a Day of Total Knee Arthroplasty Safe in the Octogenarian Population?
Bovonratwet P, Fu MC, Tyagi V, Gu A, Sculco PK, Grauer JN. Is Discharge Within a Day of Total Knee Arthroplasty Safe in the Octogenarian Population? The Journal Of Arthroplasty 2018, 34: 235-241. PMID: 30391051, DOI: 10.1016/j.arth.2018.10.005.Peer-Reviewed Original ResearchConceptsTotal knee arthroplastyNational Surgical Quality Improvement Program databaseQuality Improvement Program databasePrimary total knee arthroplastyImprovement Program databaseIndependent risk factorSerious adverse eventsAdverse eventsRisk factorsProgram databasePerioperative adverse eventsHospital lengthNonhome dischargeOctogenarian populationPerioperative complicationsElderly patientsOlder patientsPatient agePostdischarge careKnee arthroplastyPatient satisfactionProcedural characteristicsHigh riskHealthcare costsPatientsComparison of 30-Day Complications Between Navigated and Conventional Single-level Instrumented Posterior Lumbar Fusion
Bovonratwet P, Nelson SJ, Ondeck NT, Geddes BJ, Grauer JN. Comparison of 30-Day Complications Between Navigated and Conventional Single-level Instrumented Posterior Lumbar Fusion. Spine 2018, 43: 447-453. PMID: 28700450, DOI: 10.1097/brs.0000000000002327.Peer-Reviewed Original ResearchConceptsPosterior lumbar fusionOperative timeLumbar fusionHospital lengthWound infectionSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseShorter mean hospital lengthQuality Improvement Program databaseScrew placementRadiation exposureContamination/infectionLower blood transfusionRetrospective cohort comparison studyMean hospital lengthMost adverse eventsImprovement Program databaseInstrumented posterior lumbar fusionInstrumented lumbar fusionSurgeon radiation exposureCohort comparison studyPotential confounding factorsPedicle screw placementPerioperative complicationsPerioperative outcomes
2017
Outpatient elective posterior lumbar fusions appear to be safely considered for appropriately selected patients
Bovonratwet P, Ottesen TD, Gala RJ, Rubio DR, Ondeck NT, McLynn RP, Grauer JN. Outpatient elective posterior lumbar fusions appear to be safely considered for appropriately selected patients. The Spine Journal 2017, 18: 1188-1196. PMID: 29155341, DOI: 10.1016/j.spinee.2017.11.011.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAmbulatory Surgical ProceduresBlood TransfusionCohort StudiesDatabases, FactualElective Surgical ProceduresFemaleHumansInpatientsLumbar VertebraeMaleMiddle AgedPatient ReadmissionPatient SelectionPostoperative ComplicationsPropensity ScoreQuality ImprovementRetrospective StudiesSpinal FusionYoung AdultConceptsPosterior lumbar fusionPerioperative complicationsPostoperative complicationsNSQIP databaseInterbody fusionLumbar fusionNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement Program databaseElective posterior lumbar fusionQuality Improvement Program databasePropensity score-matched comparisonLower blood transfusionMost perioperative complicationsPostoperative adverse eventsRetrospective cohort comparison studyImprovement Program databaseRate of readmissionCareful patient selectionCohort comparison studyPotential confounding factorsInpatient cohortPLF casesHospital lengthPerioperative courseSelect patientsThe Rothman Index as a predictor of postdischarge adverse events after elective spine surgery
McLynn RP, Ondeck NT, Cui JJ, Swanson DR, Shultz BN, Bovonratwet P, Grauer JN. The Rothman Index as a predictor of postdischarge adverse events after elective spine surgery. The Spine Journal 2017, 18: 1149-1156. PMID: 29155251, DOI: 10.1016/j.spinee.2017.11.008.Peer-Reviewed Original ResearchConceptsElective spine surgeryPostdischarge adverse eventsMinor adverse eventsMajor adverse eventsAdverse eventsRothman IndexSpine surgeryMedical CenterOverall patient conditionRothman Index scoresHigh-risk patientsRate of readmissionRetrospective cohort studyLarge academic medical centerPostoperative day 30Body mass indexLength of stayAcademic medical centerPresent studyElectronic medical recordsLater scoresAnesthesiologists classHospital lengthPerioperative outcomesCohort studyComparison of Outpatient vs Inpatient Total Knee Arthroplasty: An ACS-NSQIP Analysis
Bovonratwet P, Ondeck NT, Nelson SJ, Cui JJ, Webb ML, Grauer JN. Comparison of Outpatient vs Inpatient Total Knee Arthroplasty: An ACS-NSQIP Analysis. The Journal Of Arthroplasty 2017, 32: 1773-1778. PMID: 28237215, DOI: 10.1016/j.arth.2017.01.043.Peer-Reviewed Original ResearchMeSH KeywordsAgedAmbulatory Surgical ProceduresArthroplasty, Replacement, KneeBlood TransfusionCohort StudiesComorbidityDatabases, FactualFemaleHumansInpatientsMaleMiddle AgedMultivariate AnalysisOutcome Assessment, Health CareOutpatientsPatient ReadmissionPostoperative ComplicationsPropensity ScoreQuality ImprovementConceptsTotal knee arthroplastyOutpatient total knee arthroplastyAdverse eventsKnee arthroplastyOutpatient procedureSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseMultivariate analysisInpatient total knee arthroplastyElective total knee arthroplastyQuality Improvement Program databasePrimary total knee arthroplastyComparison of outpatientPerioperative outcome measuresImprovement Program databasePerioperative adverse eventsIndividual adverse eventsACS-NSQIP AnalysisInpatient cohortHospital lengthLess comorbiditySelect patientsTKA patientsOutpatient cohortPostoperative period
2014
Preoperative Factors Affecting Length of Stay After Elective Anterior Cervical Discectomy and Fusion With and Without Corpectomy
Basques BA, Bohl DD, Golinvaux NS, Gruskay JA, Grauer JN. Preoperative Factors Affecting Length of Stay After Elective Anterior Cervical Discectomy and Fusion With and Without Corpectomy. Spine 2014, 39: 939-946. PMID: 24718069, PMCID: PMC4024365, DOI: 10.1097/brs.0000000000000307.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAdultAgedCardiovascular DiseasesCervical VertebraeComorbidityConfounding Factors, EpidemiologicConnecticutDiskectomyElective Surgical ProceduresFemaleHospitals, UniversityHumansLength of StayLung DiseasesMaleMiddle AgedMultivariate AnalysisNeoplasmsRetrospective StudiesRisk FactorsSpinal FusionConceptsElective anterior cervical discectomyAnterior cervical discectomyExtended LOSPreoperative factorsCervical discectomyPulmonary diseaseRetrospective cohort studyCervical spine pathologyProlonged hospital lengthFactors Affecting LengthCommon treatment modalityMultivariate logistic regressionSingle academic institutionElective ACDFHospital lengthCohort studyPatient demographicsAverage LOSSingle institutionTreatment modalitiesOperative characteristicsSpine pathologyACDFBACKGROUND DATAPatientsUsing the ACS-NSQIP to Identify Factors Affecting Hospital Length of Stay After Elective Posterior Lumbar Fusion
Basques BA, Fu MC, Buerba RA, Bohl DD, Golinvaux NS, Grauer JN. Using the ACS-NSQIP to Identify Factors Affecting Hospital Length of Stay After Elective Posterior Lumbar Fusion. Spine 2014, 39: 497-502. PMID: 24384669, PMCID: PMC3961012, DOI: 10.1097/brs.0000000000000184.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedBlood TransfusionBody Mass IndexChi-Square DistributionComorbidityDecision Support TechniquesElective Surgical ProceduresFemaleHumansLength of StayLinear ModelsLumbar VertebraeMaleMiddle AgedMultivariate AnalysisObesity, MorbidOperative TimePatient SelectionRetrospective StudiesRisk AssessmentRisk FactorsSpinal DiseasesSpinal FusionTime FactorsTreatment OutcomeUnited StatesConceptsElective posterior lumbar fusionPosterior lumbar fusionNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement Program databaseQuality Improvement Program databaseImprovement Program databaseLumbar fusionHospital lengthIntraoperative variablesExtended LOSProgram databaseAmerican CollegePosterior lumbar spine fusionPredictors of LOSRetrospective cohort studyBody mass indexLumbar spine fusionCommon surgical procedureImportant clinical variablesInpatient hospital costsLumbar spine pathologyAnesthesiologists classIntraoperative transfusionMorbid obesityCohort study