2024
Perioperative inpatient falls for anterior cervical discectomy and fusion patients are on the rise: Risk factors associated with this “never event”
Seddio A, Jabbouri S, Gouzoulis M, Vasudevan R, Halperin S, Varthi A, Rubio D, Grauer J. Perioperative inpatient falls for anterior cervical discectomy and fusion patients are on the rise: Risk factors associated with this “never event”. The Spine Journal 2024 PMID: 39631462, DOI: 10.1016/j.spinee.2024.11.018.Peer-Reviewed Original ResearchInpatient fallsLength of stayMultivariate logistic regressionAnterior cervical discectomyInpatient ACDFElixhauser Comorbidity IndexMultidisciplinary fall prevention programAnnual incidenceRisk factorsInpatient fall preventionFall prevention programsLogistic regressionNational sample of patientsCervical discectomyNational Quality ForumSocioeconomically disadvantaged patientsHistory of dementiaUnderweight body mass indexACDF patientsObese BMI >Posterior cervical proceduresBody mass indexMulti-level ACDFAdult patientsQuality ForumTrends in Total Hip Arthroplasty Length of Stay and Coding Status From 2018 to 2021: Two-Year Impact of the Removal From the Inpatient-Only List
Sanchez J, Dhodapkar M, Halperin S, Jiang W, Grauer J, Rubin L. Trends in Total Hip Arthroplasty Length of Stay and Coding Status From 2018 to 2021: Two-Year Impact of the Removal From the Inpatient-Only List. Arthroplasty Today 2024, 30: 101568. DOI: 10.1016/j.artd.2024.101568.Peer-Reviewed Original ResearchLength of stayInpatient-onlyCode statusCenters for MedicareAverage length of stayPearson chi-square testOutpatient total hip arthroplastyCurrent Procedural Terminology codesChi-square testTotal hip arthroplasty patientsSmoking statusMethods DataTotal hip arthroplastyTwo-year impactProcedural Terminology codesNational Surgical Quality Improvement Program databaseAmerican Society of Anesthesiologists classificationAnalysis of variance testQuality Improvement Program databaseOutpatient statusOutpatient casesAge groupsYear of surgeryCategorical variablesTerminology codesAnkle fracture open reduction and internal fixation in patients with cerebral palsy
Dhodapkar M, Yang A, Jiang W, Halperin S, Frumberg D, Grauer J. Ankle fracture open reduction and internal fixation in patients with cerebral palsy. Developmental Medicine & Child Neurology 2024, 66: 1496-1501. PMID: 38773804, DOI: 10.1111/dmcn.15958.Peer-Reviewed Original ResearchAnkle fracture ORIFCerebral palsyAnkle fracturesElixhauser Comorbidity IndexInternational Classification of Diseases (ICD)-9 and ICD-10Increased oddsIsolated ankle fracturesEmergency department visitsClosed ankle fracturesInternal fixationProlonged lengthMultivariate logistic regressionAnkle fracture open reductionProlonged length of stayDepartment visitsLength of stayInternational ClassificationAdverse eventsStudy of adult patientsFracture open reductionMinor adverse eventsICD-10Logistic regressionORAnkle
2023
Anterior Cervical Discectomy and Fusion Outcomes in Patients With and Without Bariatric Surgery—Weight Loss Does Make a Difference
Joo P, Zhu J, Wilhelm C, Tang K, Day W, Moran J, Grauer J. Anterior Cervical Discectomy and Fusion Outcomes in Patients With and Without Bariatric Surgery—Weight Loss Does Make a Difference. Spine 2023, 48: 400-406. PMID: 36735637, DOI: 10.1097/brs.0000000000004580.Peer-Reviewed Original ResearchConceptsAnterior cervical discectomyBariatric surgeryMorbid obesityAdverse eventsCervical discectomyReoperation rateBS proceduresFive-Year Reoperation RatesRetrospective comparative cohort studyHistory of BSMinor adverse eventsNon-obese patientsAdverse event ratesComparative cohort studyElixhauser Comorbidity IndexKaplan-Meier analysisRisk of complicationsNon-obese controlsLength of stayACDF patientsElective ACDFComorbidity indexFusion patientsPulmonary embolismCohort study
2022
Four-level anterior versus posterior cervical fusions: Perioperative outcomes and five-year reoperation rates Outcomes after four-level anterior versus posterior cervical procedures
Joo PY, Jayaram RH, McLaughlin WM, Ameri B, Kammien AJ, Arnold PM, Grauer JN. Four-level anterior versus posterior cervical fusions: Perioperative outcomes and five-year reoperation rates Outcomes after four-level anterior versus posterior cervical procedures. North American Spine Society Journal (NASSJ) 2022, 10: 100115. PMID: 35392022, PMCID: PMC8980614, DOI: 10.1016/j.xnsj.2022.100115.Peer-Reviewed Original ResearchPosterior cervical fusionFour-level ACDFAdverse eventsReoperation rateCervical fusionOdds ratioMinor adverse eventsMultilevel cervical pathologyPosterior cervical proceduresRate of dysphagiaFive-year incidencePerioperative adverse eventsAnterior cervical discectomyHigher reoperation rateLength of stayGreater odds ratioRisk/benefit considerationsPosterior approach proceduresTimes lower oddsCervical reoperationCervical proceduresCervical discectomyPerioperative outcomesPosterior proceduresACDF cases
2020
Metric Selection, Metric Targets, and Risk Adjustment Should be Considered in the Design of Gainsharing Models for Bundled Payment Programs in Total Joint Arthroplasty
Keswani AH, Snyder DJ, Ahn A, Austin DC, Jayakumar P, Grauer JN, Poeran J, Bozic KJ, Moschetti WE, Jevsevar DS, Galatz LM, Bronson MJ, Chen DD, Moucha CS. Metric Selection, Metric Targets, and Risk Adjustment Should be Considered in the Design of Gainsharing Models for Bundled Payment Programs in Total Joint Arthroplasty. The Journal Of Arthroplasty 2020, 36: 801-809. PMID: 33199096, DOI: 10.1016/j.arth.2020.10.007.Peer-Reviewed Original ResearchConceptsPatient-reported outcomesTotal joint arthroplastyRisk adjustmentJoint arthroplastyLength of stayUrban health systemSurgeon performanceBundled payment programsBundled payment modelReadmission ratesPRO collectionInclusion criteriaPatientsLevel IIIHealth systemArthroplastyPayment modelsAcceptable targetsPayment programsImportant mechanismAdjustmentTargetUse of intraoperative navigation for posterior spinal fusion in adolescent idiopathic scoliosis surgery is safe to consider
Moore HG, Samuel AM, Burroughs PJ, Pathak N, Tuason DA, Grauer JN. Use of intraoperative navigation for posterior spinal fusion in adolescent idiopathic scoliosis surgery is safe to consider. Spine Deformity 2020, 9: 403-410. PMID: 33025389, DOI: 10.1007/s43390-020-00218-x.Peer-Reviewed Original ResearchConceptsAdolescent idiopathic scoliosisNon-navigated patientsPerioperative adverse outcomesPosterior spinal fusionUse of navigationPosterior fusionAdverse outcomesSpinal fusionShort-term adverse eventsPost-operative hospital stayAdolescent idiopathic scoliosis surgeryStereotactic navigationNon-navigated casesNSQIP-Pediatric databaseThirty-day outcomesYear of procedureLonger operative timeIdiopathic scoliosis surgeryLength of stayIntraoperative navigationNational pediatric databaseHospital stayPerioperative outcomesAdverse eventsPediatric patients
2019
The Use of Older Versus Newer Data in the National Surgical Quality Improvement Program Database Influences the Results of Total Hip Arthroplasty Outcomes Studies
Shultz BN, Galivanche AR, Ottesen TD, Bovonratwet P, Grauer JN. The Use of Older Versus Newer Data in the National Surgical Quality Improvement Program Database Influences the Results of Total Hip Arthroplasty Outcomes Studies. JAAOS Global Research And Reviews 2019, 3: e19.00108. PMID: 31773075, PMCID: PMC6855500, DOI: 10.5435/jaaosglobal-d-19-00108.Peer-Reviewed Original ResearchLength of stayUrinary tract infectionPerioperative outcomesTHA patientsPreoperative characteristicsTract infectionsERA groupDeep vein thrombosis/thrombophlebitisNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseArthroplasty outcome studiesImprovement Program databaseMultivariate Poisson regressionNSQIP data setsUnplanned reintubationBlood transfusionNSQIP dataNSQIP variablesProgram databaseOutcome studiesArthroplasty studiesMultivariate analysisPoisson regressionDemographic dataPatientsSurgical Treatment of Septic Shoulders: A Comparison Between Arthrotomy and Arthroscopy
Bovonratwet P, Fu MC, Pathak N, Ondeck NT, Bohl DD, Nho SJ, Grauer JN. Surgical Treatment of Septic Shoulders: A Comparison Between Arthrotomy and Arthroscopy. Arthroscopy The Journal Of Arthroscopic And Related Surgery 2019, 35: 1984-1991. PMID: 31196694, DOI: 10.1016/j.arthro.2019.02.036.Peer-Reviewed Original ResearchConceptsPatients' preoperative characteristicsRate of reoperationSeptic shoulderAdverse eventsPreoperative characteristicsPerioperative complicationsNative shoulderNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseNational patient populationMinor adverse eventsSerious adverse eventsImprovement Program databaseRisk of reoperationRetrospective comparative studyLength of staySignificant differencesUnderwent irrigationPostoperative complicationsPatient characteristicsSurgical groupSurgical treatmentSeptic arthritisOperative timePatient populationSafety of Outpatient Single-level Cervical Total Disc Replacement
Bovonratwet P, Fu MC, Tyagi V, Ondeck NT, Albert TJ, Grauer JN. Safety of Outpatient Single-level Cervical Total Disc Replacement. Spine 2019, Publish Ahead of Print: &na;. PMID: 30247372, DOI: 10.1097/brs.0000000000002884.Peer-Reviewed Original ResearchConceptsSingle-level cervical total disc replacementCervical total disc replacementSingle-level ACDFPerioperative complicationsTotal disc replacementPerioperative outcomesOutpatient settingDisc replacementNational Surgical Quality Improvement Program databaseSingle-level anterior cervical discectomyQuality Improvement Program databasePropensity scoreRetrospective cohort comparison studyPatient baseline characteristicsAdverse event profileAnterior cervical discectomyImprovement Program databasePerioperative adverse eventsRate of readmissionLength of stayCohort comparison studyHospital stayAdverse eventsBaseline characteristicsCervical discectomyManagement of Degenerative Spondylolisthesis: Analysis of a Questionnaire Study, Correlation With a National Sample, and Perioperative Outcomes of Treatment Options.
Bovonratwet P, Webb ML, Ondeck NT, Cui JJ, McLynn RP, Kadimcherla P, Kim DH, Grauer JN. Management of Degenerative Spondylolisthesis: Analysis of a Questionnaire Study, Correlation With a National Sample, and Perioperative Outcomes of Treatment Options. The International Journal Of Spine Surgery 2019, 13: 169-177. PMID: 31131217, PMCID: PMC6510177, DOI: 10.14444/6023.Peer-Reviewed Original ResearchInstrumented posterior fusionLumbar degenerative spondylolisthesisLong-term outcomesDegenerative spondylolisthesisPerioperative outcomesPosterior fusionSurgical treatmentSurgical approachPractice patternsSurgical techniqueSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramBetter long-term outcomesSurgical Quality Improvement ProgramPerioperative outcome measuresPostoperative adverse eventsACS-NSQIP dataPosterior surgical approachLength of stayCommon surgical treatmentSurgical practice patternsQuality Improvement ProgramConservative treatmentAdverse eventsACS-NSQIPPediatric obesity is associated with short-term risks after pelvic osteotomy
Basques BA, Meadows MC, Grauer JN, Kogan M. Pediatric obesity is associated with short-term risks after pelvic osteotomy. Journal Of Pediatric Orthopaedics B 2019, 28: 95-99. PMID: 30234701, DOI: 10.1097/bpb.0000000000000552.Peer-Reviewed Original ResearchConceptsPelvic osteotomyRisk factorsNational Surgical Quality Improvement Program Pediatric databasePediatric pelvic osteotomiesRetrospective cohort studyIndependent risk factorLength of stayShort-term riskNonobese patientsPerioperative morbidityAdverse eventsCohort studyBlood transfusionOperative timePediatric obesityPatient counselingFemoral osteotomySurgical correctionPediatric databaseHip dysplasiaOsteotomyReadmissionObesityPatientsTransfusion
2018
Increased complications in geriatric patients with a fracture of the hip whose postoperative weight-bearing is restricted: an analysis of 4918 patients.
Ottesen TD, McLynn RP, Galivanche AR, Bagi PS, Zogg CK, Rubin LE, Grauer JN. Increased complications in geriatric patients with a fracture of the hip whose postoperative weight-bearing is restricted: an analysis of 4918 patients. The Bone & Joint Journal 2018, 100-B: 1377-1384. PMID: 30295535, DOI: 10.1302/0301-620x.100b10.bjj-2018-0489.r1.Peer-Reviewed Original ResearchConceptsWeight-bearing restrictionsLength of stayAdverse eventsPostoperative weight-bearing restrictionsMajor adverse eventsEvidence-based guidelinesBone Joint JOperating theatreMultivariate regression analysisMultivariate oddsFrail patientsThromboembolic eventsElderly patientsHip fractureGeriatric patientsProcedural characteristicsInclusion criteriaPatientsGreater riskProcedural factorsHipReadmissionDeliriumTransfusionSurgeryThromboembolic Events After Traumatic Vertebral Fractures
Samuel AM, Diaz-Collado PJ, Gala RJ, Webb ML, Lukasiewicz AM, Basques BA, Bohl DD, Kim HJ, Grauer JN. Thromboembolic Events After Traumatic Vertebral Fractures. Spine 2018, 43: 1289-1295. PMID: 29538240, DOI: 10.1097/brs.0000000000002634.Peer-Reviewed Original ResearchConceptsVenous thromboembolism eventsTraumatic vertebral fracturesVertebral fracturesSpinal cord injuryOdds ratioCord injuryRisk factorsNational Trauma Data Bank Research Data SetLonger inpatient lengthPulmonary embolism eventsDeep vein thrombosisHigh-energy injuriesVertebral fracture patientsLength of stayAdditional risk factorsMultivariate logistic regressionSuch adverse outcomesOverall rateThromboembolism eventsHospital courseThromboembolic eventsFracture patientsVein thrombosisLonger LOSTrauma patientsInaccuracies in ICD Coding for Obesity Would Be Expected to Bias Administrative Database Spine Studies Toward Overestimating the Impact of Obesity on Perioperative Adverse Outcomes
McLynn RP, Geddes BJ, Cui JJ, Ondeck NT, Bovonratwet P, Shultz BN, Grauer JN. Inaccuracies in ICD Coding for Obesity Would Be Expected to Bias Administrative Database Spine Studies Toward Overestimating the Impact of Obesity on Perioperative Adverse Outcomes. Spine 2018, 43: 526-532. PMID: 28767639, DOI: 10.1097/brs.0000000000002356.Peer-Reviewed Original ResearchConceptsBody mass indexMajor adverse eventsAdverse eventsICD codesVenous thromboembolismElective posterior lumbar fusionGreater body mass indexPerioperative adverse outcomesPostoperative adverse eventsRetrospective cohort studyAssociation of obesityImpact of obesityLength of stayPosterior lumbar fusionLarge academic hospitalSpine surgery literaturePostoperative complicationsPostoperative factorsCohort studyMass indexAdverse outcomesLumbar fusionAcademic hospitalBACKGROUND DATASpine studiesComparison of Outcomes of Total Hip Arthroplasty to Hemiarthroplasty for Geriatric Hip Fractures: A Literature Review of Large Database Studies
Haynes M, Grauer J. Comparison of Outcomes of Total Hip Arthroplasty to Hemiarthroplasty for Geriatric Hip Fractures: A Literature Review of Large Database Studies. The Journal Of Hip Surgery 2018, 02: 033-046. DOI: 10.1055/s-0038-1646936.Peer-Reviewed Original ResearchTotal hip arthroplastyTHA patientsLength of stayPostoperative transfusionDislocation rateHip arthroplastyNational Surgical Quality Improvement Program databaseGeriatric hip fracture patientsQuality Improvement Program databaseNational Hospital Discharge SurveyClinical postoperative outcomesGeriatric hip fracturesMinor adverse eventsHip fracture patientsImprovement Program databaseHospital Episode StatisticsFemoral neck fracturesPrimary outcome variableHospital Discharge SurveyLarge database studiesComparison of outcomesKey search termsFull-text papersFracture patientsMinor complications
2017
Results of Database Studies in Spine Surgery Can Be Influenced by Missing Data
Basques BA, McLynn RP, Fice MP, Samuel AM, Lukasiewicz AM, Bohl DD, Ahn J, Singh K, Grauer JN. Results of Database Studies in Spine Surgery Can Be Influenced by Missing Data. Clinical Orthopaedics And Related Research® 2017, 475: 2893-2904. PMID: 27896677, PMCID: PMC5670041, DOI: 10.1007/s11999-016-5175-7.Peer-Reviewed Original ResearchMeSH KeywordsComorbidityData AccuracyData CollectionData MiningDatabases, FactualDecision Support TechniquesHumansLength of StayLogistic ModelsMultivariate AnalysisOdds RatioOperative TimeOrthopedic ProceduresPostoperative ComplicationsPredictive Value of TestsProcess Assessment, Health CareRetrospective StudiesRisk AssessmentRisk FactorsSpinal DiseasesSpineTime FactorsTreatment OutcomeUnited StatesConceptsACS-NSQIP databaseAdverse eventsPreoperative laboratory valuesRisk factorsSpine surgeryOperating room timeLaboratory valuesSpine studiesACS-NSQIPDatabase studyRoom timeReference rangeQuality Improvement Program databasePerioperative laboratory valuesVariable reference rangesAnterior cervical discectomyImprovement Program databaseMost risk factorsLength of stayLarge database studiesDifferent risk factorsEffect sizeCervical discectomyMedical comorbiditiesGreater effect sizeThe 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 studyDiscriminative Ability of Elixhauser's Comorbidity Measure is Superior to Other Comorbidity Scores for Inpatient Adverse Outcomes After Total Hip Arthroplasty
Ondeck NT, Bohl DD, Bovonratwet P, McLynn RP, Cui JJ, Grauer JN. Discriminative Ability of Elixhauser's Comorbidity Measure is Superior to Other Comorbidity Scores for Inpatient Adverse Outcomes After Total Hip Arthroplasty. The Journal Of Arthroplasty 2017, 33: 250-257. PMID: 28927567, DOI: 10.1016/j.arth.2017.08.032.Peer-Reviewed Original ResearchConceptsElixhauser comorbidity measuresCharlson Comorbidity IndexTotal hip arthroplastyAdverse outcomesComorbidity measuresComorbidity indexHip arthroplastyDiscriminative abilityBody mass indexNational Inpatient SampleLength of stayAdverse patient outcomesComorbidity scoreHospital stayPerioperative courseFrailty indexMass indexComplication measuresPatient's probabilityInpatient SamplePatient outcomesDemographic factors ageHigh riskOptimize outcomesAdmission center
2016
Perioperative Outcomes After Cervical Laminoplasty Versus Posterior Decompression and Fusion
Varthi AG, Basques BA, Bohl DD, Golinvaux NS, Grauer JN. Perioperative Outcomes After Cervical Laminoplasty Versus Posterior Decompression and Fusion. Clinical Spine Surgery A Spine Publication 2016, 29: e226-e232. PMID: 25310393, DOI: 10.1097/bsd.0000000000000183.Peer-Reviewed Original ResearchConceptsMultilevel cervical pathologyBaseline patient characteristicsCervical laminoplastyShort-term outcomesPosterior decompressionLaminoplasty patientsFusion patientsCervical decompressionAdverse eventsPatient characteristicsCervical pathologySurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databasePropensity-adjusted multivariate analysisQuality Improvement Program databaseWorse short-term outcomesCharlson Comorbidity IndexPosterior cervical decompressionRetrospective cohort studyImprovement Program databaseLength of stayBivariate logistic regressionAnesthesiologists (ASA) scoreComorbidity indexPerioperative outcomes