2024
Insurance Disparities in Patient Outcomes and Healthcare Resource Utilization Following Neonatal Intraventricular Hemorrhage
Sayeed S, Theriault B, Hengartner A, Ahsan N, Sadeghzadeh S, Elsamadicy E, DiLuna M, Elsamadicy A. Insurance Disparities in Patient Outcomes and Healthcare Resource Utilization Following Neonatal Intraventricular Hemorrhage. World Neurosurgery 2024 PMID: 38815926, DOI: 10.1016/j.wneu.2024.05.136.Peer-Reviewed Original ResearchIntraventricular hemorrhagePI patientsInsurance statusAssociated with surgical delayDiagnosis of intraventricular hemorrhageMultivariate logistic regression analysisNeonatal intraventricular hemorrhageAssociated with increased healthcare utilizationNational Inpatient Sample databaseRetrospective cohort studyImpact of insurance statusTime to referralAssociated with increased oddsInpatient Sample databaseAssociation of insurance statusLogistic regression analysisLength of stayMyelomeningocele repairSurgical delayCost of admissionAdverse eventsPrivate insuranceCohort studyMedicaid patientsPI cohortSociodemographic Disparities and Postoperative Outcomes Following Cranial Vault Remodeling for Craniosynostosis: Analysis of the 2012 to 2021 NSQIP-Pediatric Database
Hengartner A, Serrato P, Sayeed S, Sadeghzadeh S, Prassinos A, Alperovich M, DiLuna M, Elsamadicy A. Sociodemographic Disparities and Postoperative Outcomes Following Cranial Vault Remodeling for Craniosynostosis: Analysis of the 2012 to 2021 NSQIP-Pediatric Database. Journal Of Craniofacial Surgery 2024, 35: 1310-1314. PMID: 38752737, DOI: 10.1097/scs.0000000000010303.Peer-Reviewed Original ResearchNon-Hispanic blacksNon-Hispanic whitesLength of stayCranial vault repairAdverse eventsNational Surgical Quality Improvement Program-Pediatric databaseAmerican College of Surgeons National Surgical Quality Improvement Program Pediatric databaseMultivariate logistic regression analysisNSQIP-Pediatric databaseAge of presentationNon-Hispanic Black patientsNon-Hispanic white patientsIncreased complication rateHospital length of stayExtended length of stayPostoperative clinical outcomesEquitable health careRetrospective cohort studyCranial vault remodelingCurrent Procedural Terminology codesPostoperative adverse eventsCranial vault reconstructionProcedural Terminology codesLogistic regression analysisNon-white patientsReduced racial disparities among newborns with intraventricular hemorrhage
Sayeed S, Reeves B, Theriault B, Hengartner A, Ahsan N, Sadeghzadeh S, Elsamadicy E, DiLuna M, Elsamadicy A. Reduced racial disparities among newborns with intraventricular hemorrhage. Child's Nervous System 2024, 40: 2051-2059. PMID: 38526575, DOI: 10.1007/s00381-024-06369-w.Peer-Reviewed Original ResearchLength of stayIntroductionIntraventricular hemorrhageAdverse eventsMultivariate logistic regression analysisRate of adverse eventsPermanent neurological dysfunctionProlonged length of stayNational Inpatient Sample databaseRates of NECInpatient Sample databaseLogistic regression analysisIntraventricular hemorrhageAA patientsImpact of raceCost of admissionIndependent predictorsRate of mortalityPatient characteristicsMultivariate analysisPercentage of AAWhite patientsNeurological dysfunctionNewbornsPatient genderPatientsImpact 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 predictorsAssociated Risk Factors for Extended Operative Time Following Cranial Vault Remodeling for Craniosynostosis: Analysis of the 2012 to 2021 NSQIP-Pediatric Database
Serrato P, Hengartner A, Sayeed S, Prassinos A, Alperovich M, DiLuna M, Elsamadicy A. Associated Risk Factors for Extended Operative Time Following Cranial Vault Remodeling for Craniosynostosis: Analysis of the 2012 to 2021 NSQIP-Pediatric Database. Journal Of Craniofacial Surgery 2023, 35: 427-431. PMID: 38078913, DOI: 10.1097/scs.0000000000009920.Peer-Reviewed Original ResearchExtended operative timeCranial vault remodelingRetrospective cohort studyAdverse eventsCohort studyIndependent predictorsPediatric patientsOperative timeRisk factorsVault remodelingNational Surgical Quality Improvement Program-PediatricHealth care resource utilizationPostoperative surgical site infectionSurgeons National Surgical Quality Improvement Program-PediatricMultivariate logistic regression analysisDiseases 9/10 codesNSQIP-Pediatric databasePostoperative adverse eventsHigher American SocietySurgical site infectionAssociated risk factorsSurgical adverse eventsLength of stayLogistic regression analysisNon-Hispanic whitesPrevalence 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 demographicsPerioperative outcomes and survival after surgery for intramedullary spinal cord tumors: a single-institution series of 302 patients.
Hersh AM, Patel J, Pennington Z, Porras JL, Goldsborough E, Antar A, Elsamadicy AA, Lubelski D, Wolinsky JP, Jallo G, Gokaslan ZL, Lo SL, Sciubba DM. Perioperative outcomes and survival after surgery for intramedullary spinal cord tumors: a single-institution series of 302 patients. Journal Of Neurosurgery Spine 2022, 37: 252-262. PMID: 35213831, DOI: 10.3171/2022.1.spine211235.Peer-Reviewed Original ResearchIntramedullary spinal cord tumorsLong-term survivalPerioperative outcomesSpinal cord tumorsSingle-institution seriesFisher's exact testChi-square testCervical cordCord tumorsClinical presentationTumor histologyAmerican Spinal Injury Association gradeExact testPrimary intramedullary spinal cord tumorsTumor pathologyShort-term clinical coursePoor long-term survivalLarge single-institution seriesBaseline neurological statusHigh-grade ependymomasCohort of patientsGross total resectionExtent of resectionLog-rank testLength of stayHospital 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
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 predictorsImpact 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 centerPatient- 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 SystemDrivers of Readmission and Reoperation After Surgery for Vertebral Column Metastases
Patel J, Pennington Z, Hersh AM, Hung B, Schilling A, Antar A, Elsamadicy AA, de la Garza Ramos R, Lubelski D, Larry Lo SF, Sciubba DM. Drivers of Readmission and Reoperation After Surgery for Vertebral Column Metastases. World Neurosurgery 2021, 154: e806-e814. PMID: 34389529, DOI: 10.1016/j.wneu.2021.08.015.Peer-Reviewed Original ResearchConceptsCharlson Comorbidity IndexSpinal metastasis surgeryComprehensive cancer centerUnplanned reoperationMedical comorbiditiesMetastasis surgeryIndependent predictorsUnplanned readmissionWound infectionCancer CenterDrivers of readmissionsLonger index admissionsVertebral Column MetastasesBaseline laboratory valuesMultivariable logistic regressionLength of stayPopulation of adultsOutcomes of interestWound healing factorsComorbidity indexIndex admissionVenous thromboembolismLocal recurrenceSurgical morbidityMultivariable analysis