2021
Long-term Corticosteroid Use Independently Correlates With Complications After Posterior Lumbar Spine Surgery.
Kebaish KJ, Galivanche AR, Varthi AG, Ottesen TD, Rubin LE, Grauer JN. Long-term Corticosteroid Use Independently Correlates With Complications After Posterior Lumbar Spine Surgery. Orthopedics 2021, 44: 172-179. PMID: 34039214, DOI: 10.3928/01477447-20210416-01.Peer-Reviewed Original ResearchConceptsLong-term corticosteroid usePosterior lumbar spine surgeryPosterior lumbar surgeryLumbar spine surgeryPerioperative adverse outcomesCorticosteroid useAdverse eventsLumbar surgerySpine surgeryPropensity matchingAdverse outcomesNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseMinor adverse eventsEffect of immunosuppressionImprovement Program databaseLong-term corticosteroidsSerious adverse eventsBody mass indexMultiple surgical specialtiesAnesthesiologists classComparable patientsPerioperative outcomesSurgical factorsMore patients
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 training
2018
Unlike Native Hip Fractures, Delay to Periprosthetic Hip Fracture Stabilization Does Not Significantly Affect Most Short-Term Perioperative Outcomes
Bovonratwet P, Fu MC, Adrados M, Ondeck NT, Su EP, Grauer JN. Unlike Native Hip Fractures, Delay to Periprosthetic Hip Fracture Stabilization Does Not Significantly Affect Most Short-Term Perioperative Outcomes. The Journal Of Arthroplasty 2018, 34: 564-569. PMID: 30514642, DOI: 10.1016/j.arth.2018.11.006.Peer-Reviewed Original ResearchConceptsPeriprosthetic hip fracturesNative hip fracturesIndependent risk factorSerious adverse eventsHip fracturePerioperative complicationsAdverse eventsRisk factorsNational Surgical Quality Improvement Program databaseDependent preoperative functional statusPostoperative serious adverse eventsPreoperative congestive heart failureQuality Improvement Program databaseExtended postoperative stayPreoperative functional statusImprovement Program databaseCongestive heart failureTotal hip arthroplastyPostoperative stayPerioperative outcomesHeart failureHospital admissionPotential confoundersFunctional statusProgram databaseIs 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 costsPatientsTiming of Adverse Events Following Geriatric Hip Fracture Surgery: A Study of 19,873 Patients in the American College of Surgeons National Surgical Quality Improvement Program.
Bohl DD, Samuel AM, Webb ML, Lukasiewicz AM, Ondeck NT, Basques BA, Anandasivam NS, Grauer JN. Timing of Adverse Events Following Geriatric Hip Fracture Surgery: A Study of 19,873 Patients in the American College of Surgeons National Surgical Quality Improvement Program. The American Journal Of Orthopedics 2018, 47 PMID: 30296324, DOI: 10.12788/ajo.2018.0080.Peer-Reviewed Original ResearchConceptsSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramGeriatric hip fracture surgerySurgical Quality Improvement ProgramHip fracture surgeryAdverse eventsPostoperative day 30Quality Improvement ProgramFracture surgeryAmerican CollegeDay 30Urinary tract infections 7Median postoperative dayProspective surgical registryPostoperative adverse eventsSpecific adverse eventsInfection 7Mortality 11Pneumonia 4Postoperative dayHip fractureCardiac arrestClinical surveillancePatient counselingMyocardial infarctionSystematic Changes in the National Surgical Quality Improvement Program Database Over the Years Can Affect Comorbidity Indices Such as the Modified Frailty Index and Modified Charlson Comorbidity Index for Lumbar Fusion Studies
Shultz BN, Ottesen TD, Ondeck NT, Bovonratwet P, McLynn RP, Cui JJ, Grauer JN. Systematic Changes in the National Surgical Quality Improvement Program Database Over the Years Can Affect Comorbidity Indices Such as the Modified Frailty Index and Modified Charlson Comorbidity Index for Lumbar Fusion Studies. Spine 2018, 43: 798-804. PMID: 28922281, DOI: 10.1097/brs.0000000000002418.Peer-Reviewed Original ResearchConceptsNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseCharlson Comorbidity IndexImprovement Program databaseComorbidity indexFrailty indexNSQIP databaseProgram databaseSurgeons National Surgical Quality Improvement Program databaseElective posterior lumbar fusionModified Charlson Comorbidity IndexModified Frailty IndexAdverse postoperative outcomesRetrospective cohort studyMean American SocietyMean ASA scorePosterior lumbar fusionAnesthesiologists (ASA) scoreASA scoreCohort studyPostoperative outcomesLumbar fusionBACKGROUND DATAAmerican CollegePatientsDialysis Patients Undergoing Total Knee Arthroplasty Have Significantly Increased Odds of Perioperative Adverse Events Independent of Demographic and Comorbidity Factors
Ottesen TD, Zogg CK, Haynes MS, Malpani R, Bellamkonda KS, Grauer JN. Dialysis Patients Undergoing Total Knee Arthroplasty Have Significantly Increased Odds of Perioperative Adverse Events Independent of Demographic and Comorbidity Factors. The Journal Of Arthroplasty 2018, 33: 2827-2834. PMID: 29754981, DOI: 10.1016/j.arth.2018.04.012.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overArthroplasty, Replacement, KneeComorbidityElective Surgical ProceduresFemaleHumansInpatientsLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPatient DischargePatient ReadmissionPostoperative ComplicationsQuality ImprovementRegression AnalysisRenal DialysisReoperationRetrospective StudiesRisk AssessmentConceptsTotal knee arthroplastyDialysis-dependent patientsAdverse eventsPatient demographicsDialysis patientsAdverse outcomesKnee arthroplastyNational Surgical Quality Improvement Program databaseOverall healthRisk-adjusted logistic regressionElective total knee arthroplastyQuality Improvement Program databaseImprovement Program databaseMinor adverse eventsNational inpatient databaseSevere adverse eventsBone health statusNondialysis cohortNondialysis patientsPerioperative periodTKA patientsAdult patientsPreoperative riskComorbidity factorsInstitutional cohortEvaluating the effect of growing patient numbers and changing data elements in the National Surgical Quality Improvement Program (NSQIP) database over the years: a study of posterior lumbar fusion outcomes
Shultz BN, Bovonratwet P, Ondeck NT, Ottesen TD, McLynn RP, Grauer JN. Evaluating the effect of growing patient numbers and changing data elements in the National Surgical Quality Improvement Program (NSQIP) database over the years: a study of posterior lumbar fusion outcomes. The Spine Journal 2018, 18: 1982-1988. PMID: 29649610, DOI: 10.1016/j.spinee.2018.03.016.Peer-Reviewed Original ResearchMeSH KeywordsData CollectionDatabases, FactualElective Surgical ProceduresHumansLumbosacral RegionPostoperative ComplicationsQuality ImprovementConceptsNational Surgical Quality Improvement ProgramNSQIP databaseERA groupPreoperative characteristicsPostoperative outcomesBlood transfusionSeptic shockOutcome studiesNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement ProgramQuality Improvement Program databaseSurgical Quality Improvement ProgramPosterior lumbar fusion surgeryLumbar fusion outcomesRetrospective cohort studyImprovement Program databaseYear of surgeryDeep vein thrombosisUrinary tract infectionLumbar fusion surgeryPostoperative day 30Number of patientsMultivariate Poisson regressionQuality Improvement ProgramPerioperative outcomesMissing data treatments matter: an analysis of multiple imputation for anterior cervical discectomy and fusion procedures
Ondeck NT, Fu MC, Skrip LA, McLynn RP, Cui JJ, Basques BA, Albert TJ, Grauer JN. Missing data treatments matter: an analysis of multiple imputation for anterior cervical discectomy and fusion procedures. The Spine Journal 2018, 18: 2009-2017. PMID: 29649614, DOI: 10.1016/j.spinee.2018.04.001.Peer-Reviewed Original ResearchConceptsSevere adverse eventsNational Surgical Quality Improvement ProgramAnterior cervical discectomyAdverse eventsPreoperative anemiaPreoperative hypoalbuminemiaPreoperative albuminCervical discectomyHospital readmissionAdverse outcomesComplete case analysisSurgical Quality Improvement ProgramAdverse outcome variablesOne-level ACDFPreoperative laboratory valuesBody mass indexFusion proceduresMultiple imputationLogistic regression analysisQuality Improvement ProgramPreoperative hematocritPostoperative outcomesRetrospective reviewMass indexLaboratory valuesMissing data may lead to changes in hip fracture database studies: a study of the American College of Surgeons National Surgical Quality Improvement Program.
Basques BA, McLynn RP, Lukasiewicz AM, Samuel AM, Bohl DD, Grauer JN. Missing data may lead to changes in hip fracture database studies: a study of the American College of Surgeons National Surgical Quality Improvement Program. The Bone & Joint Journal 2018, 100-B: 226-232. PMID: 29437066, DOI: 10.1302/0301-620x.100b2.bjj-2017-0791.r1.Peer-Reviewed Original ResearchConceptsAdverse eventsRisk factorsDatabase studyNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramQuality Improvement Program databaseSurgical Quality Improvement ProgramPostoperative adverse eventsImprovement Program databaseNational database studyDifferent risk factorsMultivariate regressionQuality Improvement ProgramElderly patientsNSQIP databaseBone JointProgram databaseLaboratory valuesAmerican CollegePatientsHipFracturesComorbiditiesSurgery
2017
After Posterior Fusions for Adult Spinal Deformity, Operative Time is More Predictive of Perioperative Morbidity, Rather Than Surgical Invasiveness
Samuel AM, Fu MC, Anandasivam NS, Webb ML, Lukasiewicz AM, Kim HJ, Grauer JN. After Posterior Fusions for Adult Spinal Deformity, Operative Time is More Predictive of Perioperative Morbidity, Rather Than Surgical Invasiveness. Spine 2017, 42: 1880-1887. PMID: 28538595, DOI: 10.1097/brs.0000000000002243.Peer-Reviewed Original ResearchConceptsAdult spinal deformityPosterior spinal fusionOperative timeSurgical invasivenessSpinal deformitySpinal fusionMultivariate analysisPerioperative outcomesPosterior fusionOperative timingNational Surgical Quality Improvement Program databaseIndependent effectsQuality Improvement Program databaseImprovement Program databaseRetrospective cohort studyLonger operative timeOverall operative timeAdult deformity surgeryInvasive surgical proceduresInpatient complicationsPerioperative complicationsPerioperative morbidityAdult patientsCohort studyDeformity surgeryOutpatient 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 patientsTreatments of Missing Values in Large National Data Affect Conclusions: The Impact of Multiple Imputation on Arthroplasty Research
Ondeck NT, Fu MC, Skrip LA, McLynn RP, Su EP, Grauer JN. Treatments of Missing Values in Large National Data Affect Conclusions: The Impact of Multiple Imputation on Arthroplasty Research. The Journal Of Arthroplasty 2017, 33: 661-667. PMID: 29153865, DOI: 10.1016/j.arth.2017.10.034.Peer-Reviewed Original ResearchConceptsUnicompartmental knee arthroplastyPreoperative albuminAdverse outcomesKnee arthroplastyNational Surgical Quality Improvement ProgramComplete case analysisHematocrit valuesSurgical Quality Improvement ProgramDemographics of patientsPreoperative laboratory valuesMultiple imputationQuality Improvement ProgramArthroplasty researchSelection biasHealthy patientsLaboratory valuesPotential selection biasPatientsJoint surgeonsComplete dataArthroplastyOnly caseNational datasetOutcomesConclusionWhich Pediatric Orthopaedic Procedures Have the Greatest Risk of Adverse Outcomes?
Basques BA, Lukasiewicz AM, Samuel AM, Webb ML, Bohl DD, Smith BG, Grauer JN. Which Pediatric Orthopaedic Procedures Have the Greatest Risk of Adverse Outcomes? Journal Of Pediatric Orthopaedics 2017, 37: 429-434. PMID: 26558959, DOI: 10.1097/bpo.0000000000000683.Peer-Reviewed Original ResearchConceptsPediatric orthopaedic proceduresCommon pediatric orthopaedic proceduresAdverse outcomesAdverse eventsOrthopedic proceduresSpinal fusionPediatric patientsPediatric databaseNational Surgical Quality Improvement Program Pediatric databaseSurgeons National Surgical Quality Improvement Program Pediatric databaseNSQIP-Pediatric databasePediatric orthopedic patientsRetrospective cohort studyMultiple patient characteristicsPosterior spinal fusionPediatric patient samplesDifferent orthopedic proceduresASA classCohort studyPerioperative safetyPatient characteristicsNonidiopathic scoliosisOrthopedic patientsOperative characteristicsExternal fixationOf 20,376 Lumbar Discectomies, 2.6% of Patients Readmitted Within 30 Days
Webb ML, Nelson SJ, Save A, Cui J, Lukasiewicz AM, Samuel AM, Diaz-Collado PJ, Bohl DD, Ondeck NT, McLynn RP, Grauer JN. Of 20,376 Lumbar Discectomies, 2.6% of Patients Readmitted Within 30 Days. Spine 2017, 42: 1267-1273. PMID: 27926671, DOI: 10.1097/brs.0000000000002014.Peer-Reviewed Original ResearchConceptsSurgical site infectionLumbar discectomyThromboembolic eventsHospital readmissionSite infectionSurgical variablesCommon reasonSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseCauses of readmissionHigher American SocietyImprovement Program databaseRetrospective cohort studyDay of surgeryQuality-based reimbursementQuality improvement initiativesPearson chi-squareAnesthesiologists classPostoperative painPatient demographicsCohort studyOperative timeAffordable Care ActRisk factorsIncidence, Risk Factors, and Impact of Clostridium difficile Colitis Following Primary Total Hip and Knee Arthroplasty
Bovonratwet P, Bohl DD, Malpani R, Nam D, Della Valle CJ, Grauer JN. Incidence, Risk Factors, and Impact of Clostridium difficile Colitis Following Primary Total Hip and Knee Arthroplasty. The Journal Of Arthroplasty 2017, 33: 205-210.e1. PMID: 28870746, DOI: 10.1016/j.arth.2017.08.004.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overArthroplasty, Replacement, HipArthroplasty, Replacement, KneeClostridioides difficileColitisEnterocolitis, PseudomembranousFemaleHumansIncidenceKnee JointMaleMiddle AgedPatient DischargePostoperative ComplicationsQuality ImprovementRetrospective StudiesRisk FactorsUnited StatesConceptsNational Surgical Quality Improvement ProgramSurgical Quality Improvement ProgramDifficile colitisPrimary total hipRisk factorsQuality Improvement ProgramPrimary THATotal hipProcedural risk factorsClostridium difficile colitisHigh-risk patientsUrinary tract infectionInfectious risk factorsPoisson multivariate regressionPreoperative anemiaPerioperative antibioticsPostoperative periodTract infectionsPrimary outcomeSubstantial morbidityKnee arthroplastyColitisPatientsClinical implicationsHospital qualityRevision Total Knee Arthroplasty in Octogenarians: An Analysis of 957 Cases
Bovonratwet P, Tyagi V, Ottesen TD, Ondeck NT, Rubin LE, Grauer JN. Revision Total Knee Arthroplasty in Octogenarians: An Analysis of 957 Cases. The Journal Of Arthroplasty 2017, 33: 178-184. PMID: 28844628, DOI: 10.1016/j.arth.2017.07.032.Peer-Reviewed Original ResearchConceptsRevision total knee arthroplastyTotal knee arthroplastyBlood transfusionOctogenarian patientsKnee arthroplastyPatient populationNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseLonger lengthYoung populationHigh rateImprovement Program databaseYoung patient populationNumber of octogenariansLarger patient populationYear oldsHospital stayIntraoperative characteristicsPerioperative complicationsPerioperative coursePropensity matchingAdvanced ageProgram databaseOctogenariansStayOutpatient and Inpatient Unicompartmental Knee Arthroplasty Procedures Have Similar Short-Term Complication Profiles
Bovonratwet P, Ondeck NT, Tyagi V, Nelson SJ, Rubin LE, Grauer JN. Outpatient and Inpatient Unicompartmental Knee Arthroplasty Procedures Have Similar Short-Term Complication Profiles. The Journal Of Arthroplasty 2017, 32: 2935-2940. PMID: 28602533, DOI: 10.1016/j.arth.2017.05.018.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAmbulatory Surgical ProceduresArthroplasty, Replacement, KneeCohort StudiesComorbidityDatabases, FactualFemaleHumansInpatientsLength of StayMaleMiddle AgedOutcome Assessment, Health CareOutpatientsPatient ReadmissionPatient SatisfactionPostoperative ComplicationsPropensity ScoreQuality ImprovementUnited StatesConceptsUnicompartmental knee arthroplastyNational Surgical Quality Improvement Program databaseInpatient Unicompartmental Knee ArthroplastyQuality Improvement Program databaseLength of hospitalImprovement Program databasePerioperative complicationsProgram databaseOutpatient unicompartmental knee arthroplastyShort-term complication profileUnicompartmental knee arthroplasty (UKA) proceduresNational patient populationPerioperative outcome measuresHigh patient satisfactionKnee arthroplasty proceduresPotential confounding factorsInpatient cohortPerioperative outcomesPostdischarge complicationsPatient characteristicsComplication profileOutpatient surgeryPatient populationKnee arthroplastyOutpatient procedureComparison of Perioperative Adverse Event Rates After Total Knee Arthroplasty in Patients With Diabetes: Insulin Dependence Makes a Difference
Webb ML, Golinvaux NS, Ibe IK, Bovonratwet P, Ellman MS, Grauer JN. Comparison of Perioperative Adverse Event Rates After Total Knee Arthroplasty in Patients With Diabetes: Insulin Dependence Makes a Difference. The Journal Of Arthroplasty 2017, 32: 2947-2951. PMID: 28559194, DOI: 10.1016/j.arth.2017.04.032.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedArthroplasty, Replacement, KneeComorbidityDatabases, FactualDiabetes Mellitus, Type 1Diabetes Mellitus, Type 2FemaleHumansInsulinMaleMiddle AgedOrthopedic ProceduresPostoperative ComplicationsPrevalenceQuality ImprovementRetrospective StudiesRisk FactorsTreatment OutcomeUnited StatesYoung AdultConceptsTotal knee arthroplastyInsulin-dependent DMDiabetes mellitusAdverse eventsGreater riskKnee arthroplastySurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databasePerioperative adverse event ratesQuality Improvement Program databaseInsulin-dependent diabetes mellitusPerioperative adverse outcomesRetrospective cohort studyImprovement Program databasePerioperative adverse eventsAdverse event ratesDependent diabetes mellitusPreoperative risk stratificationEffective treatment optionMultivariate Poisson regressionMultiple adverse eventsCohort studyInsulin dependencePostoperative daySurgical complicationsDifferences in Short-Term Outcomes Between Primary and Revision Anterior Cervical Discectomy and Fusion
Basques BA, Ondeck NT, Geiger EJ, Samuel AM, Lukasiewicz AM, Webb ML, Bohl DD, Massel DH, Mayo BC, Singh K, Grauer JN. Differences in Short-Term Outcomes Between Primary and Revision Anterior Cervical Discectomy and Fusion. Spine 2017, 42: 253-260. PMID: 28207667, DOI: 10.1097/brs.0000000000001718.Peer-Reviewed Original ResearchConceptsRevision anterior cervical discectomyAnterior cervical discectomySurgical site infectionACDF proceduresRevision proceduresAdverse eventsPostoperative lengthThromboembolic eventsCervical discectomySite infectionBlood transfusionOperative timeNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement Program databaseQuality Improvement Program databaseOperating roomImprovement Program databaseMinor adverse eventsRetrospective cohort studySevere adverse eventsShort-term morbidityRisk of readmissionAverage operative timeShort-term outcomesMultiple adverse outcomes