2024
Polypharmacy in elective lumbar spinal surgery for degenerative conditions with 24-month follow-up
Dietz N, Kumar C, Elsamadicy A, Bjurström M, Wong K, Jamieson A, Sharma M, Wang D, Ugiliweneza B, Drazin D, Boakye M. Polypharmacy in elective lumbar spinal surgery for degenerative conditions with 24-month follow-up. Scientific Reports 2024, 14: 25340. PMID: 39455709, PMCID: PMC11511981, DOI: 10.1038/s41598-024-76248-6.Peer-Reviewed Original ResearchConceptsDegenerative lumbar pathologySurgical site infectionSpinal surgeryPolypharmacy groupSite infectionLumbar pathologyFollow-upMedical complicationsElective lumbar spinal surgeryLumbar spinal surgeryUrinary tract infectionDegenerative lumbar conditionsReturn to the emergency departmentTract infectionsNon-polypharmacy groupSurgical patientsLumbar conditionsSurgeryPatientsComplicationsPolypharmacyEmergency departmentPrescribed medicationsMarketScan datasetDegenerative conditions
2023
Socioeconomic and Racial/Ethnic Disparities in Perception of Health Status and Literacy in Spine Oncological Patients
Elsamadicy A, Wang C, Reeves B, Sherman J, Craft S, Rajjoub R, Koo A, Hersh A, Pennington Z, Lo S, Shin J, Mendel E, Sciubba D. Socioeconomic and Racial/Ethnic Disparities in Perception of Health Status and Literacy in Spine Oncological Patients. Spine 2023, 48: 1107-1115. PMID: 37163649, DOI: 10.1097/brs.0000000000004712.Peer-Reviewed Original ResearchConceptsNon-White HispanicsOncology patientsHigh response rateWhite/CaucasianHealth statusHealth literacyWC patientsResponse rateICD-9/10-CM codesOwn general healthSocioeconomic statusBaseline health statusRacial/Ethnic DisparitiesCross-sectional studyRace/ethnicityExcellent/Severe fatigueGeneral healthOncological patientsBACKGROUND DATADisease processHealthcare costsPatientsMedical careEthnic disparitiesImpact of insurance status on healthcare resource utilization and outcomes in adolescent patients presenting with spinal cord injuries.
Sandhu M, David W, Reeves B, Sherman J, Craft S, Jayaraj C, Boroumand S, Clappier M, Gutierrez A, Sarkozy M, Koo A, Tuason D, DiLuna M, Elsamadicy A. Impact of insurance status on healthcare resource utilization and outcomes in adolescent patients presenting with spinal cord injuries. Journal Of Neurosurgery Pediatrics 2023, 32: 294-301. PMID: 37021755, DOI: 10.3171/2023.2.peds22506.Peer-Reviewed Original ResearchConceptsSpinal cord injuryHospital adverse eventsHealthcare resource utilizationAdverse eventsInsurance statusAdolescent patientsGovernmental insuranceInsurance cohortCord injuryNon-Hispanic white patientsNational Trauma Data BankPrivate insuranceThoracic spinal cord injuryPrivate insurance cohortAdministrative database studyTrauma Data BankClinical Modification codingMultivariate regression analysisPI cohortMedian LOSAdult patientsDischarge dispositionPatient demographicsSCI patientsWhite patientsDifferences in Outcomes and Health Care Resource Utilization After Surgical Intervention for Metastatic Spinal Column Tumor in Safety-Net Hospitals
Elsamadicy A, Koo A, David W, Reeves B, Sherman J, Craft S, Hersh A, Duvall J, Lo S, Shin J, Mendel E, Sciubba D. Differences in Outcomes and Health Care Resource Utilization After Surgical Intervention for Metastatic Spinal Column Tumor in Safety-Net Hospitals. Spine 2023, 48: 800-809. PMID: 36972069, DOI: 10.1097/brs.0000000000004643.Peer-Reviewed Original ResearchConceptsSpinal column tumorsSNH statusPostoperative complicationsDischarge dispositionMultivariable analysisTumor surgeryMetastatic spinal tumor surgeryHealth care resource utilizationNationwide Inpatient Sample databaseICD-10-CM codingNonroutine discharge dispositionObservational cohort studySpinal tumor surgerySafety-net hospitalNonroutine dischargeSNH patientsHospital lengthStudy patientsAdult patientsCohort studyIntraoperative variablesExtended LOSIndependent predictorsLonger LOSProlonged hospitalizationPrevalence 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 demographicsEmergent external ventricular drain placement in patients with factor Xa inhibitor-associated intracerebral hemorrhage after reversal with andexanet alfa
Ammar A, Elsamadicy A, Ammar M, Reeves B, Koo A, Falcone G, Hwang D, Petersen N, Kim J, Beekman R, Prust M, Magid-Bernstein J, Acosta J, Herbert R, Sheth K, Matouk C, Gilmore E. Emergent external ventricular drain placement in patients with factor Xa inhibitor-associated intracerebral hemorrhage after reversal with andexanet alfa. Clinical Neurology And Neurosurgery 2023, 226: 107621. PMID: 36791588, DOI: 10.1016/j.clineuro.2023.107621.Peer-Reviewed Original ResearchConceptsAndexanet alfaExtra-axial hemorrhageEVD placementThrombotic eventsNew hemorrhagePrimary safety outcomeExternal ventricular drain placementLarge prospective studiesIntensive care unitIntracerebral hemorrhage patientsVentricular drain placementBolus patientsHospital lengthHospital LOSICU LOSTract hemorrhageRankin scoreSecondary outcomesAdult patientsBolus groupPrimary outcomeCare unitIntracerebral hemorrhageLong administration timeHemorrhage patients
2022
Geriatric relationship with inpatient opioid consumption and hospital outcomes after open posterior spinal fusion for adult spine deformity
Elsamadicy A, Sandhu M, Reeves B, Sherman J, Craft S, Williams M, Shin J, Sciubba D. Geriatric relationship with inpatient opioid consumption and hospital outcomes after open posterior spinal fusion for adult spine deformity. Clinical Neurology And Neurosurgery 2022, 224: 107532. PMID: 36436433, DOI: 10.1016/j.clineuro.2022.107532.Peer-Reviewed Original ResearchConceptsNon-routine dischargeHealthcare resource utilizationAdverse eventsGeriatric cohortMME useGeriatric patientsSpinal fusionSpine deformityMultivariate logistic regression analysisInpatient narcotic consumptionInpatient opioid consumptionInpatient opioid usePremier Healthcare DatabasePoor surgical outcomesPatient risk stratificationPosterior spinal fusionAdult spinal deformityAdult spine deformityICD-10-CM codesGreater proportionLogistic regression analysisGreater resource utilizationNon-Hispanic whitesOlder CohortOpioid consumptionAssociation of inpatient opioid consumption on postoperative outcomes after open posterior spinal fusion for adult spine deformity
Elsamadicy A, Sandhu M, Reeves B, Freedman I, Koo A, Jayaraj C, Hengartner A, Havlik J, Hersh A, Pennington Z, Lo S, Shin J, Mendel E, Sciubba D. Association of inpatient opioid consumption on postoperative outcomes after open posterior spinal fusion for adult spine deformity. Spine Deformity 2022, 11: 439-453. PMID: 36350557, DOI: 10.1007/s43390-022-00609-2.Peer-Reviewed Original ResearchConceptsAdult spinal deformityInpatient opioid useProportion of patientsOpioid useAdverse eventsHigher MMESpinal fusionHospital costsMME consumptionPostoperative outcomesDischarge dispositionHospital admissionRisk factorsMultivariate analysisLong-term opioid useMethodsA retrospective cohort studyHigh opioid useInpatient opioid consumptionOpioid-related disordersPremier Healthcare DatabasePostoperative adverse eventsPostoperative opioid useRetrospective cohort studyHealthcare resource utilizationNon-routine dischargeImpact 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 Spinal Metastases Surgery Risk Stratification Tools in Breast Cancer by Molecular Subtype
Duvall J, Massaad E, Siraj L, Kiapour A, Connolly I, Hadzipasic M, Elsamadicy A, Williamson T, Shankar G, Schoenfeld A, Fourman M, Shin J. Assessment of Spinal Metastases Surgery Risk Stratification Tools in Breast Cancer by Molecular Subtype. Neurosurgery 2022, 92: 83-91. PMID: 36305664, PMCID: PMC10158884, DOI: 10.1227/neu.0000000000002180.Peer-Reviewed Original ResearchConceptsHuman epidermal growth factor receptor 2Epidermal growth factor receptor 2Triple-negative breast cancerGrowth factor receptor 2Factor receptor 2Breast cancerHazard ratioSpine metastasesMolecular subtypesReceptor 2Retrospective multi-institutional studyHormone receptorsBreast cancer molecular subtypesPostoperative systemic therapySystemic treatment plansPoor physical activityRisk stratification toolSpinal metastasis surgeryCancer molecular subtypesMulti-institutional studyMassachusetts General HospitalMolecular featuresPostoperative chemotherapyBrain metastasesEndocrine therapyLeveraging HFRS to assess how frailty affects healthcare resource utilization after elective ACDF for CSM
Elsamadicy AA, Koo AB, Sarkozy M, David WB, Reeves BC, Patel S, Hansen J, Sandhu MRS, Hengartner AC, Hersh A, Kolb L, Lo SL, Shin JH, Mendel E, Sciubba DM. Leveraging HFRS to assess how frailty affects healthcare resource utilization after elective ACDF for CSM. The Spine Journal 2022, 23: 124-135. PMID: 35988878, DOI: 10.1016/j.spinee.2022.08.004.Peer-Reviewed Original ResearchConceptsHighest Hospital Frailty Risk ScoresHospital Frailty Risk ScoreCervical spondylotic myelopathyNon-routine discharge dispositionDischarge dispositionElective ACDFFrail patientsExtended LOSHospital costsHealth care resource utilizationNationwide Inpatient Sample databaseMultivariate stepwise logistic regressionFrailty Risk ScorePeri-operative protocolSeverity of frailtyTotal admission costLonger hospital stayRetrospective cohort studyAnterior cervical discectomyCervical spine pathologyHealthcare resource utilizationNon-routine dischargeHigh complication rateTotal hospital costsSignificant independent predictorsAssessment 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 demographicsImpact of Frailty on Morbidity and Mortality in Adult Patients Undergoing Surgical Evacuation of Acute Traumatic Subdural Hematoma
Elsamadicy AA, Sandhu MRS, Freedman IG, Koo AB, Reeves BC, Yu J, Hengartner A, Havlik J, Hong CS, Rutherford HJV, Kim JA, Gerrard J, Gilmore EJ, Omay SB. Impact of Frailty on Morbidity and Mortality in Adult Patients Undergoing Surgical Evacuation of Acute Traumatic Subdural Hematoma. World Neurosurgery 2022, 162: e251-e263. PMID: 35276399, DOI: 10.1016/j.wneu.2022.02.122.Peer-Reviewed Original ResearchConceptsAcute traumatic subdural hematomaTraumatic subdural hematomaHospital mortalityNonroutine dischargeSubdural hematomaExtended LOSIndependent predictorsAdult patientsBaseline frailtyMultivariate logistic regression analysisExtended hospital lengthImpact of frailtyRetrospective cohort studyNational Trauma DatabaseLogistic regression analysisRegression analysisMultivariate regression analysisHealth care expendituresFrail patientsHospital lengthCohort studySurgical evacuationFrailty indexTrauma databasePatientsDifferences 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 metastases
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 SystemRamifications of Postoperative Dysphagia on Health Care Resource Utilization Following Elective Anterior Cervical Discectomy and Interbody Fusion for Cervical Spondylotic Myelopathy
Elsamadicy AA, Koo AB, David WB, Freedman IG, Reeves BC, Ehresman J, Pennington Z, Sarkozy M, Laurans M, Kolb L, Shin JH, Sciubba DM. Ramifications of Postoperative Dysphagia on Health Care Resource Utilization Following Elective Anterior Cervical Discectomy and Interbody Fusion for Cervical Spondylotic Myelopathy. Clinical Spine Surgery A Spine Publication 2021, 35: e380-e388. PMID: 34321392, DOI: 10.1097/bsd.0000000000001241.Peer-Reviewed Original ResearchConceptsHealth care resource utilizationCervical spondylotic myelopathyElective anterior cervical discectomyPostoperative dysphagiaRetrospective cohort studyAnterior cervical discectomySpondylotic myelopathyNonroutine dischargeHospital stayCervical discectomyCohort studyRisk factorsOdds ratioHigher total costsICD-10-CM diagnosisSignificant independent risk factorsNationwide Inpatient Sample databaseMultivariate stepwise logistic regressionLonger hospital LOSLonger hospital stayIndependent risk factorPatient risk factorsStepwise logistic regressionPaucity of dataHospital LOSImpact of Frailty on Morbidity and Mortality in Adult Patients Presenting with an Acute Traumatic Cervical Spinal Cord Injury
Elsamadicy AA, Sandhu MRS, Freedman IG, Reeves BC, Koo AB, Hengartner A, Havlik J, Sherman J, Maduka R, Agboola IK, Johnson DC, Kolb L, Laurans M. Impact of Frailty on Morbidity and Mortality in Adult Patients Presenting with an Acute Traumatic Cervical Spinal Cord Injury. World Neurosurgery 2021, 153: e408-e418. PMID: 34224881, DOI: 10.1016/j.wneu.2021.06.130.Peer-Reviewed Original ResearchConceptsCervical spinal cord injurySpinal cord injuryAcute cervical spinal cord injuryNational Trauma DatabaseAdverse eventsHospital mortalityFrailty scoreAdult patientsIndependent predictorsCord injuryAcute traumatic cervical spinal cord injuryTraumatic cervical spinal cord injuryRisk of AEsComplete spinal cord injuryMultivariate logistic regression analysisCentral cord syndromeHospital adverse eventsImpact of frailtyRetrospective cohort studyProportion of patientsType of injuryProcedural Coding SystemLogistic regression analysisRegression analysisMultivariate regression analysisIndependent Association of Obesity and Nonroutine Discharge Disposition After Elective Anterior Cervical Discectomy and Fusion for Cervical Spondylotic Myelopathy
Koo AB, Elsamadicy AA, Sarkozy M, David WB, Reeves BC, Hong CS, Boylan A, Laurans M, Kolb L. Independent Association of Obesity and Nonroutine Discharge Disposition After Elective Anterior Cervical Discectomy and Fusion for Cervical Spondylotic Myelopathy. World Neurosurgery 2021, 151: e950-e960. PMID: 34020060, DOI: 10.1016/j.wneu.2021.05.022.Peer-Reviewed Original ResearchConceptsCervical spondylotic myelopathyNonroutine discharge dispositionAnterior cervical discectomyElective anterior cervical discectomyDischarge dispositionSpondylotic myelopathyCervical discectomyElective ACDFComplication rateNational Inpatient Sample databaseElective spine surgeryOverall complication ratePrevalence of obesityShort-term outcomesLength of stayHospital bed sizeMultivariate regression analysisHealth care coverageMore comorbiditiesNonroutine dischargeDischarge weightIndependent predictorsElixhauser comorbiditiesGreater proportionPrimary diagnosisModified-frailty index does not independently predict complications, hospital length of stay or 30-day readmission rates following posterior lumbar decompression and fusion for spondylolisthesis
Elsamadicy AA, Freedman IG, Koo AB, David WB, Reeves BC, Havlik J, Pennington Z, Kolb L, Shin JH, Sciubba DM. Modified-frailty index does not independently predict complications, hospital length of stay or 30-day readmission rates following posterior lumbar decompression and fusion for spondylolisthesis. The Spine Journal 2021, 21: 1812-1821. PMID: 34010683, DOI: 10.1016/j.spinee.2021.05.011.Peer-Reviewed Original ResearchConceptsUnplanned readmissionAdverse eventsLumbar spinal decompressionHospital lengthReadmission ratesIndependent predictorsSpinal decompressionNational Surgical Quality Improvement Program databaseQuality Improvement Program databasePosterior lumbar spinal fusionChronic obstructive pulmonary diseaseMultivariate logistic regression analysisICD-9-CM diagnosisDependent functional statusHypertension requiring medicationInferior surgical outcomesLonger hospital stayRetrospective cohort studyImprovement Program databaseCongestive heart failureObstructive pulmonary diseaseSurgical adverse eventsSignificant independent predictorsLumbar spinal fusionProcedural Coding System