2023
Higher Hospital Frailty Risk Score Is Associated With Increased Risk of Stroke: Observational and Genetic Analyses
Renedo D, Acosta J, Koo A, Rivier C, Sujijantarat N, de Havenon A, Sharma R, Gill T, Sheth K, Falcone G, Matouk C. Higher Hospital Frailty Risk Score Is Associated With Increased Risk of Stroke: Observational and Genetic Analyses. Stroke 2023, 54: 1538-1547. PMID: 37216451, PMCID: PMC10212531, DOI: 10.1161/strokeaha.122.041891.Peer-Reviewed Original ResearchMeSH KeywordsHemorrhagic StrokeHospitalsHumansPopulation HealthRetrospective StudiesRisk FactorsStrokeConceptsHospital Frailty Risk ScoreRisk of strokeHighest Hospital Frailty Risk ScoresDate of consentFrailty Risk ScoreMendelian randomization analysisStroke riskRisk scoreRandomization analysisTime of enrollmentAvailable electronic health recordsMendelian randomizationElectronic health recordsLook-back periodIncident strokeDose-response wayFrailty statusHemorrhagic strokeMultivariable analysisStroke eventsObservational studyHigh riskFrailtySignificant associationSimilar associationPrevalence 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
Leveraging 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 predictorsHospital Frailty Risk Score Predicts Adverse Events and Readmission Following a Ventriculoperitoneal Shunt Surgery for Normal Pressure Hydrocephalus
Koo AB, Elsamadicy AA, Renedo D, Sarkozy M, Reeves BC, Barrows MM, Hengartner A, Havlik J, Sandhu MRS, Antonios JP, Malhotra A, Matouk CC. Hospital Frailty Risk Score Predicts Adverse Events and Readmission Following a Ventriculoperitoneal Shunt Surgery for Normal Pressure Hydrocephalus. World Neurosurgery 2022, 170: e9-e20. PMID: 35970293, DOI: 10.1016/j.wneu.2022.08.037.Peer-Reviewed Original ResearchConceptsHospital Frailty Risk ScoreFrailty Risk ScoreVP shunt surgeryVentriculoperitoneal shunt surgeryAdverse eventsShunt surgeryIndependent predictorsNPH patientsRisk scoreHealth care resource utilizationMultivariate logistic regression analysisNormal pressure hydrocephalus patientsRetrospective cohort studyNationwide Readmissions DatabaseNormal pressure hydrocephalusLogistic regression analysisRegression analysisMultivariate regression analysisUnplanned readmissionCohort studyHospital readmissionPressure hydrocephalusAdmission costsReadmissionHydrocephalus patientsAssessment 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 demographics
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 SystemPatient Risk Factors Associated With 30- and 90-Day Readmission After Ventriculoperitoneal Shunt Placement for Idiopathic Normal Pressure Hydrocephalus in Elderly Patients: A Nationwide Readmission Study
Koo AB, Elsamadicy AA, Lin IH, David WB, Reeves BC, Santarosa C, Cord B, Malhotra A, Kahle KT, Matouk CC. Patient Risk Factors Associated With 30- and 90-Day Readmission After Ventriculoperitoneal Shunt Placement for Idiopathic Normal Pressure Hydrocephalus in Elderly Patients: A Nationwide Readmission Study. World Neurosurgery 2021, 152: e23-e31. PMID: 33862298, DOI: 10.1016/j.wneu.2021.04.010.Peer-Reviewed Original ResearchConceptsIdiopathic normal pressure hydrocephalusVP shunt surgeryShunt surgeryElderly patientsNormal pressure hydrocephalusPressure hydrocephalusNationwide Readmissions DatabaseVentriculoperitoneal shunt surgeryPatient risk factorsVentriculoperitoneal shunt placementQuality of careMultivariate regression analysisIndex admissionUnplanned readmissionReadmission ratesRenal failureMechanical complicationsPostoperative infectionShunt placementNinth RevisionFemale sexRisk factorsSubdural hemorrhageClinical ModificationReadmissionPost-traumatic seizures following pediatric traumatic brain injury
Elsamadicy AA, Koo AB, David WB, Lee V, Zogg CK, Kundishora AJ, Hong C, Reeves BC, Sarkozy M, Kahle KT, DiLuna M. Post-traumatic seizures following pediatric traumatic brain injury. Clinical Neurology And Neurosurgery 2021, 203: 106556. PMID: 33636505, DOI: 10.1016/j.clineuro.2021.106556.Peer-Reviewed Original ResearchConceptsLoss of consciousnessTraumatic brain injuryPost-traumatic seizuresSeizure developmentBrain injuryRisk factorsPre-existing medical comorbiditiesPediatric traumatic brain injuryClinical risk factorsDevelopment of seizuresRate of seizuresDecrease healthcare costsEtiology of injuryType of injuryLogistic regression analysisQuality of careHospital complicationsMedical comorbiditiesNeurological complicationsPediatric patientsTBI patientsGreater proportionNinth RevisionSubarachnoid hemorrhageSecondary diagnosisThe Effects of Pulmonary Risk Factors on Hospital Resource Use After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis Correction
Elsamadicy AA, Freedman IG, Koo AB, David WB, Havlik J, Kundishora AJ, Sciubba DM, Kahle KT, DiLuna M. The Effects of Pulmonary Risk Factors on Hospital Resource Use After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis Correction. World Neurosurgery 2021, 149: e737-e747. PMID: 33548534, DOI: 10.1016/j.wneu.2021.01.109.Peer-Reviewed Original ResearchConceptsPosterior spinal fusionAdolescent idiopathic scoliosisPreoperative pulmonary risk factorsPulmonary risk factorsLonger hospital stayRisk factorsUnplanned readmissionHospital stayDischarge dispositionSpinal fusionNational Surgical Quality Improvement Program Pediatric databaseSurgeons National Surgical Quality Improvement Program Pediatric databaseSignificant independent risk factorsAdolescent idiopathic scoliosis correctionRetrospective cohort studyIndependent risk factorHospital resource useLength of stayIdiopathic scoliosis correctionHigh rateLonger hospitalPostoperative complicationsCohort studyIntraoperative variablesPatient demographics
2020
Predictors of Extended Length of Stay Following Treatment of Unruptured Adult Cerebral Aneurysms: A Study of The National Inpatient Sample
Koo AB, Elsamadicy AA, Lin IH, David WB, Sujijantarat N, Santarosa C, Cord BJ, Zetchi A, Hebert R, Bahrassa F, Malhotra A, Matouk CC. Predictors of Extended Length of Stay Following Treatment of Unruptured Adult Cerebral Aneurysms: A Study of The National Inpatient Sample. Journal Of Stroke And Cerebrovascular Diseases 2020, 29: 105230. PMID: 33066916, DOI: 10.1016/j.jstrokecerebrovasdis.2020.105230.Peer-Reviewed Original ResearchMeSH KeywordsAgedComorbidityDatabases, FactualEndovascular ProceduresFemaleHospital CostsHumansInpatientsIntracranial AneurysmLength of StayMaleMicrosurgeryMiddle AgedOutcome and Process Assessment, Health CarePatient AdmissionPostoperative ComplicationsQuality Indicators, Health CareRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeUnited StatesConceptsLOS cohortExtended LOSMultivariate logistic regressionUnruptured cerebral aneurysmsCerebral aneurysmsPreadmission comorbiditiesInpatient complicationsHospital stayMore patientsOdds ratioUnruptured aneurysmsHealthcare costsMultiple patient-specific factorsLogistic regressionOverall complication rateHospital-level factorsNon-routine dischargePatient-level factorsNational Inpatient SamplePatient-specific factorsOverall healthcare costsChoice of procedureIndex admissionPostoperative complicationsComplication rateClinical and economic burden of neurofibromatosis type 2 in the United States
Koo AB, Yeung JT, Freedman IG, Lee JH, Ahmed OM, Ma AK, Miyagishima DF, DiLuna M, Kahle K. Clinical and economic burden of neurofibromatosis type 2 in the United States. Clinical Neurology And Neurosurgery 2020, 197: 106053. PMID: 32683193, DOI: 10.1016/j.clineuro.2020.106053.Peer-Reviewed Original ResearchConceptsOpen resectionPatient demographicsRisk factorsMeningioma resectionMulti-year cross-sectional studyNeurofibromatosis type 2 (NF2) patientsSpine tumor resectionCommon admission diagnosesNational Inpatient SampleType 2 patientsCross-sectional studySignificant independent associationNeurofibromatosis type 2Regression analysisInflation-adjusted costAdmission diagnosisHospital stayDischarge weightIndependent predictorsObstructive hydrocephalusSurgical interventionDiagnosis codesHospital characteristicsInpatient populationInpatient SamplePatient Risk Factors Associated With 30- and 90-Day Readmission After Cervical Discectomy
Elsamadicy AA, Koo AB, Lee M, Freedman IG, David WB, Kundishora AJ, Gorrepati R, Kuzmik GA, Camara-Quintana J, Qureshi T, Kolb L, Laurans M, Abbed K. Patient Risk Factors Associated With 30- and 90-Day Readmission After Cervical Discectomy. Clinical Spine Surgery A Spine Publication 2020, 33: e434-e441. PMID: 32568863, DOI: 10.1097/bsd.0000000000001030.Peer-Reviewed Original ResearchConceptsCervical disc arthroplastyLarge hospital bed sizeRetrospective cohort studyHospital bed sizeRisk factorsIndex admissionUnplanned readmissionCohort studyReadmission ratesAnterior cervical spine proceduresPatient-related risk factorsPatient-level risk factorsAnterior cervical decompressionCervical disc pathologyNationwide Readmissions DatabaseRate of readmissionCervical spine proceduresPatient risk factorsMultivariate regression analysisBed sizeCervical decompressionInitial hospitalizationCervical discectomyGenitourinary complicationsNinth RevisionRisk Factors for the Development of Post-Traumatic Hydrocephalus in Children
Elsamadicy AA, Koo AB, Lee V, David WB, Zogg CK, Kundishora AJ, Hong CS, DeSpenza T, Reeve BC, DiLuna M, Kahle KT. Risk Factors for the Development of Post-Traumatic Hydrocephalus in Children. World Neurosurgery 2020, 141: e105-e111. PMID: 32389871, PMCID: PMC7484270, DOI: 10.1016/j.wneu.2020.04.216.Peer-Reviewed Original ResearchConceptsTraumatic brain injuryRisk factorsBrain injuryNationwide Emergency Department Sample databasePost-traumatic hydrocephalusClinical risk factorsDevelopment of hydrocephalusNeurologic complicationsRespiratory complicationsPediatric patientsHydrocephalus developmentNinth RevisionSubarachnoid hemorrhageEmergency departmentSecondary diagnosisPrimary diagnosisSubdural hemorrhageClinical ModificationInternational ClassificationHydrocephalusHemorrhagePatientsBaseline returnSample databaseAge 6Associated risk factors for extended length of stay following anterior cervical discectomy and fusion for cervical spondylotic myelopathy
Elsamadicy AA, Koo AB, Lee M, David WB, Kundishora AJ, Robert SM, Kuzmik GA, Coutinho PO, Kolb L, Laurans M, Abbed K. Associated risk factors for extended length of stay following anterior cervical discectomy and fusion for cervical spondylotic myelopathy. Clinical Neurology And Neurosurgery 2020, 195: 105883. PMID: 32428797, DOI: 10.1016/j.clineuro.2020.105883.Peer-Reviewed Original ResearchConceptsCervical spondylotic myelopathyHospital-level factorsLOS cohortAnterior cervical discectomyExtended LOSMultivariate logistic regressionSpondylotic myelopathyPostoperative complicationsCervical discectomyBlood transfusionOdds ratioNational Inpatient Sample databaseLogistic regressionFurther investigational studiesOverall complication rateNon-routine dischargeAssociated risk factorsNational cohort studyNumber of complicationsRisk-adjusted LOSGreater overall costsLow socioeconomic statusPaucity of literatureHospital LOSHospital stayThirty- and 90-Day Readmissions After Treatment of Traumatic Subdural Hematoma: National Trend Analysis
Koo AB, Elsamadicy AA, David WB, Zogg CK, Santarosa C, Sujijantarat N, Robert SM, Kundishora AJ, Cord BJ, Hebert R, Bahrassa F, Malhotra A, Matouk CC. Thirty- and 90-Day Readmissions After Treatment of Traumatic Subdural Hematoma: National Trend Analysis. World Neurosurgery 2020, 139: e212-e219. PMID: 32272271, PMCID: PMC7380544, DOI: 10.1016/j.wneu.2020.03.168.Peer-Reviewed Original ResearchConceptsTraumatic subdural hematomaSubdural hematomaRheumatoid arthritis/collagen vascular diseasesMultivariate logistic regression analysisCollagen vascular diseaseNationwide Readmissions DatabaseCongestive heart failureLikelihood of readmissionPrimary procedure codeTraumatic brain injuryLogistic regression analysisReadmission ratesRenal failureHeart failurePostoperative infectionNinth RevisionSurgical interventionPatient populationVascular diseaseCerebral meningesBrain injuryClinical ModificationPatient managementReadmissionInternational ClassificationRisk Factors Portending Extended Length of Stay After Suboccipital Decompression for Adult Chiari I Malformation
Elsamadicy AA, Koo AB, Lee M, David WB, Kundishora AJ, Freedman IG, Zogg CK, Hong CS, DeSpenza T, Sarkozy M, Kahle KT, DiLuna M. Risk Factors Portending Extended Length of Stay After Suboccipital Decompression for Adult Chiari I Malformation. World Neurosurgery 2020, 138: e515-e522. PMID: 32147550, PMCID: PMC7379177, DOI: 10.1016/j.wneu.2020.02.158.Peer-Reviewed Original ResearchConceptsPatient-level factorsMultivariate logistic regressionExtended LOSLOS cohortSurgical decompressionDecompression surgeryOdds ratioGreater overall complication ratesMultiple patient-level factorsLogistic regressionChiari malformation type IAdult Chiari I malformationPatient's baseline comorbidityOverall complication rateRetrospective cohort studyChiari I malformationRisk-adjusted LOSPostoperative complicationsAdult patientsCohort studyComplication ratePatient demographicsSuboccipital decompressionElectrolyte disordersObstructive hydrocephalus