2024
Surgical site infection following isolated lumbar discectomy increases odds of revision lumbar surgery within first 6 months, but not beyond
Kim L, Halperin S, Grauer J. Surgical site infection following isolated lumbar discectomy increases odds of revision lumbar surgery within first 6 months, but not beyond. The Spine Journal 2024, 24: 1459-1466. PMID: 38570035, DOI: 10.1016/j.spinee.2024.03.017.Peer-Reviewed Original ResearchSurgical site infectionRevision lumbar surgeryLumbar discectomyLumbar surgeryElixhauser Comorbidity IndexSite infectionFactors associated with surgical site infectionPreoperative diagnosis of infectionIncidence of secondary surgeryLumbar discectomy patientsDiagnosis of infectionMultivariate logistic regressionPreoperative diagnosisDiscectomy patientsPostoperative complicationsIndex surgeryPatient ageSecondary surgerySpinal surgeryIndependent predictorsAdult patientsLumbar fusionPerforming surgeryDiscectomyI&D
2023
Do Children With Medicaid Insurance Have Increased Revision Rates 5 Years After Posterior Spinal Fusions?
Moore H, Patibandla S, McClung A, Grauer J, Sucato D, Wise C, Johnson M, Rathjen K, McIntosh A, Ramo B, Brooks J. Do Children With Medicaid Insurance Have Increased Revision Rates 5 Years After Posterior Spinal Fusions? Journal Of Pediatric Orthopaedics 2023, 43: 615-619. PMID: 37694695, DOI: 10.1097/bpo.0000000000002504.Peer-Reviewed Original ResearchConceptsPosterior spinal fusionAdolescent idiopathic scoliosisMedicaid insurancePrivate insuranceRevision surgerySpinal fusionInternational ClassificationBaseline medical comorbiditiesKaplan-Meier analysisLog-rank testSegmental spinal instrumentationLong fusion constructsBaseline comorbiditiesIndependent t-testIndex surgeryMedical comorbiditiesPostoperative complicationsCause revisionCohort studyNinth RevisionAIS patientsRevision codesPrimary diagnosisHigh prevalenceMedicaid patientsMedicaid Insurance Is Associated With More Complications and Emergency Department Visits but Equivalent 5-Year Secondary Surgery Rate After Primary Hip Arthroscopy
Gillinov S, Kim D, Islam W, Lee M, Moran J, Fong S, Mahatme R, McLaughlin W, Maldonado D, Medvecky M, Grauer J, Jimenez A. Medicaid Insurance Is Associated With More Complications and Emergency Department Visits but Equivalent 5-Year Secondary Surgery Rate After Primary Hip Arthroscopy. Arthroscopy The Journal Of Arthroscopic And Related Surgery 2023, 40: 1117-1125. PMID: 37597701, DOI: 10.1016/j.arthro.2023.08.011.Peer-Reviewed Original ResearchPrimary hip arthroscopyFemoroacetabular impingement syndromeEmergency department visitsSecondary surgery rateED visitsMedicaid patientsHip arthroscopyDepartment visitsSurgery ratesSecondary surgeryLabral tearsLarge national database studyTenth Revision diagnosis codesNational database studyFive-year ratesElixhauser Comorbidity IndexKaplan-Meier analysisRevision diagnosis codesBody mass indexMultivariate logistic regressionTotal hip arthroplastyLarge national databaseComorbidity indexPostoperative complicationsAdverse events
2022
Total shoulder arthroplasty: ninety-day adverse events and 5-year implant survival in patients with hidradenitis suppurativa
Gouzoulis M, Ratnasamy P, Caruana D, Wiznia D, Medvecky M, Grauer J. Total shoulder arthroplasty: ninety-day adverse events and 5-year implant survival in patients with hidradenitis suppurativa. Seminars In Arthroplasty JSES 2022, 32: 676-680. DOI: 10.1053/j.sart.2022.07.012.Peer-Reviewed Original ResearchTotal shoulder arthroplastySurgical site infectionMinor adverse eventsAdverse eventsSite infectionTSA patientsImplant survivalHS patientsSkin lesionsLog-rank Mantel-Cox testFive-year implant survivalKaplan-Meier survival curvesHigher comorbidity burdenMethods Adult patientsNon-HS groupsSevere adverse eventsElixhauser Comorbidity IndexChronic skin disorderPotential risk factorsMantel-Cox testRisk of infectionComorbidity burdenComorbidity indexPostoperative complicationsReoperation rate
2021
COVID-positive ankle fracture patients are at increased odds of perioperative surgical complications following open reduction internal fixation surgery
Mercier MR, Galivanche AR, Brand JP, Pathak N, Medvecky MJ, Varthi AG, Rubin LE, Grauer JN. COVID-positive ankle fracture patients are at increased odds of perioperative surgical complications following open reduction internal fixation surgery. PLOS ONE 2021, 16: e0262115. PMID: 34972190, PMCID: PMC8719674, DOI: 10.1371/journal.pone.0262115.Peer-Reviewed Original ResearchConceptsCOVID-positive patientsAnkle fracture surgeryPerioperative adverse eventsAdverse eventsAnkle fracture patientsFracture surgeryFracture patientsOperative interventionAnkle fracturesPropensity matchingCOVID statusOpen reduction internal fixation surgeryPerioperative adverse outcomesPerioperative surgical complicationsMinor adverse eventsPostoperative adverse eventsSerious adverse eventsChronic kidney diseaseCOVID-19 Research DatabaseLong-term outcomesInternal fixation surgeryBasis of agePropensity-score matchingPostoperative complicationsNegative patientsPatients With Ehlers-Danlos Syndromes Experience Higher Rates of Prosthetic Dislocation After Total Hip Arthroplasty and Worse Implant Survival at 5 Years
Moore HG, Burroughs PJ, Rubin LE, Frumberg DB, Sculco PK, Grauer JN. Patients With Ehlers-Danlos Syndromes Experience Higher Rates of Prosthetic Dislocation After Total Hip Arthroplasty and Worse Implant Survival at 5 Years. Journal Of The American Academy Of Orthopaedic Surgeons 2021, 30: 177-183. PMID: 34967762, DOI: 10.5435/jaaos-d-21-00347.Peer-Reviewed Original ResearchConceptsEhlers-Danlos syndromeTotal hip arthroplastyImplant survivalHip arthroplastyAdverse eventsDiagnosis of EDSGenetic connective tissue disorderNinety-day incidenceWorse implant survivalHigh rateDay of surgeryLong-term outcomesLog-rank testMultivariate logistic regressionConnective tissue disordersMultiple organ systemsConnective tissue laxityPerioperative dislocationPeriprosthetic dislocationPostoperative complicationsPostoperative periodProsthetic dislocationHospital readmissionControl subjectsAdministrative databasesAmbulatory Single-level Posterior Cervical Foraminotomy for Cervical Radiculopathy
Bovonratwet P, Retzky JS, Chen AZ, Ondeck NT, Samuel AM, Qureshi SA, Grauer JN, Albert TJ. Ambulatory Single-level Posterior Cervical Foraminotomy for Cervical Radiculopathy. Clinical Spine Surgery A Spine Publication 2021, 35: e306-e313. PMID: 34654773, DOI: 10.1097/bsd.0000000000001252.Peer-Reviewed Original ResearchConceptsSingle-level posterior cervical foraminotomyPosterior cervical foraminotomyCervical radiculopathyInpatient proceduresCervical foraminotomyPerioperative complicationsAmbulatory proceduresSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databasePropensity scoreRetrospective cohort comparison studyImprovement Program databaseSurgical site infectionCohort comparison studyHospital lengthPain controlPerioperative outcomesPostoperative complicationsThromboembolic eventsWound complicationsNSQIP databasePatient characteristicsSite infectionIndividual complicationsTotal Hip Arthroplasty in Patients With Cerebral Palsy: A Matched Comparison of 90-Day Adverse Events and 5-Year Implant Survival
Moore HG, Gardezi M, Burroughs PJ, Rubin LE, Frumberg DB, Grauer JN. Total Hip Arthroplasty in Patients With Cerebral Palsy: A Matched Comparison of 90-Day Adverse Events and 5-Year Implant Survival. The Journal Of Arthroplasty 2021, 36: 3534-3537. PMID: 34176692, DOI: 10.1016/j.arth.2021.05.039.Peer-Reviewed Original ResearchConceptsTotal hip arthroplastyFive-year implant survivalUrinary tract infectionCerebral palsyImplant survivalAdverse eventsTract infectionsComorbid factorsPeriprosthetic fracturesHigher oddsHip arthroplastyPerioperative urinary tract infectionNinety-day incidencePerioperative adverse eventsLong-term outcomesLog-rank testKaplan-Meier plotsMultivariate logistic regressionPerioperative complicationsPostoperative complicationsCP cohortHospital readmissionMatched ComparisonAdministrative databasesPatientsA Matched Comparison of Postoperative Complications Between Smokers and Nonsmokers Following Open Reduction Internal Fixation of Distal Radius Fractures
Galivanche AR, FitzPatrick S, Dussik C, Malpani R, Nduaguba A, Varthi AG, Grauer JN. A Matched Comparison of Postoperative Complications Between Smokers and Nonsmokers Following Open Reduction Internal Fixation of Distal Radius Fractures. The Journal Of Hand Surgery 2021, 46: 1-9.e4. PMID: 33390240, DOI: 10.1016/j.jhsa.2020.09.020.Peer-Reviewed Original ResearchConceptsMinor adverse eventsDistal radius fracturesOpen reduction internal fixationSerious adverse eventsReduction internal fixationAdverse eventsRadius fracturesPropensity-score matchingInternal fixationSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseSTUDY/LEVELImprovement Program databasePerioperative adverse eventsMultivariable logistic analysisDemographic characteristicsSimilar demographic characteristicsHigh rateNonsmoker cohortPostoperative complicationsOperative treatmentPatient characteristicsSmoking groupComorbidity status
2020
Postoperative Pressure Ulcers After Geriatric Hip Fracture Surgery Are Predicted by Defined Preoperative Comorbidities and Postoperative Complications.
Galivanche AR, Kebaish KJ, Adrados M, Ottesen TD, Varthi AG, Rubin LE, Grauer JN. Postoperative Pressure Ulcers After Geriatric Hip Fracture Surgery Are Predicted by Defined Preoperative Comorbidities and Postoperative Complications. Journal Of The American Academy Of Orthopaedic Surgeons 2020, 28: 342-351. PMID: 31567615, DOI: 10.5435/jaaos-d-19-00104.Peer-Reviewed Original ResearchConceptsPostoperative pressure ulcersHip fracture surgeryPostoperative complicationsPressure ulcersRisk factorsPreoperative comorbiditiesFracture surgerySurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseGeriatric hip fracture patientsGeriatric hip fracture surgeryQuality Improvement Program databaseMultivariate regressionNSQIP Participant Use FilePreoperative risk factorsHip fracture patientsImprovement Program databaseUrinary tract infectionElevated platelet countInsulin-dependent diabetesParticipant Use FilePressure ulcer developmentQuality Improvement ProgramPostoperative deliriumPostoperative pneumoniaHigh, As Well As Low, Preoperative Platelet Counts Correlate With Adverse Outcomes After Elective Posterior Lumbar Surgery.
Malpani R, Gala RJ, Adrados M, Galivanche AR, Clark MG, Mercier MR, Pathak N, Mets EJ, Grauer JN. High, As Well As Low, Preoperative Platelet Counts Correlate With Adverse Outcomes After Elective Posterior Lumbar Surgery. Spine 2020, 45: 349-356. PMID: 32045405, DOI: 10.1097/brs.0000000000003248.Peer-Reviewed Original ResearchConceptsPosterior lumbar surgeryPreoperative platelet countLow platelet countPlatelet countLumbar surgeryAdverse outcomesAdverse eventsHospital lengthNational Surgical Quality Improvement Program databaseLow preoperative platelet countPreoperative low platelet countQuality Improvement Program databaseHigh platelet groupLonger hospital lengthLumbar surgery patientsPerioperative adverse outcomesMinor adverse eventsPostoperative adverse eventsImprovement Program databaseRetrospective cohort studyHigher platelet countsLarger patient populationPostoperative complicationsCohort studyPlatelet groupSafety and Effectiveness of Antifibrinolytics in Posterior Scoliosis Surgery for Adolescent Idiopathic Scoliosis
Bovonratwet P, Sheha ED, Ondeck NT, Malpani R, Smith BG, Grauer JN. Safety and Effectiveness of Antifibrinolytics in Posterior Scoliosis Surgery for Adolescent Idiopathic Scoliosis. Clinical Spine Surgery A Spine Publication 2020, 33: e26-e32. PMID: 31162181, DOI: 10.1097/bsd.0000000000000836.Peer-Reviewed Original ResearchConceptsAdolescent idiopathic scoliosisPosterior spinal fusionMultilevel posterior spinal fusionIntensive care unitAntifibrinolytic useHospital lengthCare unitTreatment groupsIdiopathic scoliosisOperating roomEffectiveness of antifibrinolyticsNSQIP-Pediatric databasePediatric deformity surgeryPerioperative transfusion ratesVolume of transfusionLonger operative timePosterior scoliosis surgeryLarge national databaseTransfusion reductionPerioperative complicationsPostoperative complicationsTransfusion ratePostoperative outcomesPediatric patientsOperative time
2019
Surgical 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 populationAbnormally High, as Well as Low, Preoperative Platelet Counts Correlate With Adverse Outcomes and Readmissions After Elective Total Knee Arthroplasty
Malpani R, Haynes MS, Clark MG, Galivanche AR, Bovonratwet P, Grauer JN. Abnormally High, as Well as Low, Preoperative Platelet Counts Correlate With Adverse Outcomes and Readmissions After Elective Total Knee Arthroplasty. The Journal Of Arthroplasty 2019, 34: 1670-1676. PMID: 31072745, DOI: 10.1016/j.arth.2019.04.012.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAnemiaArthroplasty, Replacement, KneeDatabases, FactualDiabetes ComplicationsElective Surgical ProceduresFemaleHumansLength of StayMaleMiddle AgedPatient ReadmissionPlatelet CountPostoperative ComplicationsPostoperative PeriodPreoperative PeriodRetrospective StudiesThrombocytopeniaThrombocytosisTreatment OutcomeUnited StatesYoung AdultConceptsTotal knee arthroplastyElective total knee arthroplastyMinor adverse eventsPreoperative platelet countAbnormal platelet countLow platelet countPlatelet countHigher platelet countsAdverse eventsPostoperative complicationsTKA patientsAdverse outcomesKnee arthroplastyNational Surgical Quality Improvement Program databaseElective primary total knee arthroplastyMultivariate analysisQuality Improvement Program databasePrimary total knee arthroplastyMulticenter patient populationImprovement Program databasePostoperative adverse outcomesPlatelet count thresholdRetrospective comparative studyNormal platelet countLarger patient sample size
2018
Adverse Events Following Posterior Lumbar Fusion: A Comparison of Spine Surgeons Perceptions and Reported Data for Rates and Risk Factors.
Ondeck NT, Bohl DD, Bovonratwet P, McLynn RP, Cui JJ, Samuel AM, Webb ML, Grauer JN. Adverse Events Following Posterior Lumbar Fusion: A Comparison of Spine Surgeons Perceptions and Reported Data for Rates and Risk Factors. The International Journal Of Spine Surgery 2018, 12: 603-610. PMID: 30364864, PMCID: PMC6198632, DOI: 10.14444/5074.Peer-Reviewed Original ResearchPosterior lumbar fusionPatient risk factorsAdverse eventsRisk factorsPatient factorsLumbar fusionDegenerative conditionsElective posterior lumbar fusionSpine surgeons’ perceptionPostoperative adverse eventsAdverse event ratesUrinary tract infectionDeep vein thrombosisInsulin-dependent diabetesPostoperative complicationsCurrent smokingTract infectionsVein thrombosisDependent diabetesNSQIP dataExpectation settingInclusion criteriaAmerican CollegeSpine surgeonsEvent ratesDiscriminative Ability for Adverse Outcomes After Surgical Management of Hip Fractures
Ondeck NT, Bovonratwet P, Ibe IK, Bohl DD, McLynn RP, Cui JJ, Baumgaertner MR, Grauer JN. Discriminative Ability for Adverse Outcomes After Surgical Management of Hip Fractures. Journal Of Orthopaedic Trauma 2018, 32: 231-237. PMID: 29401098, DOI: 10.1097/bot.0000000000001140.Peer-Reviewed Original ResearchConceptsElixhauser comorbidity measuresCharlson Comorbidity IndexExtended hospital stayAdverse outcomesHip fractureComorbidity indexAdverse eventsSurgical managementLargest discriminative abilityHospital stayDiscriminative abilityDemographic factorsHospital adverse outcomesPrognostic Level IIIHip fracture surgeryMinor adverse eventsSevere adverse eventsHip fracture studiesNational Inpatient SampleOverall discriminative abilityAppropriate patient expectationsPostoperative complicationsFrailty indexFracture surgeryMedical managementInaccuracies 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 studiesAseptic revision total hip arthroplasty in the elderly : quantifying the risks for patients over 80 years old.
Bovonratwet P, Malpani R, Ottesen TD, Tyagi V, Ondeck NT, Rubin LE, Grauer JN. Aseptic revision total hip arthroplasty in the elderly : quantifying the risks for patients over 80 years old. The Bone & Joint Journal 2018, 100-B: 143-151. PMID: 29437055, DOI: 10.1302/0301-620x.100b2.bjj-2017-0895.r1.Peer-Reviewed Original ResearchConceptsAseptic revision total hip arthroplastyRevision total hip arthroplastyTotal hip arthroplastySerious adverse eventsAdverse eventsRisk factorsProcedural characteristicsHip arthroplastyNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseImprovement Program databaseIndependent risk factorUrinary tract infectionMultivariate regression analysisAnesthesiologists (ASA) scoreMedical optimizationPerioperative complicationsPerioperative mortalityPostoperative complicationsTract infectionsYounger patientsBlood transfusionGeneral anesthesiaVulnerable patientsBone Joint
2017
Definitional Differences of ‘Outpatient’ Versus ‘Inpatient’ THA and TKA Can Affect Study Outcomes
Bovonratwet P, Webb ML, Ondeck NT, Lukasiewicz AM, Cui JJ, McLynn RP, Grauer JN. Definitional Differences of ‘Outpatient’ Versus ‘Inpatient’ THA and TKA Can Affect Study Outcomes. Clinical Orthopaedics And Related Research® 2017, 475: 2917-2925. PMID: 28083753, PMCID: PMC5670045, DOI: 10.1007/s11999-017-5236-6.Peer-Reviewed Original ResearchMeSH KeywordsAmbulatory Surgical ProceduresArthroplasty, Replacement, HipArthroplasty, Replacement, KneeData MiningDatabases, FactualFemaleHumansInpatientsKaplan-Meier EstimateLength of StayMaleMultivariate AnalysisPatient AdmissionProcess Assessment, Health CarePropensity ScoreRetrospective StudiesRisk FactorsTerminology as TopicTime FactorsTreatment OutcomeUnited StatesConceptsNational Surgical Quality Improvement ProgramHospital LOSAdverse eventsNSQIP databaseRisk factorsSurgical Quality Improvement ProgramLength of hospitalSerious adverse eventsBody mass indexTotal joint arthroplastyPotential confounding factorsLarge national databaseQuality Improvement ProgramOutpatient THAPostoperative complicationsTKA cohortSmoking statusMass indexFunctional statusOutpatient procedureJoint arthroplastyActual LOSTherapeutic studiesOutpatientsPatientsOutpatient 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 patients