2022
The case for decreased surgeon-reported complications due to surgical volume and fellowship status in the treatment of geriatric hip fracture: An analysis of the ABOS database
Ottesen TD, Mercier MR, Brand J, Amick M, Grauer JN, Rubin LE. The case for decreased surgeon-reported complications due to surgical volume and fellowship status in the treatment of geriatric hip fracture: An analysis of the ABOS database. PLOS ONE 2022, 17: e0263475. PMID: 35213546, PMCID: PMC8880652, DOI: 10.1371/journal.pone.0263475.Peer-Reviewed Original ResearchConceptsHip fracture patientsSurgical complicationsFracture patientsHip fractureCase volumeFellowship trainingBinary multivariate logistic regressionSurgeon-reported complicationsGeriatric hip fracturesOdds of complicationsSurgical adverse eventsMultivariate logistic regressionFellowship statusAdverse eventsComplication riskSurgical interventionSurgical outcomesABOS databaseSurgical volumeSurgeon cohortComplicationsType of fellowshipIndependent factorsPatientsOrthopaedic surgeons
2020
Incidence, predictors, and timing of post-operative stroke following elective total hip arthroplasty and total knee arthroplasty
Haynes MS, Alder KD, Bellamkonda K, Kuzomunhu L, Grauer JN. Incidence, predictors, and timing of post-operative stroke following elective total hip arthroplasty and total knee arthroplasty. PLOS ONE 2020, 15: e0239239. PMID: 32941539, PMCID: PMC7498016, DOI: 10.1371/journal.pone.0239239.Peer-Reviewed Original ResearchConceptsTotal knee arthroplastyTotal hip arthroplastyIndependent risk factorPostoperative day twoPostoperative strokeKnee arthroplastyRisk factorsHip arthroplastyElective primary total hip arthroplastyTHA/TKANational Surgical Quality Improvement databaseElective total hip arthroplastyDay twoPrimary total hip arthroplastyPostoperative day ninePost-operative strokeTiming of strokeHigher American SocietyIncidence of strokePostoperative day oneMajority of strokesQuality improvement databaseRetrospective comparative studyAnesthesiologists (ASA) scoreCouncil patientsCoagulopathies Are a Risk Factor for Adverse Events Following Total Hip and Total Knee Arthroplasty.
Malpani R, Mclynn RP, Bovonratwet P, Bagi PS, Yurter A, Mercier MR, Rubin LE, Grauer JN. Coagulopathies Are a Risk Factor for Adverse Events Following Total Hip and Total Knee Arthroplasty. Orthopedics 2020, 43: 233-238. PMID: 32674174, DOI: 10.3928/01477447-20200624-02.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overArthroplasty, Replacement, HipArthroplasty, Replacement, KneeBlood Coagulation DisordersDatabases, FactualFemaleHumansMaleMiddle AgedMultivariate AnalysisOutcome Assessment, Health CarePatient ReadmissionPostoperative ComplicationsRetrospective StudiesRisk FactorsYoung AdultConceptsHigher international normalized ratioInternational normalized ratioMajor adverse eventsTotal hip arthroplastyPartial thromboplastin timeHigher partial thromboplastin timeMinor adverse eventsAdverse eventsLow plateletsHematological conditionsSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseTotal knee arthroplasty (TKA) populationQuality Improvement Program databasePrimary total hip arthroplastyDependent functional statusImprovement Program databasePostsurgical adverse eventsTotal knee arthroplastyMultiple adverse eventsPreoperative coagulopathyTHA cohortTKA groupTKA patientsHospital readmissionPostoperative 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 pneumoniaUnderweight patients are at just as much risk as super morbidly obese patients when undergoing anterior cervical spine surgery
Ottesen TD, Malpani R, Galivanche AR, Zogg CK, Varthi AG, Grauer JN. Underweight patients are at just as much risk as super morbidly obese patients when undergoing anterior cervical spine surgery. The Spine Journal 2020, 20: 1085-1095. PMID: 32194246, PMCID: PMC7380546, DOI: 10.1016/j.spinee.2020.03.007.Peer-Reviewed Original ResearchConceptsAnterior cervical spine surgeryBody mass indexCervical spine surgeryNational Surgical Quality Improvement Program databaseSuper morbidly obese patientsQuality Improvement Program databaseWorld Health Organization categoriesMorbidly obese patientsImprovement Program databaseObese patientsAdverse eventsAdverse outcomesSpine surgeryUnderweight patientsPostoperative infectionProgram databaseSurgeons National Surgical Quality Improvement Program databaseMultivariate analysisAnterior cervical spine proceduresOverweight/obese categoriesThirty-day adverse eventsHigher body mass indexLower body mass indexAdverse outcome categoriesNormal BMI patients
2019
Preoperative laboratory testing for total hip arthroplasty: Unnecessary tests or a helpful prognosticator
Ondeck NT, Fu MC, McLynn RP, Bovonratwet P, Malpani R, Grauer JN. Preoperative laboratory testing for total hip arthroplasty: Unnecessary tests or a helpful prognosticator. Journal Of Orthopaedic Science 2019, 25: 854-860. PMID: 31668911, DOI: 10.1016/j.jos.2019.09.019.Peer-Reviewed Original ResearchConceptsTotal hip arthroplastyPreoperative laboratory testingBlood urea nitrogenAdverse outcomesCreatinine levelsBUN levelsHip arthroplastySodium levelsNational Surgical Quality Improvement ProgramRoutine preoperative laboratory testingPrimary total hip arthroplastySurgical Quality Improvement ProgramElective arthroplasty proceduresHealth adverse outcomesPatient baseline characteristicsPreoperative creatinine levelPerioperative adverse eventsLower extremity arthroplastyQuality Improvement ProgramLaboratory testingHealth care deliveryHelpful prognosticatorInfectious indicationsPreoperative sodiumAdverse eventsAbnormally 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 sizeCardiac Complications Related to Spine Surgery: Timing, Risk Factors, and Clinical Effect.
Bovonratwet P, Bohl DD, Malpani R, Haynes MS, Rubio DR, Ondeck NT, Shultz BN, Mahal AR, Grauer JN. Cardiac Complications Related to Spine Surgery: Timing, Risk Factors, and Clinical Effect. Journal Of The American Academy Of Orthopaedic Surgeons 2019, 27: 256-263. PMID: 30897607, DOI: 10.5435/jaaos-d-17-00650.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overDatabases, FactualFemaleHeart ArrestHumansIncidenceIntraoperative ComplicationsLength of StayMaleMiddle AgedMonitoring, PhysiologicMultivariate AnalysisMyocardial InfarctionOrthopedic ProceduresPatient ReadmissionPerioperative PeriodPostoperative ComplicationsRisk FactorsSpineTime FactorsYoung AdultConceptsCardiac complicationsSpine surgeryRisk factorsPostoperative periodNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramQuality Improvement Program databaseSurgical Quality Improvement ProgramPerioperative cardiac complicationsHigh-risk patientsImprovement Program databaseInsulin-dependent diabetesLarge cohort studyQuality Improvement ProgramPreoperative anemiaPostoperative lengthCohort studyPerioperative periodPrimary outcomeClinical effectsCardiac arrestMyocardial infarctionProgram databaseAmerican CollegeElective Total Shoulder Arthroplasty in Octogenarians: A Safe Procedure.
Bovonratwet P, Malpani R, Ondeck NT, Tyagi V, Grauer JN. Elective Total Shoulder Arthroplasty in Octogenarians: A Safe Procedure. Journal Of The American Academy Of Orthopaedic Surgeons 2019, 27: 145-154. PMID: 30252789, DOI: 10.5435/jaaos-d-17-00364.Peer-Reviewed Original ResearchConceptsPrimary total shoulder arthroplastyTotal shoulder arthroplastyNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseImprovement Program databasePerioperative complicationsHospital stayProgram databaseShoulder arthroplastyElective total shoulder arthroplastyPropensity score-matched comparisonYoung populationRate of readmissionUrinary tract infectionPost-discharge careOctogenarian patientsPreoperative optimizationOctogenarian populationPerioperative coursePatient characteristicsTract infectionsSafe procedureRisk factorsOctogenariansReadmission
2018
What Associations Exist Between Comorbidity Indices and Postoperative Adverse Events After Total Shoulder Arthroplasty?
Fu MC, Ondeck NT, Nwachukwu BU, Garcia GH, Gulotta LV, Verma NN, Grauer JN. What Associations Exist Between Comorbidity Indices and Postoperative Adverse Events After Total Shoulder Arthroplasty? Clinical Orthopaedics And Related Research® 2018, 477: 881-890. PMID: 30614913, PMCID: PMC6437372, DOI: 10.1097/corr.0000000000000624.Peer-Reviewed Original ResearchConceptsNational Surgical Quality Improvement ProgramBody mass indexTotal shoulder arthroplastyPostoperative adverse eventsComorbidity indexAdverse eventsHighest AUCShoulder arthroplastyAnthropometric variablesSurgical Quality Improvement ProgramReverse total shoulder arthroplastyDiscriminative abilityCharlson Comorbidity IndexThirty-day outcomesSevere adverse eventsPreoperative risk stratificationModerate discriminative abilityYears of ageQuality Improvement ProgramGood discriminative abilityGreater associationCombination of ageAnesthesiologists classificationASA scoreMedical comorbiditiesUnlike 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 costsPatientsIncreased complications in geriatric patients with a fracture of the hip whose postoperative weight-bearing is restricted: an analysis of 4918 patients.
Ottesen TD, McLynn RP, Galivanche AR, Bagi PS, Zogg CK, Rubin LE, Grauer JN. Increased complications in geriatric patients with a fracture of the hip whose postoperative weight-bearing is restricted: an analysis of 4918 patients. The Bone & Joint Journal 2018, 100-B: 1377-1384. PMID: 30295535, DOI: 10.1302/0301-620x.100b10.bjj-2018-0489.r1.Peer-Reviewed Original ResearchConceptsWeight-bearing restrictionsLength of stayAdverse eventsPostoperative weight-bearing restrictionsMajor adverse eventsEvidence-based guidelinesBone Joint JOperating theatreMultivariate regression analysisMultivariate oddsFrail patientsThromboembolic eventsElderly patientsHip fractureGeriatric patientsProcedural characteristicsInclusion criteriaPatientsGreater riskProcedural factorsHipReadmissionDeliriumTransfusionSurgeryThromboembolic Events After Traumatic Vertebral Fractures
Samuel AM, Diaz-Collado PJ, Gala RJ, Webb ML, Lukasiewicz AM, Basques BA, Bohl DD, Kim HJ, Grauer JN. Thromboembolic Events After Traumatic Vertebral Fractures. Spine 2018, 43: 1289-1295. PMID: 29538240, DOI: 10.1097/brs.0000000000002634.Peer-Reviewed Original ResearchConceptsVenous thromboembolism eventsTraumatic vertebral fracturesVertebral fracturesSpinal cord injuryOdds ratioCord injuryRisk factorsNational Trauma Data Bank Research Data SetLonger inpatient lengthPulmonary embolism eventsDeep vein thrombosisHigh-energy injuriesVertebral fracture patientsLength of stayAdditional risk factorsMultivariate logistic regressionSuch adverse outcomesOverall rateThromboembolism eventsHospital courseThromboembolic eventsFracture patientsVein thrombosisLonger LOSTrauma patientsTiming 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 infarctionIncidence, Risk Factors, and Impact of Clostridium difficile Colitis After Spine Surgery
Bovonratwet P, Bohl DD, Russo GS, Ondeck NT, Singh K, Grauer JN. Incidence, Risk Factors, and Impact of Clostridium difficile Colitis After Spine Surgery. Spine 2018, 43: 861-868. PMID: 28953711, DOI: 10.1097/brs.0000000000002430.Peer-Reviewed Original ResearchConceptsClostridium difficile colitisDifficile colitisIndependent risk factorSpine surgical proceduresRisk factorsSpine surgerySurgical proceduresPosterior lumbar fusion proceduresPost-hospitalization followSpine surgery patientsHigh-risk patientsLarge cohort studyLumbar fusion proceduresPre-existing infectionLarge national databasePostoperative lengthCohort studyNSQIP databasePostoperative periodSurgery patientsPrimary outcomeRetrospective studyDifficile infectionClinical impactInfection diagnosisDiscriminative 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 managementDialysis 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 cohortThe Rothman Index Is Associated With Postdischarge Adverse Events After Hip Fracture Surgery in Geriatric Patients
McLynn RP, Ottesen TD, Ondeck NT, Cui JJ, Rubin LE, Grauer JN. The Rothman Index Is Associated With Postdischarge Adverse Events After Hip Fracture Surgery in Geriatric Patients. Clinical Orthopaedics And Related Research® 2018, 476: 997-1006. PMID: 29419631, PMCID: PMC5916609, DOI: 10.1007/s11999.0000000000000186.Peer-Reviewed Original ResearchConceptsRothman Index scoresPostdischarge adverse eventsHip fracture surgeryPostdischarge adverse outcomesAdverse eventsASA classRothman IndexHip fractureFracture surgeryIndex scoreGeriatric patientsAdverse outcomesMedical CenterOverall patient statusHip fracture careRoutine laboratory valuesMeasures of comorbidityRisk of complicationsBody mass indexAge 65 yearsPlan of careVulnerable patient populationCondition of patientsAcademic medical centerElectronic medical recordsInaccuracies 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 studies