2022
Underweight patients are the highest risk body mass index group for perioperative adverse events following stand-alone anterior lumbar interbody fusion
Ottesen TD, Galivanche AR, Greene JD, Malpani R, Varthi AG, Grauer JN. Underweight patients are the highest risk body mass index group for perioperative adverse events following stand-alone anterior lumbar interbody fusion. The Spine Journal 2022, 22: 1139-1148. PMID: 35231643, DOI: 10.1016/j.spinee.2022.02.012.Peer-Reviewed Original ResearchConceptsBody mass indexNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseAnterior lumbar interbody fusionObese class 1Improvement Program databaseClass 2 patientsAdverse eventsUnderweight patientsBMI categoriesAdverse outcomesBMI spectrumInterbody fusionProgram databaseTwo-level anterior lumbar interbody fusionSurgeons National Surgical Quality Improvement Program databaseMultivariate analysisThirty-day adverse eventsWorld Health Organization categoriesBody mass index groupsPostoperative adverse eventsRetrospective cohort studyPerioperative adverse eventsNormal-weight subjectsPost-operative infectionCharacteristics, Management, and Outcomes of Patients With Osteosarcoma: An Analysis of Outcomes From the National Cancer Database
Ottesen TD, Shultz BN, Munger AM, Sibindi C, Yurter A, Varthi AG, Grauer JN. Characteristics, Management, and Outcomes of Patients With Osteosarcoma: An Analysis of Outcomes From the National Cancer Database. JAAOS Global Research And Reviews 2022, 6: e22.00009. PMID: 35192571, PMCID: PMC8865506, DOI: 10.5435/jaaosglobal-d-22-00009.Peer-Reviewed Original ResearchConceptsLikelihood of deathDistant metastasisKaplan-Meier survival curvesNational Cancer DatabaseOutcomes of patientsPoor prognostic signMultivariate Cox analysisMeier survival curvesAnalysis of outcomesPatient characteristicsCox analysisPrognostic signSurgical excisionMale sexPatient survivalPatient numbersCancer DatabasePatient variablesTumor managementPrimary siteTumor typesSurvival curvesTreatment dataOsteosarcomaPatients
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 patients
2018
Different Fusion Approaches for Single-level Lumbar Spondylolysis Have Similar Perioperative Outcomes
Gala RJ, Bovonratwet P, Webb ML, Varthi AG, Daubs MD, Grauer JN. Different Fusion Approaches for Single-level Lumbar Spondylolysis Have Similar Perioperative Outcomes. Spine 2018, 43: e111-e117. PMID: 28591074, DOI: 10.1097/brs.0000000000002262.Peer-Reviewed Original ResearchConceptsTransforaminal lumbar interbody fusionAnterior lumbar interbody fusionPosterior spinal fusionPerioperative adverse eventsAdverse eventsLong-term outcomesLumbar interbody fusionLumbar spondylolysisPerioperative outcomesOperative timeSurgical approachFusion groupInterbody fusionSurgeons National Surgical Quality Improvement databaseNational Surgical Quality Improvement databasePerioperative adverse event ratesSimilar long-term outcomesPropensity scoreMinor adverse eventsPrevious cohort studiesSerious adverse eventsSimilar perioperative outcomesAdverse event ratesIndividual adverse eventsQuality improvement database
2016
Is Outpatient Total Hip Arthroplasty Safe?
Nelson SJ, Webb ML, Lukasiewicz AM, Varthi AG, Samuel AM, Grauer JN. Is Outpatient Total Hip Arthroplasty Safe? The Journal Of Arthroplasty 2016, 32: 1439-1442. PMID: 28065622, DOI: 10.1016/j.arth.2016.11.053.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedArthroplasty, Replacement, HipBlood TransfusionDatabases, FactualFemaleHumansInpatientsLength of StayLogistic ModelsMaleMiddle AgedMultivariate AnalysisOutpatientsPatient DischargePatient ReadmissionPatient SafetyPoisson DistributionPostoperative ComplicationsPropensity ScoreQuality ImprovementRegression AnalysisRetrospective StudiesYoung AdultConceptsOutpatient total hip arthroplastyTotal hip arthroplastyAdverse eventsPropensity scoreSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseGeneral health outcome measuresDays adverse eventsImprovement Program databaseMultivariate Poisson regressionHealth outcome measuresHospital dischargePostoperative dayBlood transfusionExtended LOSTHA patientsPotential confoundersInpatient proceduresProgram databaseRelative riskHip arthroplastyOutcome measuresSafety dataStudy groupPerioperative Outcomes After Cervical Laminoplasty Versus Posterior Decompression and Fusion
Varthi AG, Basques BA, Bohl DD, Golinvaux NS, Grauer JN. Perioperative Outcomes After Cervical Laminoplasty Versus Posterior Decompression and Fusion. Clinical Spine Surgery A Spine Publication 2016, 29: e226-e232. PMID: 25310393, DOI: 10.1097/bsd.0000000000000183.Peer-Reviewed Original ResearchConceptsMultilevel cervical pathologyBaseline patient characteristicsCervical laminoplastyShort-term outcomesPosterior decompressionLaminoplasty patientsFusion patientsCervical decompressionAdverse eventsPatient characteristicsCervical pathologySurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databasePropensity-adjusted multivariate analysisQuality Improvement Program databaseWorse short-term outcomesCharlson Comorbidity IndexPosterior cervical decompressionRetrospective cohort studyImprovement Program databaseLength of stayBivariate logistic regressionAnesthesiologists (ASA) scoreComorbidity indexPerioperative outcomesVariation in Resource Utilization for Patients With Hip and Pelvic Fractures Despite Equal Medicare Reimbursement
Samuel AM, Webb ML, Lukasiewicz AM, Basques BA, Bohl DD, Varthi AG, Lane JM, Grauer JN. Variation in Resource Utilization for Patients With Hip and Pelvic Fractures Despite Equal Medicare Reimbursement. Clinical Orthopaedics And Related Research® 2016, 474: 1486-1494. PMID: 26913512, PMCID: PMC4868172, DOI: 10.1007/s11999-016-4765-8.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overDiagnosis-Related GroupsFee-for-Service PlansFemaleFracture FixationHealth ResourcesHip FracturesHospital CostsHumansIntensive Care UnitsLength of StayMaleMedicarePatient Care BundlesPelvic BonesProcess Assessment, Health CareRegistriesRespiration, ArtificialRetrospective StudiesTime FactorsTrauma CentersTreatment OutcomeUnited StatesConceptsIntensive care unitDiagnosis-related groupsPelvic fracturesHip fractureInpatient lengthAcetabulum fracturesVentilator timeICU lengthHospital factorsVentilation timePelvis fracturesIntensive care unit stayNational Trauma Data BankTotal inpatient lengthTrue hospital costsMechanical ventilation timeInpatient resource utilizationHigh-energy traumaTrauma Data BankIncidence of fracturesNonoperative fracturesUnit stayTrauma patientsCare unitPelvic traumaSpinal Fracture in Patients With Ankylosing Spondylitis
Lukasiewicz AM, Bohl DD, Varthi AG, Basques BA, Webb ML, Samuel AM, Grauer JN. Spinal Fracture in Patients With Ankylosing Spondylitis. Spine 2016, 41: 191-196. PMID: 26579959, DOI: 10.1097/brs.0000000000001190.Peer-Reviewed Original ResearchConceptsNational Inpatient SampleSpinal fracturesAdverse eventsCervical fracturesSpinal columnHospital adverse eventsMortality of fracturesSmall case seriesSpinal cord injuryAnkylosed spinePatient demographicsRetrospective cohortThoracic fracturesCase seriesHigh morbidityInjury characteristicsInpatient stayMinor traumaCord injuryPatient populationCase reportInpatient SampleBACKGROUND DATAHigh riskPatientsCeramic-on-Ceramic Total Hip Arthroplasty in a Twelve-Year-Old Patient: Case Report with a 27-Year Follow-Up.
Save AV, Varthi A, Talusan PG, Gala R, Nelson S, Keggi KJ. Ceramic-on-Ceramic Total Hip Arthroplasty in a Twelve-Year-Old Patient: Case Report with a 27-Year Follow-Up. Connecticut Medicine 2016, 80: 341-5. PMID: 27509640.Peer-Reviewed Original ResearchConceptsTotal hip arthroplastyCeramic total hip arthroplastyHip arthroplastyJuvenile patientsCase reportTwelve-year-old patientLong-term pain reliefJuvenile rheumatoid arthritisFemoral component looseningPain reliefRheumatoid arthritisExcellent outcomesRevision surgeryComponent looseningPatientsArthroplastyAge 12Hip prosthesisReportArthritisSurgeryYearsHip
2015
Overall Similar Infection Rates Reported in the Physician-reported Scoliosis Research Society Database and the Chart-abstracted American College of Surgeons National Surgical Quality Improvement Program Database
Webb ML, Lukasiewicz AM, Samuel AM, Bohl DD, Basques BA, Varthi AG, Grauer JN. Overall Similar Infection Rates Reported in the Physician-reported Scoliosis Research Society Database and the Chart-abstracted American College of Surgeons National Surgical Quality Improvement Program Database. Spine 2015, 40: 1431-1435. PMID: 26110664, DOI: 10.1097/brs.0000000000001033.Peer-Reviewed Original ResearchConceptsACS-NSQIP databaseSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseImprovement Program databaseInfection rateSRS databasePostoperative infectionProgram databaseAmerican CollegeScoliosis Research Society MorbidityAcute postoperative infectionSurgeon-reported dataPostoperative infection rateRetrospective cohort studyNinth Revision codesSimilar infection ratesDegenerative spondylolithesisCohort studyScheuermann's kyphosisSurgical databaseRevision codesSurgical correctionBACKGROUND DATASurgical cases
2014
Risk Factors for Short-term Adverse Events and Readmission After Arthroscopic Meniscectomy
Basques BA, Gardner EC, Varthi AG, Fu MC, Bohl DD, Golinvaux NS, Grauer JN. Risk Factors for Short-term Adverse Events and Readmission After Arthroscopic Meniscectomy. The American Journal Of Sports Medicine 2014, 43: 169-175. PMID: 25294869, DOI: 10.1177/0363546514551923.Peer-Reviewed Original ResearchConceptsSevere adverse eventsAdverse eventsRisk factorsMedical comorbiditiesOlder patientsArthroscopic meniscectomySurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseShort-term adverse eventsQuality Improvement Program databaseMultivariate logistic regression analysisOdds of readmissionPostoperative adverse eventsImprovement Program databaseHistory of smokingCase-control studyEvidence of osteoarthritisLevel of evidenceLogistic regression analysisComorbidity burdenPulmonary diseasePatient selectionPreoperative counselingCommon surgeryMean ageUse of an Operating Microscope During Spine Surgery Is Associated With Minor Increases in Operating Room Times and No Increased Risk of Infection
Basques BA, Golinvaux NS, Bohl DD, Yacob A, Toy JO, Varthi AG, Grauer JN. Use of an Operating Microscope During Spine Surgery Is Associated With Minor Increases in Operating Room Times and No Increased Risk of Infection. Spine 2014, 39: 1910-1916. PMID: 25188600, PMCID: PMC4192002, DOI: 10.1097/brs.0000000000000558.Peer-Reviewed Original ResearchConceptsOperating room timeRisk of infectionDay of surgerySurgical site infectionRoom timeSpine proceduresSite infectionOperative timeSpine surgeryNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement Program databaseMicroscope useMultivariate analysisDeep surgical site infectionSepsis/septic shockQuality Improvement Program databaseSuperficial surgical site infectionElective spinal proceduresElective spine proceduresOrgan space infectionAverage patient ageImprovement Program databaseAverage operative timeRetrospective database reviewMultivariate logistic regressionComplication Rates Following Elective Lumbar Fusion in Patients With Diabetes
Golinvaux NS, Varthi AG, Bohl DD, Basques BA, Grauer JN. Complication Rates Following Elective Lumbar Fusion in Patients With Diabetes. Spine 2014, 39: 1809-1816. PMID: 25010098, DOI: 10.1097/brs.0000000000000506.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedChi-Square DistributionDatabases, FactualDiabetes Mellitus, Type 1Diabetes Mellitus, Type 2Elective Surgical ProceduresFemaleHumansHypoglycemic AgentsInsulinLength of StayLogistic ModelsLumbar VertebraeMaleMiddle AgedMultivariate AnalysisOdds RatioPatient ReadmissionPostoperative ComplicationsRetrospective StudiesRisk FactorsSpinal FusionTime FactorsTreatment OutcomeUnited StatesYoung AdultConceptsInsulin-dependent diabetes mellitusLumbar fusion surgeryDiabetes mellitusPostoperative complicationsFusion surgeryLumbar fusionSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseElective lumbar fusion surgeryQuality Improvement Program databaseEffects of NIDDMVentilator-assisted respirationWound-related infectionsAdverse postoperative outcomesRetrospective cohort studyImprovement Program databaseUrinary tract infectionDependent diabetes mellitusElective lumbar fusionPreoperative risk stratificationRisk of deathCommon chronic diseasesLength of stayCounseling of patientsUnplanned intubationPatient Characteristics Associated With Increased Postoperative Length of Stay and Readmission After Elective Laminectomy for Lumbar Spinal Stenosis
Basques BA, Varthi AG, Golinvaux NS, Bohl DD, Grauer JN. Patient Characteristics Associated With Increased Postoperative Length of Stay and Readmission After Elective Laminectomy for Lumbar Spinal Stenosis. Spine 2014, 39: 833-840. PMID: 24525996, PMCID: PMC4006290, DOI: 10.1097/brs.0000000000000276.Peer-Reviewed Original ResearchConceptsLumbar spinal stenosisAnesthesiologists class 3Independent risk factorBody mass indexSpinal stenosisRisk factorsElective laminectomyPostoperative lengthPatient characteristicsReadmission analysisMass indexAmerican CollegeNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramSurgical site-related infectionsQuality Improvement Program databaseSurgical Quality Improvement ProgramAverage postoperative LOSImprovement Program databaseAmerican SocietyQuality Improvement ProgramClass 3Preoperative hematocritFactors Predictive of Increased Surgical Drain Output After Anterior Cervical Discectomy and Fusion
Basques BA, Bohl DD, Golinvaux NS, Yacob A, Varthi AG, Grauer JN. Factors Predictive of Increased Surgical Drain Output After Anterior Cervical Discectomy and Fusion. Spine 2014, 39: 728-735. PMID: 24480948, PMCID: PMC3991728, DOI: 10.1097/brs.0000000000000237.Peer-Reviewed Original ResearchConceptsTotal drain outputDrain outputSurgical drain placementSurgical drain outputNeck hematomaDrain placementSurgical drainsRetrospective cohort studyAnterior cervical discectomyHistory of smokingRisk of complicationsPostoperative neck hematomaAge 50 yearsMultivariate logistic regressionSingle academic institutionAverage drain outputElective ACDFCervical discectomyCohort studyConsecutive patientsDrain useIndependent predictorsFactors PredictiveMedical recordsACDF
2013
Recovery Room Radiographs Not Found to Have Incremental Utility Above Intraoperative Images After Lumbar Fusion Procedures
Bohl DD, Gruskay JA, Miller CP, Varthi A, Ruiz FK, Whang PG, Grauer JN. Recovery Room Radiographs Not Found to Have Incremental Utility Above Intraoperative Images After Lumbar Fusion Procedures. Spine 2013, 38: 1927-1933. PMID: 23883831, DOI: 10.1097/brs.0b013e3182a527be.Peer-Reviewed Original ResearchConceptsLumbar fusion proceduresLumbar interbody fusionClinical utilityRecovery roomInterbody fusionFusion proceduresSurgical constructTransforaminal lumbar interbody fusionAnterior lumbar interbody fusionAnterior-posterior fusionRetrospective case seriesPosterolateral lumbar fusionLow clinical utilityPlain film imagesRecovery room radiographsIntraoperative imagesIncremental clinical utilityCase seriesConsecutive seriesLumbar fusionBACKGROUND DATAIntraoperative fluoroscopic imagesWound closureRadiation exposureIncremental utilityOsteonecrosis of the Knee — Which Joint Preservation Procedures Work?
Lieberman JR, Varthi AG, Polkowski GG. Osteonecrosis of the Knee — Which Joint Preservation Procedures Work? The Journal Of Arthroplasty 2013, 29: 52-56. PMID: 23725928, DOI: 10.1016/j.arth.2013.04.036.Peer-Reviewed Original ResearchConceptsMulti-center randomized trialsAdditional surgical treatmentJoint preservation proceduresCore decompressionSurgical treatmentAdditional surgeryRandomized trialsInclusion criteriaSystematic reviewKnee jointOsteochondral graftsKneePreservation proceduresOsteonecrosisFailure rateBest procedurePatientsSurgeryGraftDiseaseTrialsDecompression
2012
Physical examination and radiographic interpretation of carpal anatomy in orthopedic residents and emergency medicine physicians.
Russo GS, Olson RL, Varthi A, Patel N, Leger R, Rodner CM. Physical examination and radiographic interpretation of carpal anatomy in orthopedic residents and emergency medicine physicians. The American Journal Of Orthopedics 2012, 41: 262-7. PMID: 22837989.Peer-Reviewed Original ResearchConceptsEmergency medicine physiciansMedicine physiciansOrthopaedic residentsEmergency medicine residentsRadiographic interpretationCarpal bonesMedicine residentsEmergency medicine groupCarpal anatomyOrthopaedic surgery residentsPhysical examinationMedicine groupAssessment scoresBony landmarksPhysiciansSurgery residentsEducational interventionResident cohortResident involvementEmergency medicineCohortPalpationYear medical studentsAnatomyRadiographic anatomy