2022
Admission NarxCare Narcotic Scores Are Associated With Increased Odds of Readmission and Prolonged Length of Hospital Stay After Primary Elective Total Knee Arthroplasty
Galivanche A, Zhu J, Mercier M, McLean R, Wilhelm C, Varthi A, Grauer J, Rubin L. Admission NarxCare Narcotic Scores Are Associated With Increased Odds of Readmission and Prolonged Length of Hospital Stay After Primary Elective Total Knee Arthroplasty. JAAOS Global Research And Reviews 2022, 6: e22.00040. PMID: 36732305, PMCID: PMC9726283, DOI: 10.5435/jaaosglobal-d-22-00040.Peer-Reviewed Original ResearchMeSH KeywordsArthroplasty, Replacement, KneeHospitalizationHumansLength of StayNarcoticsPatient ReadmissionConceptsPrimary elective total knee arthroplastyElective total knee arthroplastyTotal knee arthroplastyNarcotic scoreOverall opioid usageAdverse eventsTKA patientsHospital stayKnee arthroplastyRisk of AEsOdds of readmissionPrimary TKA patientsPreoperative narcotic useTime of admissionDose-dependent increaseOpioid usagePostoperative outcomesPatient characteristicsProlonged lengthNarcotic useAdverse outcomesSingle institutionRevision surgeryReadmissionPatients
2021
Hospital Consumer Assessment of Healthcare Providers and Systems survey response rates are significantly affected by patient characteristics and postoperative outcomes for patients undergoing primary total knee arthroplasty
Mercier MR, Galivanche AR, David WB, Malpani R, Pathak N, Hilibrand AS, Rubin LE, Grauer JN. Hospital Consumer Assessment of Healthcare Providers and Systems survey response rates are significantly affected by patient characteristics and postoperative outcomes for patients undergoing primary total knee arthroplasty. PLOS ONE 2021, 16: e0257555. PMID: 34582475, PMCID: PMC8478166, DOI: 10.1371/journal.pone.0257555.Peer-Reviewed Original ResearchConceptsTotal knee arthroplastyPrimary total knee arthroplastyHospital Consumer AssessmentPostoperative outcomesPatient characteristicsHCAHPS survey resultsHCAHPS surveySurvey response rateKnee arthroplastyResponse rateHealthcare providersConsumer AssessmentHigher American SocietyMultivariate regression analysisAnesthesia scorePostoperative variablesTKA patientsAdult patientsPrimary outcomePatient factorsSurgical variablesPatient populationPatient satisfactionSingle institutionHospital experienceCenters for Medicare & Medicaid Services' 2018 Removal of Total Knee Arthroplasty From the Inpatient-only List Led to Broad Changes in Hospital Length of Stays
Rankin KA, Freedman IG, Rubin LE, Grauer JN. Centers for Medicare & Medicaid Services' 2018 Removal of Total Knee Arthroplasty From the Inpatient-only List Led to Broad Changes in Hospital Length of Stays. Journal Of The American Academy Of Orthopaedic Surgeons 2021, 29: 1061-1067. PMID: 33960970, DOI: 10.5435/jaaos-d-20-01228.Peer-Reviewed Original ResearchConceptsTotal knee arthroplastyHospital lengthKnee arthroplastyNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseMedicare eligibilityCategorical data comparisonsOverall practice patternsRetrospective cohort studyImprovement Program databaseSame dayRemoval of TKAPearson's chi-squared testChi-squared testMann-Whitney testLOS daysProlonged LOSMost patientsTKA patientsCohort studyMore patientsPractice patternsPatient characterizationProgram databaseActual LOS
2020
Preoperative High, as well as Low, Platelet Counts Correlate With Adverse Outcomes After Elective Total Hip Arthroplasty
Malpani R, Bovonratwet P, Clark MG, Ottesen TD, Mercier MR, Grauer JN. Preoperative High, as well as Low, Platelet Counts Correlate With Adverse Outcomes After Elective Total Hip Arthroplasty. JAAOS Global Research And Reviews 2020, 4: e20.00049. PMID: 32890010, PMCID: PMC7470002, DOI: 10.5435/jaaosglobal-d-20-00049.Peer-Reviewed Original ResearchMeSH KeywordsArthroplasty, Replacement, HipElective Surgical ProceduresHumansLength of StayPatient ReadmissionPlatelet CountConceptsTotal hip arthroplastyNational Surgical Quality Improvement Program databaseQuality Improvement Program databasePreoperative platelet countAbnormal platelet countImprovement Program databasePlatelet countPerioperative complicationsAdverse eventsHospital readmissionTHA patientsAdverse outcomesProgram databaseHip arthroplastyElective primary total hip arthroplastyElective total hip arthroplastyPrimary total hip arthroplastyMulticenter patient populationPreoperative laboratory studiesMinor adverse eventsPostoperative adverse eventsLow platelet countPostoperative complication dataNormal platelet countHigher platelet countsHigh, 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
Safety of Outpatient Single-level Cervical Total Disc Replacement
Bovonratwet P, Fu MC, Tyagi V, Ondeck NT, Albert TJ, Grauer JN. Safety of Outpatient Single-level Cervical Total Disc Replacement. Spine 2019, Publish Ahead of Print: &na;. PMID: 30247372, DOI: 10.1097/brs.0000000000002884.Peer-Reviewed Original ResearchConceptsSingle-level cervical total disc replacementCervical total disc replacementSingle-level ACDFPerioperative complicationsTotal disc replacementPerioperative outcomesOutpatient settingDisc replacementNational Surgical Quality Improvement Program databaseSingle-level anterior cervical discectomyQuality Improvement Program databasePropensity scoreRetrospective cohort comparison studyPatient baseline characteristicsAdverse event profileAnterior cervical discectomyImprovement Program databasePerioperative adverse eventsRate of readmissionLength of stayCohort comparison studyHospital stayAdverse eventsBaseline characteristicsCervical discectomyAbnormally 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 CollegePediatric obesity is associated with short-term risks after pelvic osteotomy
Basques BA, Meadows MC, Grauer JN, Kogan M. Pediatric obesity is associated with short-term risks after pelvic osteotomy. Journal Of Pediatric Orthopaedics B 2019, 28: 95-99. PMID: 30234701, DOI: 10.1097/bpb.0000000000000552.Peer-Reviewed Original ResearchConceptsPelvic osteotomyRisk factorsNational Surgical Quality Improvement Program Pediatric databasePediatric pelvic osteotomiesRetrospective cohort studyIndependent risk factorLength of stayShort-term riskNonobese patientsPerioperative morbidityAdverse eventsCohort studyBlood transfusionOperative timePediatric obesityPatient counselingFemoral osteotomySurgical correctionPediatric databaseHip dysplasiaOsteotomyReadmissionObesityPatientsTransfusionElective 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
Predicting Adverse Outcomes After Total Hip Arthroplasty: A Comparison of Demographics, the American Society of Anesthesiologists class, the Modified Charlson Comorbidity Index, and the Modified Frailty Index.
Ondeck NT, Bohl DD, Bovonratwet P, Anandasivam NS, Cui JJ, McLynn RP, Grauer JN. Predicting Adverse Outcomes After Total Hip Arthroplasty: A Comparison of Demographics, the American Society of Anesthesiologists class, the Modified Charlson Comorbidity Index, and the Modified Frailty Index. Journal Of The American Academy Of Orthopaedic Surgeons 2018, 26: 735-743. PMID: 30130353, DOI: 10.5435/jaaos-d-17-00009.Peer-Reviewed Original ResearchConceptsCharlson Comorbidity IndexTotal hip arthroplastyComorbidity indexAdverse outcomesAdverse eventsFrailty indexAnesthesiologists classTHA patientsHip arthroplastyModified Charlson Comorbidity IndexGeneral health complicationsModified Frailty IndexPerioperative adverse outcomesMinor adverse eventsExtended hospital staySevere adverse eventsHigh-level careComparison of demographicsAmerican SocietyDiscriminative abilityPatients ASAHospital stayPerioperative outcomesGreater discriminative abilityHealth complicationsIs 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 costsPatientsWhat Is the Adverse Event Profile After Prophylactic Treatment of Femoral Shaft or Distal Femur Metastases?
McLynn RP, Ondeck NT, Grauer JN, Lindskog DM. What Is the Adverse Event Profile After Prophylactic Treatment of Femoral Shaft or Distal Femur Metastases? Clinical Orthopaedics And Related Research® 2018, 476: 2381-2388. PMID: 30260860, PMCID: PMC6259894, DOI: 10.1097/corr.0000000000000489.Peer-Reviewed Original ResearchMeSH KeywordsAgedBlood TransfusionDatabases, FactualDiaphysesFemaleFemoral FracturesFemurFracture FixationFractures, SpontaneousHumansLength of StayLogistic ModelsMaleMiddle AgedMultivariate AnalysisNeoplasm MetastasisOdds RatioOperative TimePatient DischargePostoperative ComplicationsProspective StudiesRetrospective StudiesRisk FactorsTime FactorsTreatment OutcomeConceptsBody mass indexPathologic fractureAdverse eventsProphylactic treatment groupProphylactic treatmentBlood transfusionDisseminated cancerFemoral shaftComplication profileFracture groupFunctional outcomeProphylactic fixationDistal femurTreatment groupsNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseGreater body mass indexPerioperative complication profileProphylactic surgical stabilizationProphylactic surgical treatmentPostoperative adverse eventsAdverse event profileCurrent Procedural Terminology codesImprovement Program databaseMajor adverse eventsThromboembolic 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 patientsLonger Operative Time Is Associated With Increased Adverse Events After Anterior Cervical Diskectomy and Fusion: 15-Minute Intervals Matter.
Ondeck NT, Bohl DD, McLynn RP, Cui JJ, Bovonratwet P, Singh K, Grauer JN. Longer Operative Time Is Associated With Increased Adverse Events After Anterior Cervical Diskectomy and Fusion: 15-Minute Intervals Matter. Orthopedics 2018, 41: e483-e488. PMID: 29708570, DOI: 10.3928/01477447-20180424-02.Peer-Reviewed Original ResearchConceptsAnterior cervical diskectomyOperative timeAdverse eventsCervical diskectomyPerioperative outcomesSurgical durationSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramSurgical Quality Improvement ProgramIndividual adverse outcomesPostoperative adverse eventsLonger operative timeGreater operative timeQuality Improvement ProgramUnplanned intubationHospital stayBaseline characteristicsVenous thromboembolismHospital readmissionAdverse outcomesPatient variablesAmerican CollegeAnesthetic effectSurgical pathologyPhysiologic stressComparison of 30-Day Complications Between Navigated and Conventional Single-level Instrumented Posterior Lumbar Fusion
Bovonratwet P, Nelson SJ, Ondeck NT, Geddes BJ, Grauer JN. Comparison of 30-Day Complications Between Navigated and Conventional Single-level Instrumented Posterior Lumbar Fusion. Spine 2018, 43: 447-453. PMID: 28700450, DOI: 10.1097/brs.0000000000002327.Peer-Reviewed Original ResearchConceptsPosterior lumbar fusionOperative timeLumbar fusionHospital lengthWound infectionSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseShorter mean hospital lengthQuality Improvement Program databaseScrew placementRadiation exposureContamination/infectionLower blood transfusionRetrospective cohort comparison studyMean hospital lengthMost adverse eventsImprovement Program databaseInstrumented posterior lumbar fusionInstrumented lumbar fusionSurgeon radiation exposureCohort comparison studyPotential confounding factorsPedicle screw placementPerioperative complicationsPerioperative outcomesDiscrepancies in the Definition of “Outpatient” Surgeries and Their Effect on Study Outcomes Related to ACDF and Lumbar Discectomy Procedures
Bovonratwet P, Webb ML, Ondeck NT, Gala RJ, Nelson SJ, McLynn RP, Cui JJ, Grauer JN. Discrepancies in the Definition of “Outpatient” Surgeries and Their Effect on Study Outcomes Related to ACDF and Lumbar Discectomy Procedures. Clinical Spine Surgery A Spine Publication 2018, 31: e152-e159. PMID: 29351096, DOI: 10.1097/bsd.0000000000000615.Peer-Reviewed Original ResearchConceptsACDF patientsLumbar discectomy patientsDiscectomy procedureDiscectomy patientsSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseACS-NSQIP databaseAnterior cervical discectomyImprovement Program databaseSame-day dischargePossibility of patientsCervical discectomyOutpatient statusRetrospective studyOutpatient surgeryAdverse outcomesOutpatient settingOutpatient procedureProgram databaseBACKGROUND DATADay dischargeAmerican CollegeACDFOutpatientsHow Common—and How Serious— Is Clostridium difficile Colitis After Geriatric Hip Fracture? Findings from the NSQIP Dataset
Bovonratwet P, Bohl DD, Russo GS, Ondeck NT, Nam D, Della Valle CJ, Grauer JN. How Common—and How Serious— Is Clostridium difficile Colitis After Geriatric Hip Fracture? Findings from the NSQIP Dataset. Clinical Orthopaedics And Related Research® 2018, 476: 453-462. PMID: 29443839, PMCID: PMC6260047, DOI: 10.1007/s11999.0000000000000099.Peer-Reviewed Original ResearchConceptsHip fracture surgeryClostridium difficile colitisDifficile colitisGeriatric hip fracturesChronic care facilitiesHip fractureFracture surgeryPostoperative lengthGeriatric patientsHigh riskPreoperative anemiaCurrent smokersCare facilitiesStrict hand hygieneProphylactic antibiotic regimensFuture prospective studiesHospital quality metricsLarge database studiesStepwise multivariate modelLarge national databasePostdischarge dataAntibiotic regimensInfectious diagnosisPreoperative factorsProphylactic antibioticsMissing data may lead to changes in hip fracture database studies: a study of the American College of Surgeons National Surgical Quality Improvement Program.
Basques BA, McLynn RP, Lukasiewicz AM, Samuel AM, Bohl DD, Grauer JN. Missing data may lead to changes in hip fracture database studies: a study of the American College of Surgeons National Surgical Quality Improvement Program. The Bone & Joint Journal 2018, 100-B: 226-232. PMID: 29437066, DOI: 10.1302/0301-620x.100b2.bjj-2017-0791.r1.Peer-Reviewed Original ResearchConceptsAdverse eventsRisk factorsDatabase studyNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramQuality Improvement Program databaseSurgical Quality Improvement ProgramPostoperative adverse eventsImprovement Program databaseNational database studyDifferent risk factorsMultivariate regressionQuality Improvement ProgramElderly patientsNSQIP databaseBone JointProgram databaseLaboratory valuesAmerican CollegePatientsHipFracturesComorbiditiesSurgery