2022
Utilization of Machine Learning to Model Important Features of 30-day Readmissions following Surgery for Metastatic Spinal Column Tumors: The Influence of Frailty
Elsamadicy A, Koo A, Reeves B, Cross J, Hersh A, Hengartner A, Karhade A, Pennington Z, Akinduro O, Lo S, Gokaslan Z, Shin J, Mendel E, Sciubba D. Utilization of Machine Learning to Model Important Features of 30-day Readmissions following Surgery for Metastatic Spinal Column Tumors: The Influence of Frailty. Global Spine Journal 2022, 14: 1227-1237. PMID: 36318478, PMCID: PMC11289550, DOI: 10.1177/21925682221138053.Peer-Reviewed Original ResearchHospital Frailty Risk ScoreSpinal column tumorsFrailty Risk ScoreInfluence of frailtySpinal column metastasesProportion of patientsRetrospective cohort studyNationwide Readmissions DatabaseRisk of readmissionMultivariate regression analysisIntermediate frailtyAdult patientsCohort studyIndependent predictorsSurgical interventionSpine surgeryReadmissionPatient readmissionRisk scorePatientsFrailtySurgeryCohortTumorsRegression analysisHospital 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 patientsHigher 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 demographicsImpact of Frailty on Morbidity and Mortality in Adult Patients Undergoing Surgical Evacuation of Acute Traumatic Subdural Hematoma
Elsamadicy AA, Sandhu MRS, Freedman IG, Koo AB, Reeves BC, Yu J, Hengartner A, Havlik J, Hong CS, Rutherford HJV, Kim JA, Gerrard J, Gilmore EJ, Omay SB. Impact of Frailty on Morbidity and Mortality in Adult Patients Undergoing Surgical Evacuation of Acute Traumatic Subdural Hematoma. World Neurosurgery 2022, 162: e251-e263. PMID: 35276399, DOI: 10.1016/j.wneu.2022.02.122.Peer-Reviewed Original ResearchConceptsAcute traumatic subdural hematomaTraumatic subdural hematomaHospital mortalityNonroutine dischargeSubdural hematomaExtended LOSIndependent predictorsAdult patientsBaseline frailtyMultivariate logistic regression analysisExtended hospital lengthImpact of frailtyRetrospective cohort studyNational Trauma DatabaseLogistic regression analysisRegression analysisMultivariate regression analysisHealth care expendituresFrail patientsHospital lengthCohort studySurgical evacuationFrailty indexTrauma databasePatients134 Racial Disparities in Healthcare Resource Utilization After Pediatric Cervical and/or Thoracic Spinal Injuries: Is it Black and White?
Elsamadicy A, Sandhu M, Freedman I, Koo A, Hengartner A, Reeves B, Havlik J, Sarkozy M, Kundishora A, Tuason D, DiLuna M. 134 Racial Disparities in Healthcare Resource Utilization After Pediatric Cervical and/or Thoracic Spinal Injuries: Is it Black and White? Neurosurgery 2022, 68: 39-39. DOI: 10.1227/neu.0000000000001880_134.Peer-Reviewed Original ResearchHealthcare resource utilizationAfrican American patientsMultivariate regression analysisAfrican American cohortHospital complicationsHospital LOSComplication ratePediatric patientsSpinal traumaRacial disparitiesGreater prevalenceLogistic multivariate regression analysisLength of ICUOverall complication rateThoracic spine injuriesAfrican American raceDiagnosis coding systemRegression analysisThoracic spinal injuryPaucity of dataAfrican American/BlackUnited States healthcare systemICU LOSHospital stayInjury presentations307 The Hospital Frailty Risk Score Independently Predicts Increased Complication Rates and Healthcare Resource Utilization After Endovascular Treatment of Ruptured Aneurysms
Koo A, Elsamadicy A, Sarkozy M, Sherman J, Reeves B, Freedman I, Antonios J, Sujijantarat N, Renado D, Hebert R, Malhotra A, Matouk C. 307 The Hospital Frailty Risk Score Independently Predicts Increased Complication Rates and Healthcare Resource Utilization After Endovascular Treatment of Ruptured Aneurysms. Neurosurgery 2022, 68: 67-68. DOI: 10.1227/neu.0000000000001880_307.Peer-Reviewed Original ResearchHospital Frailty Risk ScoreNon-routine dischargeFrailty Risk ScoreEndovascular treatmentIntracranial aneurysmsPerioperative complicationsLower frailtyHospital costsRisk scoreNational Inpatient Sample databaseMean total hospital costMultivariate logistic regression analysisICD-10 diagnostic codesImpact of frailtyRetrospective cohort studyHealthcare resource utilizationEvaluation of patientsTotal hospital costsAdverse healthcare outcomesAdministrative hospital dataRuptured intracranial aneurysmLogistic regression analysisRegression analysisMultivariate regression analysisAdult patients464 Hospital Frailty Risk Score and Healthcare Resource Utilization After Surgery for Metastatic Spinal Column Tumors
Elsamadicy A, Koo A, Reeves B, Pennington Z, Yu J, Goodwin C, Kolb L, Laurans M, Lo S, Shin J, Sciubba D. 464 Hospital Frailty Risk Score and Healthcare Resource Utilization After Surgery for Metastatic Spinal Column Tumors. Neurosurgery 2022, 68: 113-113. DOI: 10.1227/neu.0000000000001880_464.Peer-Reviewed Original ResearchHospital Frailty Risk ScoreNon-routine dischargeFrailty Risk ScoreSpinal column tumorsPatient populationRisk scoreLarge national database studyNational Inpatient Sample databaseMultivariate logistic regression analysisICD-10 diagnostic codesProlonged hospital LOSImpact of frailtyNational database studyHealthcare resource utilizationRetrospective cohort studyTotal hospital costsProcedural Coding SystemLogistic regression analysisRegression analysisMultivariate regression analysisHospital LOSCohort studyHospital admissionIndependent predictorsLonger LOSDifferences in Health Care Resource Utilization After Surgery for Metastatic Spinal Column Tumors in Patients with a Concurrent Affective Disorder in the United States
Elsamadicy AA, Koo AB, Sarkozy M, Reeves BC, Pennington Z, Havlik J, Sandhu MR, Hersh A, Patel S, Kolb L, Larry Lo SF, Shin JH, Mendel E, Sciubba DM. Differences in Health Care Resource Utilization After Surgery for Metastatic Spinal Column Tumors in Patients with a Concurrent Affective Disorder in the United States. World Neurosurgery 2022, 161: e252-e267. PMID: 35123021, DOI: 10.1016/j.wneu.2022.01.112.Peer-Reviewed Original ResearchConceptsLength of stayHealth care resource utilizationPostoperative adverse eventsNonroutine dischargeAdverse eventsAffective disordersNational Inpatient Sample databaseMultivariate logistic regression analysisSpinal column metastasesRetrospective cohort studyMetastatic spinal tumorsSpinal column tumorsLogistic regression analysisConcurrent affective disorderGreater total costsRegression analysisMultivariate regression analysisAdult patientsCohort studyDischarge dispositionIntraoperative variablesPatient demographicsHospital admissionIndependent predictorsSpinal metastases
2021
Racial Disparities in Health Care Resource Utilization After Pediatric Cervical and/or Thoracic Spinal Injuries
Elsamadicy AA, Sandhu MR, Freedman IG, Koo AB, Hengartner AC, Reeves BC, Havlik J, Sarkozy M, Hong CS, Kundishora AJ, Tuason DA, DiLuna M. Racial Disparities in Health Care Resource Utilization After Pediatric Cervical and/or Thoracic Spinal Injuries. World Neurosurgery 2021, 156: e307-e318. PMID: 34560297, DOI: 10.1016/j.wneu.2021.09.047.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAsianBlack or African AmericanCervical VertebraeChildChild, PreschoolCohort StudiesFemaleHealth Status DisparitiesHealthcare DisparitiesHispanic or LatinoHumansInfantLength of StayMalePostoperative ComplicationsRetrospective StudiesSocioeconomic FactorsSpinal InjuriesThoracic VertebraeUnited StatesWhite PeopleConceptsHealth care resource utilizationNon-Hispanic blacksNon-Hispanic AsiansHospital complicationsPediatric patientsMultivariate regression analysisNon-Hispanic whitesHospital LOSComplication rateGreater prevalenceICD-10-CM diagnosisLogistic multivariate regression analysisNational Trauma Data BankLonger hospital LOSOverall complication rateThoracic spine injuriesTrauma Data BankRegression analysisThoracic spinal injuryNHB patientsHospital lengthRetrospective cohortSpine injuriesThoracic injuriesRisk ratioImpact of Frailty on Morbidity and Mortality in Adult Patients Presenting with an Acute Traumatic Cervical Spinal Cord Injury
Elsamadicy AA, Sandhu MRS, Freedman IG, Reeves BC, Koo AB, Hengartner A, Havlik J, Sherman J, Maduka R, Agboola IK, Johnson DC, Kolb L, Laurans M. Impact of Frailty on Morbidity and Mortality in Adult Patients Presenting with an Acute Traumatic Cervical Spinal Cord Injury. World Neurosurgery 2021, 153: e408-e418. PMID: 34224881, DOI: 10.1016/j.wneu.2021.06.130.Peer-Reviewed Original ResearchConceptsCervical spinal cord injurySpinal cord injuryAcute cervical spinal cord injuryNational Trauma DatabaseAdverse eventsHospital mortalityFrailty scoreAdult patientsIndependent predictorsCord injuryAcute traumatic cervical spinal cord injuryTraumatic cervical spinal cord injuryRisk of AEsComplete spinal cord injuryMultivariate logistic regression analysisCentral cord syndromeHospital adverse eventsImpact of frailtyRetrospective cohort studyProportion of patientsType of injuryProcedural Coding SystemLogistic regression analysisRegression analysisMultivariate regression analysisRace Is an Independent Predictor for Nonroutine Discharges After Spine Surgery for Spinal Intradural/Cord Tumors
Elsamadicy AA, Koo AB, David WB, Reeves BC, Freedman IG, Pennington Z, Ehresman J, Kolb L, Laurans M, Shin JH, Sciubba DM. Race Is an Independent Predictor for Nonroutine Discharges After Spine Surgery for Spinal Intradural/Cord Tumors. World Neurosurgery 2021, 151: e707-e717. PMID: 33940256, DOI: 10.1016/j.wneu.2021.04.085.Peer-Reviewed Original ResearchConceptsNonroutine discharge dispositionIndependent predictorsNonroutine dischargeDischarge dispositionCord tumorsAA raceSurgical interventionNational Inpatient Sample databaseMultivariable logistic regression analysisStepwise multivariable logistic regression analysisBackward stepwise multivariable logistic regression analysisAfrican AmericansPostoperative complication rateRetrospective cohort studyClinical Modification diagnosisLength of hospitalizationProcedural Coding SystemLogistic regression analysisHealth care costsRegression analysisMultivariate regression analysisAA/BlackPostoperative complicationsCohort studyComplication rate
2019
Intraoperative ketamine may increase risk of post-operative delirium after complex spinal fusion for adult deformity correction
Elsamadicy AA, Charalambous LT, Sergesketter AR, Drysdale N, Adil SM, Freedman IG, Williamson T, Kundishora AJ, Camara-Quintana J, Abd-El-Barr MM, Goodwin CR, Karikari IO. Intraoperative ketamine may increase risk of post-operative delirium after complex spinal fusion for adult deformity correction. Journal Of Spine Surgery 2019, 5: 79-87. PMID: 31032442, PMCID: PMC6465460, DOI: 10.21037/jss.2018.12.10.Peer-Reviewed Original ResearchPost-operative deliriumMultivariate nominal-logistic regression analysisComplex spinal fusionIntraoperative ketamine administrationIntraoperative ketamineNominal logistic regression analysisSpinal fusionPatient demographicsKetamine administrationDeformity correctionPrimary complex spinal fusionPost-operative complication rateAdult spine deformity patientsAdult deformity correctionBetter overall patient carePostoperative complication profileProportion of patientsLength of surgeryPost-operative painPost-operative outcomesSpine deformity patientsComplex spinal surgeryOverall patient careRegression analysisMajor academic institution
2017
Impact of Affective Disorders on Recovery of Baseline Function in Patients Undergoing Spinal Surgery: A Single Institution Study of 275 Patients
Nayar G, Elsamadicy AA, Zakare-Fagbamila R, Farquhar J, Gottfried ON. Impact of Affective Disorders on Recovery of Baseline Function in Patients Undergoing Spinal Surgery: A Single Institution Study of 275 Patients. World Neurosurgery 2017, 100: 69-73. PMID: 28057592, DOI: 10.1016/j.wneu.2016.12.098.Peer-Reviewed Original ResearchMeSH KeywordsComorbidityDecompression, SurgicalElective Surgical ProceduresFemaleHumansLength of StayMaleMiddle AgedMood DisordersMultivariate AnalysisPatient ReadmissionPatient Reported Outcome MeasuresPostoperative ComplicationsProspective StudiesRecovery of FunctionRegression AnalysisRetrospective StudiesRisk FactorsSelf ReportSpineConceptsDecompressive spinal surgeryIndependent risk factorSpinal surgeryAffective disordersRisk factorsOutcome measuresBaseline functionPatient-reported outcome measuresPoor baseline qualitySpinal surgery patientsWorse postoperative outcomesSingle-institution studyMain outcome measuresSelf-reported recoveryRegression analysisMultivariate regression analysisMajor academic institutionBaseline demographicsPerioperative variablesPostoperative outcomesSurgery patientsMore smokersSurgical outcomesPostoperative expectationsControl cohort
2016
Patient Body Mass Index is an Independent Predictor of 30-Day Hospital Readmission After Elective Spine Surgery
Elsamadicy AA, Adogwa O, Vuong VD, Mehta AI, Vasquez RA, Cheng J, Karikari IO, Bagley CA. Patient Body Mass Index is an Independent Predictor of 30-Day Hospital Readmission After Elective Spine Surgery. World Neurosurgery 2016, 96: 148-151. PMID: 27593714, DOI: 10.1016/j.wneu.2016.08.097.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBody Mass IndexCase-Control StudiesComorbidityDecompression, SurgicalElective Surgical ProceduresFemaleHumansLength of StayLogistic ModelsLumbar VertebraeMaleMiddle AgedMultivariate AnalysisObesityPatient ReadmissionPneumoniaPostoperative ComplicationsRadiculopathyRisk FactorsSpinal DiseasesSpinal FusionSpinal StenosisSpondylolisthesisSurgical Wound InfectionUrinary Tract InfectionsConceptsElective spine surgeryBody mass indexPreoperative body mass indexMultivariate logistic regression analysisDays of dischargeIndependent risk factorHospital readmissionSpine surgeryLogistic regression analysisPreoperative obesityReadmission ratesIndependent predictorsMass indexRisk factorsEarly unplanned hospital readmissionPatient body mass indexUnplanned hospital readmissionPostoperative complication rateAppropriate risk stratificationPrevalence of obesityMajor academic medical centerAcademic medical centerRegression analysisHealth care climateIndex surgery