2023
Emergency Department Visits Following Patellofemoral Arthroplasty
Ratnasamy P, Halperin S, Dhodapkar M, Rubin L, Grauer J. Emergency Department Visits Following Patellofemoral Arthroplasty. JAAOS Global Research And Reviews 2023, 7: e23.00054. PMID: 37947430, PMCID: PMC10635600, DOI: 10.5435/jaaosglobal-d-23-00054.Peer-Reviewed Original ResearchMeSH KeywordsArthroplastyComorbidityEmergency Service, HospitalHumansMedicaidPain, PostoperativeUnited StatesConceptsPatellofemoral arthroplastyED utilizationPFA patientsPostoperative painED visitsPredictive factorsHigher Elixhauser comorbidity indexPerioperative pain managementElixhauser Comorbidity IndexEmergency department utilizationPostoperative metricsComorbidity indexIndependent predictorsPain managementMedicaid insuranceEmergency departmentOrthopedic patientsPayer typePatient carePatientsYounger ageVisitsPainArthroplastyDaysDo 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 patientsUrgent Care Visits Sought After Primary Total Hip Arthroplasty: A Potentially Overlooked Resource
Dhodapkar M, Gouzoulis M, Halperin S, Radford Z, Rubin L, Grauer J. Urgent Care Visits Sought After Primary Total Hip Arthroplasty: A Potentially Overlooked Resource. The Journal Of Arthroplasty 2023, 38: 2361-2365. PMID: 37196730, DOI: 10.1016/j.arth.2023.05.012.Peer-Reviewed Original ResearchConceptsUrgent care visitsTotal hip arthroplastyPrimary total hip arthroplastyUrgent care utilizationCare visitsED utilizationCare utilizationUrgent careHip arthroplastyLess comorbidity burdenEmergency department visitsLarge national databaseLow-acuity diagnosesComorbidity burdenPostoperative EDED visitsDepartment visitsIndependent predictorsTHA patientsMultivariable analysisPostoperative weekUrgent evaluationSurgical sitePatient needsGreater incidence
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 patientsPostoperative 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 pneumoniaSafety 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
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 comorbiditiesPredicting 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 complicationsDiscriminative 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 cohortIncidence of and Risk Factors for Knee Collateral Ligament Injuries With Proximal Tibia Fractures: A Study of 32,441 Patients.
Samuel AM, Diaz-Collado PJ, Szolomayer LK, Wiznia DH, Chan WW, Lukasiewicz AM, Basques BA, Bohl DD, Grauer JN. Incidence of and Risk Factors for Knee Collateral Ligament Injuries With Proximal Tibia Fractures: A Study of 32,441 Patients. Orthopedics 2018, 41: e268-e276. PMID: 29451942, DOI: 10.3928/01477447-20180213-03.Peer-Reviewed Original ResearchConceptsCollateral ligament injuriesProximal tibia fracturesLigament injuryTibia fracturesRisk factorsCollateral ligamentLateral collateral ligament injuryMedial collateral ligament injuryNational Trauma Data BankInpatient adverse eventsLonger hospital stayInjury Severity ScoreDistal femur fracturesChronic knee instabilityTrauma Data BankKnee collateral ligamentsHospital stayInpatient outcomesAdverse eventsSimultaneous injuryFemur fracturesSeverity scoreKnee instabilityHigher oddsMultivariate analysisHow 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
2017
Results of Database Studies in Spine Surgery Can Be Influenced by Missing Data
Basques BA, McLynn RP, Fice MP, Samuel AM, Lukasiewicz AM, Bohl DD, Ahn J, Singh K, Grauer JN. Results of Database Studies in Spine Surgery Can Be Influenced by Missing Data. Clinical Orthopaedics And Related Research® 2017, 475: 2893-2904. PMID: 27896677, PMCID: PMC5670041, DOI: 10.1007/s11999-016-5175-7.Peer-Reviewed Original ResearchMeSH KeywordsComorbidityData AccuracyData CollectionData MiningDatabases, FactualDecision Support TechniquesHumansLength of StayLogistic ModelsMultivariate AnalysisOdds RatioOperative TimeOrthopedic ProceduresPostoperative ComplicationsPredictive Value of TestsProcess Assessment, Health CareRetrospective StudiesRisk AssessmentRisk FactorsSpinal DiseasesSpineTime FactorsTreatment OutcomeUnited StatesConceptsACS-NSQIP databaseAdverse eventsPreoperative laboratory valuesRisk factorsSpine surgeryOperating room timeLaboratory valuesSpine studiesACS-NSQIPDatabase studyRoom timeReference rangeQuality Improvement Program databasePerioperative laboratory valuesVariable reference rangesAnterior cervical discectomyImprovement Program databaseMost risk factorsLength of stayLarge database studiesDifferent risk factorsEffect sizeCervical discectomyMedical comorbiditiesGreater effect sizeDiscriminative Ability of Elixhauser's Comorbidity Measure is Superior to Other Comorbidity Scores for Inpatient Adverse Outcomes After Total Hip Arthroplasty
Ondeck NT, Bohl DD, Bovonratwet P, McLynn RP, Cui JJ, Grauer JN. Discriminative Ability of Elixhauser's Comorbidity Measure is Superior to Other Comorbidity Scores for Inpatient Adverse Outcomes After Total Hip Arthroplasty. The Journal Of Arthroplasty 2017, 33: 250-257. PMID: 28927567, DOI: 10.1016/j.arth.2017.08.032.Peer-Reviewed Original ResearchConceptsElixhauser comorbidity measuresCharlson Comorbidity IndexTotal hip arthroplastyAdverse outcomesComorbidity measuresComorbidity indexHip arthroplastyDiscriminative abilityBody mass indexNational Inpatient SampleLength of stayAdverse patient outcomesComorbidity scoreHospital stayPerioperative courseFrailty indexMass indexComplication measuresPatient's probabilityInpatient SamplePatient outcomesDemographic factors ageHigh riskOptimize outcomesAdmission centerOutpatient and Inpatient Unicompartmental Knee Arthroplasty Procedures Have Similar Short-Term Complication Profiles
Bovonratwet P, Ondeck NT, Tyagi V, Nelson SJ, Rubin LE, Grauer JN. Outpatient and Inpatient Unicompartmental Knee Arthroplasty Procedures Have Similar Short-Term Complication Profiles. The Journal Of Arthroplasty 2017, 32: 2935-2940. PMID: 28602533, DOI: 10.1016/j.arth.2017.05.018.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAmbulatory Surgical ProceduresArthroplasty, Replacement, KneeCohort StudiesComorbidityDatabases, FactualFemaleHumansInpatientsLength of StayMaleMiddle AgedOutcome Assessment, Health CareOutpatientsPatient ReadmissionPatient SatisfactionPostoperative ComplicationsPropensity ScoreQuality ImprovementUnited StatesConceptsUnicompartmental knee arthroplastyNational Surgical Quality Improvement Program databaseInpatient Unicompartmental Knee ArthroplastyQuality Improvement Program databaseLength of hospitalImprovement Program databasePerioperative complicationsProgram databaseOutpatient unicompartmental knee arthroplastyShort-term complication profileUnicompartmental knee arthroplasty (UKA) proceduresNational patient populationPerioperative outcome measuresHigh patient satisfactionKnee arthroplasty proceduresPotential confounding factorsInpatient cohortPerioperative outcomesPostdischarge complicationsPatient characteristicsComplication profileOutpatient surgeryPatient populationKnee arthroplastyOutpatient procedureComparison of Perioperative Adverse Event Rates After Total Knee Arthroplasty in Patients With Diabetes: Insulin Dependence Makes a Difference
Webb ML, Golinvaux NS, Ibe IK, Bovonratwet P, Ellman MS, Grauer JN. Comparison of Perioperative Adverse Event Rates After Total Knee Arthroplasty in Patients With Diabetes: Insulin Dependence Makes a Difference. The Journal Of Arthroplasty 2017, 32: 2947-2951. PMID: 28559194, DOI: 10.1016/j.arth.2017.04.032.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedArthroplasty, Replacement, KneeComorbidityDatabases, FactualDiabetes Mellitus, Type 1Diabetes Mellitus, Type 2FemaleHumansInsulinMaleMiddle AgedOrthopedic ProceduresPostoperative ComplicationsPrevalenceQuality ImprovementRetrospective StudiesRisk FactorsTreatment OutcomeUnited StatesYoung AdultConceptsTotal knee arthroplastyInsulin-dependent DMDiabetes mellitusAdverse eventsGreater riskKnee arthroplastySurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databasePerioperative adverse event ratesQuality Improvement Program databaseInsulin-dependent diabetes mellitusPerioperative adverse outcomesRetrospective cohort studyImprovement Program databasePerioperative adverse eventsAdverse event ratesDependent diabetes mellitusPreoperative risk stratificationEffective treatment optionMultivariate Poisson regressionMultiple adverse eventsCohort studyInsulin dependencePostoperative daySurgical complicationsAnalysis of Bony and Internal Organ Injuries Associated With 26,357 Adult Femoral Shaft Fractures and Their Impact on Mortality.
Anandasivam NS, Russo GS, Fischer JM, Samuel AM, Ondeck NT, Swallow MS, Chung SH, Bohl DD, Grauer JN. Analysis of Bony and Internal Organ Injuries Associated With 26,357 Adult Femoral Shaft Fractures and Their Impact on Mortality. Orthopedics 2017, 40: e506-e512. PMID: 28358976, DOI: 10.3928/01477447-20170327-01.Peer-Reviewed Original ResearchConceptsFemoral shaft fracturesMechanism of injuryCharlson Comorbidity IndexInjury Severity ScoreCommon MOIInternal organ injuriesShaft fracturesOrgan injuryAge groupsNational Trauma Data BankAdult femoral shaft fracturesRibs/sternumPredictors of mortalityAbdominal organ injuriesTrauma Data BankMultivariate logistic regressionSpectrum of injuriesMotor vehicle accidentsThoracic organ injuryOlder age groupsTibia/fibulaComorbidity burdenComorbidity indexBony injuriesTrauma patientsComparison of Outpatient vs Inpatient Total Knee Arthroplasty: An ACS-NSQIP Analysis
Bovonratwet P, Ondeck NT, Nelson SJ, Cui JJ, Webb ML, Grauer JN. Comparison of Outpatient vs Inpatient Total Knee Arthroplasty: An ACS-NSQIP Analysis. The Journal Of Arthroplasty 2017, 32: 1773-1778. PMID: 28237215, DOI: 10.1016/j.arth.2017.01.043.Peer-Reviewed Original ResearchMeSH KeywordsAgedAmbulatory Surgical ProceduresArthroplasty, Replacement, KneeBlood TransfusionCohort StudiesComorbidityDatabases, FactualFemaleHumansInpatientsMaleMiddle AgedMultivariate AnalysisOutcome Assessment, Health CareOutpatientsPatient ReadmissionPostoperative ComplicationsPropensity ScoreQuality ImprovementConceptsTotal knee arthroplastyOutpatient total knee arthroplastyAdverse eventsKnee arthroplastyOutpatient procedureSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseMultivariate analysisInpatient total knee arthroplastyElective total knee arthroplastyQuality Improvement Program databasePrimary total knee arthroplastyComparison of outpatientPerioperative outcome measuresImprovement Program databasePerioperative adverse eventsIndividual adverse eventsACS-NSQIP AnalysisInpatient cohortHospital lengthLess comorbiditySelect patientsTKA patientsOutpatient cohortPostoperative period
2016
Demographics, Mechanisms of Injury, and Concurrent Injuries Associated With Calcaneus Fractures: A Study of 14 516 Patients in the American College of Surgeons National Trauma Data Bank
Bohl DD, Ondeck NT, Samuel AM, Diaz-Collado PJ, Nelson SJ, Basques BA, Leslie MP, Grauer JN. Demographics, Mechanisms of Injury, and Concurrent Injuries Associated With Calcaneus Fractures: A Study of 14 516 Patients in the American College of Surgeons National Trauma Data Bank. Foot & Ankle Specialist 2016, 10: 402-410. PMID: 27895200, DOI: 10.1177/1938640016679703.Peer-Reviewed Original ResearchConceptsNational Trauma Data BankSurgeons National Trauma Data BankTrauma Data BankCalcaneus fracturesConcurrent injuriesNonorthopaedic injuriesSpine fracturesAmerican CollegeMechanism of injuryLower extremity fracturesLumbar spine fracturesCommon comorbiditiesFracture patientsExtremity fracturesOrgan injuryRetrospective reviewNational sampleHead injuryHigh incidenceInjury mechanismPatientsLevel IIIInjuryHospital departmentsStrong association