2023
Association Between Intravenous to Oral Opioid Transition Time and Length of Hospital Stay After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis.
Hengartner A, Havlik J, David W, Reeves B, Freedman I, Sarkozy M, Maloy G, Fernandez T, Craft S, Koo A, Tuason D, DiLuna M, Elsamadicy A. Association Between Intravenous to Oral Opioid Transition Time and Length of Hospital Stay After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis. The International Journal Of Spine Surgery 2023, 17: 468-476. PMID: 37076256, PMCID: PMC10312154, DOI: 10.14444/8448.Peer-Reviewed Original ResearchPosterior spinal fusionAdolescent idiopathic scoliosisExtended LOSSpinal fusionIdiopathic scoliosisMultivariate analysisMultilevel posterior spinal fusionLength of hospitalPostoperative complication rateMajor academic institutionOral opioidsHospital LOSStudy patientsDischarge dispositionHospital lengthPostoperative complicationsPostoperative courseComplication rateIntraoperative variablesLonger LOSPatient demographicsReadmission ratesMedical recordsUnivariate analysisOdds ratioImpact of insurance status on healthcare resource utilization and outcomes in adolescent patients presenting with spinal cord injuries.
Sandhu M, David W, Reeves B, Sherman J, Craft S, Jayaraj C, Boroumand S, Clappier M, Gutierrez A, Sarkozy M, Koo A, Tuason D, DiLuna M, Elsamadicy A. Impact of insurance status on healthcare resource utilization and outcomes in adolescent patients presenting with spinal cord injuries. Journal Of Neurosurgery Pediatrics 2023, 32: 294-301. PMID: 37021755, DOI: 10.3171/2023.2.peds22506.Peer-Reviewed Original ResearchConceptsSpinal cord injuryHospital adverse eventsHealthcare resource utilizationAdverse eventsInsurance statusAdolescent patientsGovernmental insuranceInsurance cohortCord injuryNon-Hispanic white patientsNational Trauma Data BankPrivate insuranceThoracic spinal cord injuryPrivate insurance cohortAdministrative database studyTrauma Data BankClinical Modification codingMultivariate regression analysisPI cohortMedian LOSAdult patientsDischarge dispositionPatient demographicsSCI patientsWhite patientsDifferences in Outcomes and Health Care Resource Utilization After Surgical Intervention for Metastatic Spinal Column Tumor in Safety-Net Hospitals
Elsamadicy A, Koo A, David W, Reeves B, Sherman J, Craft S, Hersh A, Duvall J, Lo S, Shin J, Mendel E, Sciubba D. Differences in Outcomes and Health Care Resource Utilization After Surgical Intervention for Metastatic Spinal Column Tumor in Safety-Net Hospitals. Spine 2023, 48: 800-809. PMID: 36972069, DOI: 10.1097/brs.0000000000004643.Peer-Reviewed Original ResearchConceptsSpinal column tumorsSNH statusPostoperative complicationsDischarge dispositionMultivariable analysisTumor surgeryMetastatic spinal tumor surgeryHealth care resource utilizationNationwide Inpatient Sample databaseICD-10-CM codingNonroutine discharge dispositionObservational cohort studySpinal tumor surgerySafety-net hospitalNonroutine dischargeSNH patientsHospital lengthStudy patientsAdult patientsCohort studyIntraoperative variablesExtended LOSIndependent predictorsLonger LOSProlonged hospitalizationPrevalence and Influence of Frailty on Hospital Outcomes After Surgical Resection of Spinal Meningiomas
Elsamadicy A, Koo A, Reeves B, Craft S, Sayeed S, Sherman J, Sarkozy M, Aurich L, Fernandez T, Lo S, Shin J, Sciubba D, Mendel E. Prevalence and Influence of Frailty on Hospital Outcomes After Surgical Resection of Spinal Meningiomas. World Neurosurgery 2023, 173: e121-e131. PMID: 36773810, DOI: 10.1016/j.wneu.2023.02.019.Peer-Reviewed Original ResearchConceptsHospital Frailty Risk ScoreLength of stayHealth care resource utilizationSpinal meningiomasNonroutine dischargeAdverse eventsDischarge dispositionInternational ClassificationExtended LOSMean LOSNational Inpatient Sample databaseFrailty Risk ScoreInfluence of frailtyImpact of frailtyRetrospective cohort studyPerioperative adverse eventsTenth Revision codesClinical Modification codesCost of admissionMultivariate regression analysisHospital outcomesPatient frailtyAdult patientsCohort studyPatient demographics
2022
Association of inpatient opioid consumption on postoperative outcomes after open posterior spinal fusion for adult spine deformity
Elsamadicy A, Sandhu M, Reeves B, Freedman I, Koo A, Jayaraj C, Hengartner A, Havlik J, Hersh A, Pennington Z, Lo S, Shin J, Mendel E, Sciubba D. Association of inpatient opioid consumption on postoperative outcomes after open posterior spinal fusion for adult spine deformity. Spine Deformity 2022, 11: 439-453. PMID: 36350557, DOI: 10.1007/s43390-022-00609-2.Peer-Reviewed Original ResearchConceptsAdult spinal deformityInpatient opioid useProportion of patientsOpioid useAdverse eventsHigher MMESpinal fusionHospital costsMME consumptionPostoperative outcomesDischarge dispositionHospital admissionRisk factorsMultivariate analysisLong-term opioid useMethodsA retrospective cohort studyHigh opioid useInpatient opioid consumptionOpioid-related disordersPremier Healthcare DatabasePostoperative adverse eventsPostoperative opioid useRetrospective cohort studyHealthcare resource utilizationNon-routine dischargeLeveraging HFRS to assess how frailty affects healthcare resource utilization after elective ACDF for CSM
Elsamadicy AA, Koo AB, Sarkozy M, David WB, Reeves BC, Patel S, Hansen J, Sandhu MRS, Hengartner AC, Hersh A, Kolb L, Lo SL, Shin JH, Mendel E, Sciubba DM. Leveraging HFRS to assess how frailty affects healthcare resource utilization after elective ACDF for CSM. The Spine Journal 2022, 23: 124-135. PMID: 35988878, DOI: 10.1016/j.spinee.2022.08.004.Peer-Reviewed Original ResearchConceptsHighest Hospital Frailty Risk ScoresHospital Frailty Risk ScoreCervical spondylotic myelopathyNon-routine discharge dispositionDischarge dispositionElective ACDFFrail patientsExtended LOSHospital costsHealth care resource utilizationNationwide Inpatient Sample databaseMultivariate stepwise logistic regressionFrailty Risk ScorePeri-operative protocolSeverity of frailtyTotal admission costLonger hospital stayRetrospective cohort studyAnterior cervical discectomyCervical spine pathologyHealthcare resource utilizationNon-routine dischargeHigh complication rateTotal hospital costsSignificant independent predictorsHigher 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 demographics356 Patient-and-Hospital-Related Risk Factors for Non-Routine Discharge After Lumbar Decompression and Fusion for Spondylolisthesis
Elsamadicy A, Freedman I, Koo A, David W, Hengartner A, Havlik J, Hersh A, Pennington Z, Kolb L, Laurans M, Shin J, Sciubba D. 356 Patient-and-Hospital-Related Risk Factors for Non-Routine Discharge After Lumbar Decompression and Fusion for Spondylolisthesis. Neurosurgery 2022, 68: 84-84. DOI: 10.1227/neu.0000000000001880_356.Peer-Reviewed Original ResearchNon-routine dischargeSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseNon-Hispanic black race/ethnicityQuality Improvement Program databaseICD-9-CM diagnosisBlack race/ethnicityMultivariate logistic regression modelDependent functional statusImprovement Program databaseRetrospective cohort studyProcedural Coding SystemQuality of careMultivariate regression analysisPaucity of dataLogistic regression modelsRace/ethnicityUnplanned readmissionCohort studyDischarge dispositionReadmission ratesAdult patientsAdverse eventsIndependent predictorsLonger LOSHospital Frailty Risk Score and healthcare resource utilization after surgery for metastatic spinal column tumors.
Elsamadicy AA, Koo AB, Reeves BC, Pennington Z, Yu J, Goodwin CR, Kolb L, Laurans M, Lo SL, Shin JH, Sciubba DM. Hospital Frailty Risk Score and healthcare resource utilization after surgery for metastatic spinal column tumors. Journal Of Neurosurgery Spine 2022, 37: 241-251. PMID: 35148505, DOI: 10.3171/2022.1.spine21987.Peer-Reviewed Original ResearchHospital Frailty Risk ScoreLength of staySpinal column tumorsFrailty Risk ScoreNonroutine dischargeHospital admissionHigh frailtyIntermediate frailtyDischarge dispositionSpinal tumorsLower frailtyDiagnostic codesRisk scoreHigher total hospital costsMean LOSNational Inpatient Sample databaseMultivariate logistic regression analysisICD-10 diagnostic codesImpact of frailtyRetrospective cohort studyHealthcare resource utilizationProportion of patientsTotal hospital costsProcedural Coding SystemLogistic regression analysisDifferences 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 metastasesHospital Frailty Risk Score and Healthcare Resource Utilization After Surgery for Primary Spinal Intradural/Cord Tumors
Elsamadicy AA, Koo AB, Reeves BC, Pennington Z, Sarkozy M, Hersh A, Havlik J, Sherman JJZ, Goodwin CR, Kolb L, Laurans M, Lo S, Shin JH, Sciubba DM. Hospital Frailty Risk Score and Healthcare Resource Utilization After Surgery for Primary Spinal Intradural/Cord Tumors. Global Spine Journal 2022, 13: 2074-2084. PMID: 35016582, PMCID: PMC10556884, DOI: 10.1177/21925682211069937.Peer-Reviewed Original ResearchHospital Frailty Risk ScoreNon-routine dischargeFrailty Risk ScoreImpact of frailtyCost of admissionDischarge dispositionFrail cohortPrimary tumorSpinal cordRisk scoreNationwide Inpatient Sample databaseRetrospective cohort studyHealthcare resource utilizationLength of stayPrimary spinal tumorsGreater mean costICD-10 codesICD-10-CM codesLarge national datasetPerioperative complicationsPostoperative complicationsAdult patientsCohort studyLonger LOSPatient characteristicsGeographic variations in health care resource utilization following elective ACDF for cervical spondylotic myelopathy: A national trend analysis
Koo AB, Elsamadicy AA, Sarkozy M, Pathak N, David WB, Freedman IG, Reeves BC, Sciubba DM, Laurans M, Kolb L. Geographic variations in health care resource utilization following elective ACDF for cervical spondylotic myelopathy: A national trend analysis. North American Spine Society Journal (NASSJ) 2022, 9: 100099. PMID: 35141663, PMCID: PMC8819911, DOI: 10.1016/j.xnsj.2022.100099.Peer-Reviewed Original ResearchCervical spondylotic myelopathyLength of stayElective ACDFSpondylotic myelopathyAdult patientsPatient demographicsComplication rateRegional cohortElective anterior cervical discectomyHealth care resource utilizationNational Inpatient Sample databaseAnterior cervical discectomyMean total costHousehold income quartileHealth care deliveryHealth care expendituresNonroutine dischargePerioperative complicationsCervical discectomyDischarge dispositionFemale patientsElixhauser comorbiditiesSurgery variesPrimary diagnosisHospital costs
2021
Independent Association of Obesity and Nonroutine Discharge Disposition After Elective Anterior Cervical Discectomy and Fusion for Cervical Spondylotic Myelopathy
Koo AB, Elsamadicy AA, Sarkozy M, David WB, Reeves BC, Hong CS, Boylan A, Laurans M, Kolb L. Independent Association of Obesity and Nonroutine Discharge Disposition After Elective Anterior Cervical Discectomy and Fusion for Cervical Spondylotic Myelopathy. World Neurosurgery 2021, 151: e950-e960. PMID: 34020060, DOI: 10.1016/j.wneu.2021.05.022.Peer-Reviewed Original ResearchConceptsCervical spondylotic myelopathyNonroutine discharge dispositionAnterior cervical discectomyElective anterior cervical discectomyDischarge dispositionSpondylotic myelopathyCervical discectomyElective ACDFComplication rateNational Inpatient Sample databaseElective spine surgeryOverall complication ratePrevalence of obesityShort-term outcomesLength of stayHospital bed sizeMultivariate regression analysisHealth care coverageMore comorbiditiesNonroutine dischargeDischarge weightIndependent predictorsElixhauser comorbiditiesGreater proportionPrimary diagnosisImpact of race on outcomes and healthcare utilization following spinal fusion for adolescent idiopathic scoliosis
Elsamadicy AA, Koo AB, David WB, Freedman IG, Kundishora AJ, Hong CS, Sarkozy M, Sciubba DM, Kahle KT, DiLuna M. Impact of race on outcomes and healthcare utilization following spinal fusion for adolescent idiopathic scoliosis. Clinical Neurology And Neurosurgery 2021, 206: 106634. PMID: 33979695, DOI: 10.1016/j.clineuro.2021.106634.Peer-Reviewed Original ResearchConceptsPosterior spinal fusionPostoperative complicationsAdolescent idiopathic scoliosisPatient demographicsIdiopathic scoliosisAdolescent patientsSpine surgerySpinal fusionBlack cohortBaseline patient demographicsRate of complicationsMajority of patientsPosterior spine surgeryPosterior spinal surgeryMedian total costBaseline comorbiditiesHospital stayDischarge dispositionInpatient managementPostoperative outcomesBlood transfusionPrimary outcomeFemale patientsHealthcare utilizationHispanic patientsRace 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 rateCost and Health Care Resource Utilization Differences After Spine Surgery for Bony Spine versus Primary Intradural Spine Tumors
Elsamadicy AA, Koo AB, Reeves BC, Freedman IG, Pennington Z, David WB, Ehresman J, Hengartner A, Laurans M, Kolb L, Shin JH, Sciubba DM. Cost and Health Care Resource Utilization Differences After Spine Surgery for Bony Spine versus Primary Intradural Spine Tumors. World Neurosurgery 2021, 151: e286-e298. PMID: 33866030, DOI: 10.1016/j.wneu.2021.04.015.Peer-Reviewed Original ResearchConceptsLength of stayPrimary intradural spinal tumorsIntradural spinal tumorsSpine tumorsSpine surgeryPerioperative complicationsSpinal tumorsNational Inpatient Sample databaseMultivariable logistic regression analysisStepwise multivariable logistic regression analysisBackward stepwise multivariable logistic regression analysisIntradural spinal neoplasmsIntradural spine tumorsRetrospective cohort studyLogistic regression analysisHealth care resourcesMore comorbiditiesAdult patientsCohort studyDischarge dispositionIntraoperative variablesPatient demographicsComplication rateHospital admissionIndependent predictorsThe Effects of Pulmonary Risk Factors on Hospital Resource Use After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis Correction
Elsamadicy AA, Freedman IG, Koo AB, David WB, Havlik J, Kundishora AJ, Sciubba DM, Kahle KT, DiLuna M. The Effects of Pulmonary Risk Factors on Hospital Resource Use After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis Correction. World Neurosurgery 2021, 149: e737-e747. PMID: 33548534, DOI: 10.1016/j.wneu.2021.01.109.Peer-Reviewed Original ResearchConceptsPosterior spinal fusionAdolescent idiopathic scoliosisPreoperative pulmonary risk factorsPulmonary risk factorsLonger hospital stayRisk factorsUnplanned readmissionHospital stayDischarge dispositionSpinal fusionNational Surgical Quality Improvement Program Pediatric databaseSurgeons National Surgical Quality Improvement Program Pediatric databaseSignificant independent risk factorsAdolescent idiopathic scoliosis correctionRetrospective cohort studyIndependent risk factorHospital resource useLength of stayIdiopathic scoliosis correctionHigh rateLonger hospitalPostoperative complicationsCohort studyIntraoperative variablesPatient demographicsOctogenarians Are Independently Associated With Extended LOS and Non-Routine Discharge After Elective ACDF for CSM
Elsamadicy AA, Koo AB, Reeves BC, Freedman IG, David WB, Ehresman J, Pennington Z, Laurans M, Kolb L, Sciubba DM. Octogenarians Are Independently Associated With Extended LOS and Non-Routine Discharge After Elective ACDF for CSM. Global Spine Journal 2021, 12: 1792-1803. PMID: 33511889, PMCID: PMC9609534, DOI: 10.1177/2192568221989293.Peer-Reviewed Original ResearchCervical spondylotic myelopathyNon-routine dischargeRetrospective cohort studyExtended LOSElective ACDFCohort studyDischarge dispositionICD-10-CM diagnosisSignificant independent risk factorsNational Inpatient Sample databaseLonger hospital stayIndependent risk factorSignificant independent predictorsYear cohortYear old cohortHospital stayPerioperative complicationsPostoperative complicationsPatient demographicsSpondylotic myelopathyAdult patientsIndependent predictorsRisk factorsACDFAge 80
2020
Scoring System to Triage Patients for Spine Surgery in the Setting of Limited Resources
Sciubba D, Ehresman J, Pennington Z, Lubelski D, Feghali J, Bydon A, Chou D, Elder B, Elsamadicy A, Goodwin M, Goodwin C, Harrop J, Huq S, Klineberg E, Laufer I, Lo S, Neumaan B, Passias P, Protopsaltis T, Shin J, Theodore N, Witham T, Benzel E. Scoring System to Triage Patients for Spine Surgery in the Setting of Limited Resources. Neurosurgery 2020, 67: nyaa447_684. PMCID: PMC7717415, DOI: 10.1093/neuros/nyaa447_684.Peer-Reviewed Original ResearchScoring systemSpine surgerySurgical casesElective spine surgery patientsFellowship-trained spine surgeonsElective spine surgeryPatient medical comorbiditiesSpine surgery patientsPost-operative complicationsSpine surgery casesLocal disease burdenFinal scoring systemAcademic medical centerElective surgical casesResource-limited settingsWeb-based calculatorHospital courseMedical comorbiditiesDischarge dispositionNeurological statusSurgery patientsDisease burdenSurgery casesMedical CenterSpine surgeonsImpact of Preoperative Anemia on Outcomes After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis
Elsamadicy AA, Freedman IG, Koo AB, David WB, Havlik J, Kundishora AJ, Hong CS, Sciubba DM, Kahle KT, DiLuna M. Impact of Preoperative Anemia on Outcomes After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis. World Neurosurgery 2020, 146: e214-e224. PMID: 33091648, DOI: 10.1016/j.wneu.2020.10.074.Peer-Reviewed Original ResearchConceptsPosterior spinal fusionAdolescent idiopathic scoliosisPreoperative anemiaAnemic cohortHospital stayReadmission ratesIndependent predictorsSpinal fusionIdiopathic scoliosisNational Surgical Quality Improvement Program Pediatric databaseSurgeons National Surgical Quality Improvement Program Pediatric databaseUnplanned reoperation rateLonger hospital stayRetrospective cohort studyThirty-day outcomesLonger operative timeLonger lengthPostoperative complicationsReoperation rateCohort studyDischarge dispositionComplication ratePediatric patientsTransfusion eventsOperative time