2023
Impact 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
Impact of Affective Disorders on Inpatient Opioid Consumption and Hospital Outcomes Following Open Posterior Spinal Fusion for Adult Spine Deformity
Elsamadicy A, Sandhu M, Reeves B, Jafar T, Craft S, Sherman J, Hersh A, Koo A, Kolb L, Lo S, Shin J, Mendel E, Sciubba D. Impact of Affective Disorders on Inpatient Opioid Consumption and Hospital Outcomes Following Open Posterior Spinal Fusion for Adult Spine Deformity. World Neurosurgery 2022, 170: e223-e235. PMID: 36332777, DOI: 10.1016/j.wneu.2022.10.114.Peer-Reviewed Original ResearchConceptsInpatient narcotic consumptionInpatient opioid consumptionHealthcare resource utilizationAD cohortAffective disordersNonroutine dischargeOpioid consumptionNarcotic consumptionSpinal fusionAdult spinal deformity surgeryInpatient opioid usePremier Healthcare DatabaseRetrospective cohort studyPosterior spinal fusionLength of staySpinal deformity surgeryAdult spinal deformityAdult spine deformityYears of ageGreater proportionMultivariate regression analysisNon-Hispanic whitesHospital outcomesStudy patientsCohort studyLeveraging 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 demographics
2021
Effects of preoperative nutritional status on complications and readmissions after posterior lumbar decompression and fusion for spondylolisthesis: A propensity-score analysis
Elsamadicy AA, Havlik J, Reeves BC, Koo AB, Sherman J, Lo SL, Shin JH, Sciubba DM. Effects of preoperative nutritional status on complications and readmissions after posterior lumbar decompression and fusion for spondylolisthesis: A propensity-score analysis. Clinical Neurology And Neurosurgery 2021, 211: 107017. PMID: 34781222, DOI: 10.1016/j.clineuro.2021.107017.Peer-Reviewed Original ResearchConceptsUnplanned readmissionAdverse eventsSpine surgerySurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseOccurrence of AEsPreoperative serum albumin levelQuality Improvement Program databaseMultivariate logistic regression analysisPosterior lumbar decompressionPreoperative nutritional statusHigh rateImprovement Program databaseRetrospective cohort studySerum albumin levelSignificant independent predictorsEffects of malnutritionLogistic regression analysisPropensity score analysisPropensity-score matchingMalnourished cohortMalnourished patientsPerioperative complicationsPostoperative complicationsLumbar decompressionRacial 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 ratioModified-frailty index does not independently predict complications, hospital length of stay or 30-day readmission rates following posterior lumbar decompression and fusion for spondylolisthesis
Elsamadicy AA, Freedman IG, Koo AB, David WB, Reeves BC, Havlik J, Pennington Z, Kolb L, Shin JH, Sciubba DM. Modified-frailty index does not independently predict complications, hospital length of stay or 30-day readmission rates following posterior lumbar decompression and fusion for spondylolisthesis. The Spine Journal 2021, 21: 1812-1821. PMID: 34010683, DOI: 10.1016/j.spinee.2021.05.011.Peer-Reviewed Original ResearchConceptsUnplanned readmissionAdverse eventsLumbar spinal decompressionHospital lengthReadmission ratesIndependent predictorsSpinal decompressionNational Surgical Quality Improvement Program databaseQuality Improvement Program databasePosterior lumbar spinal fusionChronic obstructive pulmonary diseaseMultivariate logistic regression analysisICD-9-CM diagnosisDependent functional statusHypertension requiring medicationInferior surgical outcomesLonger hospital stayRetrospective cohort studyImprovement Program databaseCongestive heart failureObstructive pulmonary diseaseSurgical adverse eventsSignificant independent predictorsLumbar spinal fusionProcedural Coding SystemImpact 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 demographics
2020
Impact 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 timePredictors of Extended Length of Stay Following Treatment of Unruptured Adult Cerebral Aneurysms: A Study of The National Inpatient Sample
Koo AB, Elsamadicy AA, Lin IH, David WB, Sujijantarat N, Santarosa C, Cord BJ, Zetchi A, Hebert R, Bahrassa F, Malhotra A, Matouk CC. Predictors of Extended Length of Stay Following Treatment of Unruptured Adult Cerebral Aneurysms: A Study of The National Inpatient Sample. Journal Of Stroke And Cerebrovascular Diseases 2020, 29: 105230. PMID: 33066916, DOI: 10.1016/j.jstrokecerebrovasdis.2020.105230.Peer-Reviewed Original ResearchMeSH KeywordsAgedComorbidityDatabases, FactualEndovascular ProceduresFemaleHospital CostsHumansInpatientsIntracranial AneurysmLength of StayMaleMicrosurgeryMiddle AgedOutcome and Process Assessment, Health CarePatient AdmissionPostoperative ComplicationsQuality Indicators, Health CareRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeUnited StatesConceptsLOS cohortExtended LOSMultivariate logistic regressionUnruptured cerebral aneurysmsCerebral aneurysmsPreadmission comorbiditiesInpatient complicationsHospital stayMore patientsOdds ratioUnruptured aneurysmsHealthcare costsMultiple patient-specific factorsLogistic regressionOverall complication rateHospital-level factorsNon-routine dischargePatient-level factorsNational Inpatient SamplePatient-specific factorsOverall healthcare costsChoice of procedureIndex admissionPostoperative complicationsComplication rateClinical and economic burden of neurofibromatosis type 2 in the United States
Koo AB, Yeung JT, Freedman IG, Lee JH, Ahmed OM, Ma AK, Miyagishima DF, DiLuna M, Kahle K. Clinical and economic burden of neurofibromatosis type 2 in the United States. Clinical Neurology And Neurosurgery 2020, 197: 106053. PMID: 32683193, DOI: 10.1016/j.clineuro.2020.106053.Peer-Reviewed Original ResearchConceptsOpen resectionPatient demographicsRisk factorsMeningioma resectionMulti-year cross-sectional studyNeurofibromatosis type 2 (NF2) patientsSpine tumor resectionCommon admission diagnosesNational Inpatient SampleType 2 patientsCross-sectional studySignificant independent associationNeurofibromatosis type 2Regression analysisInflation-adjusted costAdmission diagnosisHospital stayDischarge weightIndependent predictorsObstructive hydrocephalusSurgical interventionDiagnosis codesHospital characteristicsInpatient populationInpatient SamplePortending Influence of Racial Disparities on Extended Length of Stay after Elective Anterior Cervical Discectomy and Interbody Fusion for Cervical Spondylotic Myelopathy
Elsamadicy AA, Koo AB, David WB, Sarkozy M, Freedman IG, Reeves BC, Laurans M, Kolb L, Sciubba DM. Portending Influence of Racial Disparities on Extended Length of Stay after Elective Anterior Cervical Discectomy and Interbody Fusion for Cervical Spondylotic Myelopathy. World Neurosurgery 2020, 142: e173-e182. PMID: 32599203, DOI: 10.1016/j.wneu.2020.06.155.Peer-Reviewed Original ResearchMeSH KeywordsAgedBlack or African AmericanCerebrospinal Fluid LeakCervical VertebraeCohort StudiesComorbidityDiskectomyElective Surgical ProceduresFemaleHealthcare DisparitiesHumansIntraoperative ComplicationsLength of StayMaleMiddle AgedPostoperative ComplicationsPrevalenceRetrospective StudiesSpinal Cord CompressionSpinal FusionSpondylosisUnited StatesWhite PeopleConceptsCervical spondylotic myelopathyElective anterior cervical discectomyAnterior cervical discectomyAA cohortSpondylotic myelopathyCervical discectomyExtended LOSC cohortSignificant independent risk factorsNational Inpatient Sample databaseLonger hospital stayPrevalence of comorbiditiesRetrospective cohort studyIndependent risk factorNumber of complicationsAfrican AmericansElective ACDFNonroutine dischargeAA raceC patientsHospital stayAdult patientsCohort studyIndependent predictorsAA patientsPre-operative headaches and obstructive hydrocephalus predict an extended length of stay following suboccipital decompression for pediatric Chiari I malformation
Elsamadicy AA, Koo AB, David WB, Kundishora AJ, Hong CS, Sarkozy M, Kahle KT, DiLuna M. Pre-operative headaches and obstructive hydrocephalus predict an extended length of stay following suboccipital decompression for pediatric Chiari I malformation. Child's Nervous System 2020, 37: 91-99. PMID: 32519127, DOI: 10.1007/s00381-020-04688-2.Peer-Reviewed Original ResearchConceptsPediatric CM-I patientsExtended LOSMultivariate logistic regressionCM-I patientsObstructive hydrocephalusSurgical decompressionSuboccipital decompressionElectrolyte disordersRisk factorsHeadache symptomsHospital-level risk factorsLogistic regressionChiari malformation type IPediatric Chiari I malformationPost-operative complicationsImpact of patientChiari I malformationRisk-adjusted LOSYoung childrenAdmission comorbiditiesMethodsThe KidsPediatric CMHospital stayPatient comorbiditiesPatient demographicsAssociated risk factors for extended length of stay following anterior cervical discectomy and fusion for cervical spondylotic myelopathy
Elsamadicy AA, Koo AB, Lee M, David WB, Kundishora AJ, Robert SM, Kuzmik GA, Coutinho PO, Kolb L, Laurans M, Abbed K. Associated risk factors for extended length of stay following anterior cervical discectomy and fusion for cervical spondylotic myelopathy. Clinical Neurology And Neurosurgery 2020, 195: 105883. PMID: 32428797, DOI: 10.1016/j.clineuro.2020.105883.Peer-Reviewed Original ResearchConceptsCervical spondylotic myelopathyHospital-level factorsLOS cohortAnterior cervical discectomyExtended LOSMultivariate logistic regressionSpondylotic myelopathyPostoperative complicationsCervical discectomyBlood transfusionOdds ratioNational Inpatient Sample databaseLogistic regressionFurther investigational studiesOverall complication rateNon-routine dischargeAssociated risk factorsNational cohort studyNumber of complicationsRisk-adjusted LOSGreater overall costsLow socioeconomic statusPaucity of literatureHospital LOSHospital stayInfluence of gender on discharge disposition after spinal fusion for adult spine deformity correction
Elsamadicy AA, Freedman IG, Koo AB, David WB, Lee M, Kundishora AJ, Kuzmik GA, Gorrepati R, Hong CS, Kolb L, Laurans M, Abbed K. Influence of gender on discharge disposition after spinal fusion for adult spine deformity correction. Clinical Neurology And Neurosurgery 2020, 194: 105875. PMID: 32388244, DOI: 10.1016/j.clineuro.2020.105875.Peer-Reviewed Original ResearchConceptsDischarge dispositionSpine deformity correctionSpinal fusionFemale cohortMale cohortDeformity correctionElective spine fusion surgeryNon-routine discharge dispositionNationwide Inpatient Sample databaseSpine surgical careSurgical site hematomaNon-routine dischargeElective spinal fusionICD-9 codesSpine fusion surgeryInfluence of genderPostoperative MIPostoperative UTIHospital staySite hematomaHospital factorsIndependent predictorsMale patientsFemale patientsFusion surgery