2024
High inpatient-opioid consumption predicts extended length of hospital stay in patients undergoing spinal fusion for adolescent idiopathic scoliosis
Sandhu M, Craft S, Reeves B, Sayeed S, Hengartner A, Tuason D, DiLuna M, Elsamadicy A. High inpatient-opioid consumption predicts extended length of hospital stay in patients undergoing spinal fusion for adolescent idiopathic scoliosis. Spine Deformity 2024, 1-11. PMID: 39320702, DOI: 10.1007/s43390-024-00960-6.Peer-Reviewed Original ResearchLength of hospital stayPosterior spinal fusionAdolescent idiopathic scoliosisProportion of patientsAdverse eventsCost of admissionHospital stayIdiopathic scoliosisSpinal fusionMethodsA retrospective cohort studyLogistic multivariate regression analysisIncreased 30-day readmission ratePost-operative adverse eventsExtended length of hospital stayHospital length of stayReadmission ratesPost-operative analgesiaRetrospective cohort studyPremier Healthcare DatabaseHigh cohortPerioperative adverse eventsMultivariate regression analysisIncreased cost of admissionLength of staySpine surgery
2023
Implications of Frailty on Postoperative Health Care Resource Utilization in Ankylosing Spondylitis Patients Undergoing Spine Surgery for Spinal Fractures
Elsamadicy A, Sayeed S, Sadeghzadeh S, Reeves B, Sherman J, Craft S, Serrato P, Larry Lo S, Sciubba D. Implications of Frailty on Postoperative Health Care Resource Utilization in Ankylosing Spondylitis Patients Undergoing Spine Surgery for Spinal Fractures. World Neurosurgery 2023, 182: e16-e28. PMID: 37925147, DOI: 10.1016/j.wneu.2023.10.136.Peer-Reviewed Original ResearchNon-routine dischargeExtended hospital stayIndependent predictorsHospital stayAdverse eventsModified Frailty Index scoreNational Inpatient Sample databaseMultivariate logistic regression analysisFrailty index scoreHealthcare resource utilizationNumber of comorbiditiesHigher hospital costsPosterior spinal fusionCost of admissionImplications of frailtyLogistic regression analysisMultiple adverse eventsHealth care costsQuality patient careGreater comorbidityAdult patientsSpondylitis patientsElective surgeryRetrospective studySurgical outcomesEffects of delayed ambulation following posterior spinal fusion for adolescent idiopathic scoliosis: a single institutional study
Hengartner A, David W, Reeves B, Craft S, Boroumand S, Clappier M, Hansen J, Fernandez T, Koo A, Tuason D, DiLuna M, Elsamadicy A. Effects of delayed ambulation following posterior spinal fusion for adolescent idiopathic scoliosis: a single institutional study. Spine Deformity 2023, 11: 1127-1136. PMID: 37093449, DOI: 10.1007/s43390-023-00693-y.Peer-Reviewed Original ResearchConceptsPosterior spinal fusionAdolescent idiopathic scoliosisSpinal fusionPostoperative complicationsRisk factorsIdiopathic scoliosisMultivariate stepwise logistic regressionOral pain medicationTotal hospital lengthTwenty-nine patientsMethodsThe medical recordsSingle institutional studyStepwise logistic regressionMajor academic institutionHospital lengthHospital stayNine patientsPain medicationUnplanned readmissionIntraoperative variablesPatient demographicsPostoperative outcomesRBC transfusionHealthcare utilizationOperative time
2022
134 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 presentations
2021
Ramifications of Postoperative Dysphagia on Health Care Resource Utilization Following Elective Anterior Cervical Discectomy and Interbody Fusion for Cervical Spondylotic Myelopathy
Elsamadicy AA, Koo AB, David WB, Freedman IG, Reeves BC, Ehresman J, Pennington Z, Sarkozy M, Laurans M, Kolb L, Shin JH, Sciubba DM. Ramifications of Postoperative Dysphagia on Health Care Resource Utilization Following Elective Anterior Cervical Discectomy and Interbody Fusion for Cervical Spondylotic Myelopathy. Clinical Spine Surgery A Spine Publication 2021, 35: e380-e388. PMID: 34321392, DOI: 10.1097/bsd.0000000000001241.Peer-Reviewed Original ResearchConceptsHealth care resource utilizationCervical spondylotic myelopathyElective anterior cervical discectomyPostoperative dysphagiaRetrospective cohort studyAnterior cervical discectomySpondylotic myelopathyNonroutine dischargeHospital stayCervical discectomyCohort studyRisk factorsOdds ratioHigher total costsICD-10-CM diagnosisSignificant independent risk factorsNationwide Inpatient Sample databaseMultivariate stepwise logistic regressionLonger hospital LOSLonger hospital stayIndependent risk factorPatient risk factorsStepwise logistic regressionPaucity of dataHospital LOSImpact 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 patientsThe 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
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 ratePortending 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 surgeryIndependent Association Between Type of Intraoperative Blood Transfusion and Postoperative Delirium After Complex Spinal Fusion for Adult Deformity Correction.
Elsamadicy AA, Adil SM, Charalambous L, Drysdale N, Koo AB, Lee M, Kundishora AJ, Camara-Quintana J, Kolb L, Laurans M, Abbed K, Karikari IO. Independent Association Between Type of Intraoperative Blood Transfusion and Postoperative Delirium After Complex Spinal Fusion for Adult Deformity Correction. Spine 2020, 45: 268-274. PMID: 31996654, DOI: 10.1097/brs.0000000000003260.Peer-Reviewed Original ResearchConceptsIntraoperative blood transfusionComplex spinal fusionAllogenic blood transfusionPostoperative deliriumBlood transfusionSpinal fusionIndependent associationDeformity correctionMultivariate nominal-logistic regression analysisPrimary complex spinal fusionAdult spine deformity patientsAdult deformity correctionBetter overall patient careGreater complication risksRetrospective cohort studySpine deformity patientsOverall patient careNominal logistic regression analysisMajor academic institutionHospital stayCohort studyBlood lossPrimary outcomeComplication riskDeformity patients
2019
Reduced influence of affective disorders on perioperative complication rates, length of hospital stay, and healthcare costs following spinal fusion for adolescent idiopathic scoliosis.
Elsamadicy AA, Koo AB, Lee M, Kundishora AJ, Hong CS, Hengartner AC, Camara-Quintana J, Kahle KT, DiLuna ML. Reduced influence of affective disorders on perioperative complication rates, length of hospital stay, and healthcare costs following spinal fusion for adolescent idiopathic scoliosis. Journal Of Neurosurgery Pediatrics 2019, 24: 722-727. PMID: 31491756, DOI: 10.3171/2019.7.peds19223.Peer-Reviewed Original ResearchLength of stayPerioperative complication ratePosterior spinal fusionElective posterior spinal fusionMajority of patientsDischarge dispositionComplication rateQuality of careAffective disordersAdolescent patientsIdiopathic scoliosisPostoperative complicationsInpatient DatabaseSpinal fusionNonroutine discharge dispositionHospital-level factorsProportion of patientsOverall patient satisfactionKids' Inpatient DatabaseNumber of complicationsConcurrent affective disorderAdolescent idiopathic scoliosisHospital stayPatient comorbiditiesPatient demographicsIndependent Patient Risk Factors Associated With Increased Length of Hospital Stay, Unplanned Return to Operating Room, and 30-Day Readmission Rates After Posterior Cervical Fusion for Cervical Spondylotic Myelopathy
Elsamadicy A, Chouairi F, Lee M, Koo A, Kundishora A, Camara-Quintana J, Kolb L, Laurans M, Abbed K. Independent Patient Risk Factors Associated With Increased Length of Hospital Stay, Unplanned Return to Operating Room, and 30-Day Readmission Rates After Posterior Cervical Fusion for Cervical Spondylotic Myelopathy. Neurosurgery 2019, 66: 310-815. DOI: 10.1093/neuros/nyz310_815.Peer-Reviewed Original ResearchRate of instrumentation changes on postoperative and follow-up radiographs after primary complex spinal fusion (five or more levels) for adult deformity correction.
Elsamadicy AA, Lubkin DT, Sergesketter AR, Adil SM, Charalambous LT, Drysdale N, Williamson T, Camara-Quintana J, Abd-El-Barr MM, Goodwin CR, Karikari IO. Rate of instrumentation changes on postoperative and follow-up radiographs after primary complex spinal fusion (five or more levels) for adult deformity correction. Journal Of Neurosurgery Spine 2019, 30: 376-381. PMID: 30641841, DOI: 10.3171/2018.9.spine18686.Peer-Reviewed Original ResearchConceptsPrimary complex spinal fusionComplex spinal fusionSpinal fusionSpine surgeryDeformity correctionAdult deformity correctionCost-conscious healthcareMethodsThe medical recordsPostoperative complication rateMean lengthBody mass indexFollow-up radiographsRevision of surgeryComplex spine surgeryMajor academic institutionHospital stayAdult patientsComplication ratePatient demographicsReadmission ratesBlood lossPrimary outcomeMass indexEarly radiographsPostoperative radiographs
2018
Impact of Chronic Obstructive Pulmonary Disease on Postoperative Complication Rates, Ambulation, and Length of Hospital Stay After Elective Spinal Fusion (≥3 Levels) in Elderly Spine Deformity Patients
Elsamadicy AA, Sergesketter AR, Kemeny H, Adogwa O, Tarnasky A, Charalambous L, Lubkin DET, Davison MA, Cheng J, Bagley CA, Karikari IO. Impact of Chronic Obstructive Pulmonary Disease on Postoperative Complication Rates, Ambulation, and Length of Hospital Stay After Elective Spinal Fusion (≥3 Levels) in Elderly Spine Deformity Patients. World Neurosurgery 2018, 116: e1122-e1128. PMID: 29870850, DOI: 10.1016/j.wneu.2018.05.185.Peer-Reviewed Original ResearchConceptsChronic obstructive pulmonary diseaseElective spinal fusionPostoperative complication rateObstructive pulmonary diseaseSpine deformity patientsHospital stayCOPD cohortComplication rateSpinal fusionDeformity patientsPulmonary diseaseIncidence of durotomyModifiable risk factorsProportion of smokersLength of staySpinal deformity patientsHealth care resourcesHigh rateMajor academic institutionPostoperative feverPostoperative pneumoniaAmbulatory statusHospital lengthPostoperative complicationsElderly patientsThe use of subfascial drains after multi-level anterior cervical discectomy and fusion: does the data support its use?
Adogwa O, Khalid SI, Elsamadicy AA, Voung VD, Lilly DT, Desai SA, Sergesketter AR, Cheng J, Karikari IO. The use of subfascial drains after multi-level anterior cervical discectomy and fusion: does the data support its use? Journal Of Spine Surgery 2018, 4: 227-232. PMID: 30069511, PMCID: PMC6046311, DOI: 10.21037/jss.2018.05.10.Peer-Reviewed Original ResearchSurgical site infectionMulti-level anterior cervical discectomyAnterior cervical discectomySubfascial drainsDrain useHematoma formationACDF proceduresHospital stayCervical discectomyComparison cohortBlood transfusionDecreased incidenceDirect medical record reviewPost-operative blood transfusionDegenerative cervical stenosisMulti-level ACDFAllogenic blood transfusionPercent of patientsConsecutive adult patientsMedical record reviewPost-operative hematomaTime of surgeryCervical stenosisMultilevel ACDFAdult patients