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 diagnosis
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 surgeonsScoring System to Triage Patients for Spine Surgery in the Setting of Limited Resources: Application to the Coronavirus Disease 2019 (COVID-19) Pandemic and Beyond
Sciubba DM, Ehresman J, Pennington Z, Lubelski D, Feghali J, Bydon A, Chou D, Elder BD, Elsamadicy AA, Goodwin CR, Goodwin ML, Harrop J, Klineberg EO, Laufer I, Lo SL, Neuman BJ, Passias PG, Protopsaltis T, Shin JH, Theodore N, Witham TF, Benzel EC. Scoring System to Triage Patients for Spine Surgery in the Setting of Limited Resources: Application to the Coronavirus Disease 2019 (COVID-19) Pandemic and Beyond. World Neurosurgery 2020, 140: e373-e380. PMID: 32479913, PMCID: PMC7256646, DOI: 10.1016/j.wneu.2020.05.233.Peer-Reviewed Original ResearchConceptsElective spine surgeryCoronavirus disease 2019 (COVID-19) pandemicDisease 2019 pandemicSpine surgeryScoring systemSurgical casesFellowship-trained spine surgeonsPatient medical comorbiditiesSpine surgery casesLocal disease burdenFinal scoring systemAcademic medical centerElective surgical casesResource-limited settingsWeb-based calculatorHospital courseMedical comorbiditiesPostoperative complicationsDischarge dispositionNeurologic statusDisease burdenSurgery casesMedical CenterSpine surgeonsSpine stability
2018
Does Nasal Carriage of Staphylococcus aureus Increase the Risk of Postoperative Infections After Elective Spine Surgery: Do Most Infections Occur in Carriers?
Adogwa O, Vuong VD, Elsamadicy AA, Lilly DT, Desai SA, Khalid S, Cheng J, Bagley CA. Does Nasal Carriage of Staphylococcus aureus Increase the Risk of Postoperative Infections After Elective Spine Surgery: Do Most Infections Occur in Carriers? World Neurosurgery 2018, 116: e519-e524. PMID: 29772370, DOI: 10.1016/j.wneu.2018.05.025.Peer-Reviewed Original ResearchConceptsSurgical site infectionElective spine surgeryWound infectionNasal colonizationSite infectionSpine surgeryCases of SSIPost-operative surgical site infectionDirect medical record reviewAdult spinal deformity surgeryProspective multi-institutional studyLocal vancomycin powderPostoperative wound infectionDeep wound infectionHistory of diabetesMajority of patientsMedical record reviewDay of surgeryBody mass indexStandard deviation agePost-operative infectionSpinal deformity surgeryMulti-institutional studyBaseline characteristicsNasal carriage
2017
The prevalence of undiagnosed pre-surgical cognitive impairment and its post-surgical clinical impact in elderly patients undergoing surgery for adult spinal deformity
Adogwa O, Elsamadicy AA, Lydon E, Vuong VD, Cheng J, Karikari IO, Bagley CA. The prevalence of undiagnosed pre-surgical cognitive impairment and its post-surgical clinical impact in elderly patients undergoing surgery for adult spinal deformity. Journal Of Spine Surgery 2017, 3: 358-363. PMID: 29057343, PMCID: PMC5637212, DOI: 10.21037/jss.2017.07.01.Peer-Reviewed Original ResearchElderly patientsAdult degenerative scoliosisCognitive impairmentDischarge institutionalizationHospital stayReadmission ratesDegenerative scoliosisSLUMS scorePoor post-operative outcomesPre-existing cognitive impairmentElective spine surgeryMore postoperative complicationsElective spinal surgeryPost-operative deliriumHospital readmission ratesPost-operative outcomesPre-operative evaluationAdult spinal deformityBaseline cognitive impairmentSevere cognitive impairmentMental status testsNeuro-cognitive impairmentHigh rateMild cognitive impairmentPreoperative cognitionRelationship Among Koenig Depression Scale and Postoperative Outcomes, Ambulation, and Perception of Pain in Elderly Patients (≥65 Years) Undergoing Elective Spinal Surgery for Adult Scoliosis
Adogwa O, Elsamadicy AA, Sergesketter AR, Black C, Tarnasky A, Ongele MO, Vuong VD, Khalid S, Cheng J, Bagley CA, Karikari IO. Relationship Among Koenig Depression Scale and Postoperative Outcomes, Ambulation, and Perception of Pain in Elderly Patients (≥65 Years) Undergoing Elective Spinal Surgery for Adult Scoliosis. World Neurosurgery 2017, 107: 471-476. PMID: 28826716, DOI: 10.1016/j.wneu.2017.07.165.Peer-Reviewed Original ResearchConceptsElective spinal surgeryAmbulation abilityElderly patientsHospital dischargeComplication rateHospital stayPostoperative outcomesVAS scoresSpinal surgeryDepression ScaleVisual analog scale scoreSignificant differencesElective spine surgeryInferior postoperative outcomesPreoperative gait speedAnalog scale scoreDepressed elderly patientsPatient-reported outcomesAdult degenerative scoliosisPerception of painBoard-certified geriatriciansPostoperative complicationsBaseline demographicsIntraoperative variablesPrimary outcomeDepression as an independent predictor of postoperative delirium in spine deformity patients undergoing elective spine surgery.
Elsamadicy AA, Adogwa O, Lydon E, Sergesketter A, Kaakati R, Mehta AI, Vasquez RA, Cheng J, Bagley CA, Karikari IO. Depression as an independent predictor of postoperative delirium in spine deformity patients undergoing elective spine surgery. Journal Of Neurosurgery Spine 2017, 27: 209-214. PMID: 28574333, DOI: 10.3171/2017.4.spine161012.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAge FactorsComorbidityDecompression, SurgicalDeliriumDepressionElective Surgical ProceduresFemaleHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisOperative TimePostoperative ComplicationsPrognosisRetrospective StudiesRisk FactorsSpinal CurvaturesSpinal FusionSpineConceptsElective spine surgeryMultivariate logistic regression analysisPostoperative deliriumIndependent risk factorPostoperative complication rateSpine surgeryLogistic regression analysisPatient demographicsComplication rateIndependent predictorsDeformity patientsRisk factorsDepression groupAffective disordersSuperficial surgical site infectionSignificant between-group differencesInferior surgical outcomesPostoperative delirium rateResults Patient demographicsInitial hospital stayProportion of patientsRate of complicationsSurgical site infectionUrinary tract infectionDeep vein thrombosisAssessing the effectiveness of routine use of post-operative in-patient physical therapy services
Adogwa O, Elsamadicy AA, Fialkoff J, Vuong VD, Mehta AI, Vasquez RA, Cheng J, Karikari IO, Bagley CA. Assessing the effectiveness of routine use of post-operative in-patient physical therapy services. Journal Of Spine Surgery 2017, 3: 149-154. PMID: 28744494, PMCID: PMC5506300, DOI: 10.21037/jss.2017.04.03.Peer-Reviewed Original ResearchHospital stayPhysical therapy servicesComplication ratePT cohortTherapy servicesPeri-operative complication ratesPost-operative complication rateRoutine useElective spine surgeryPost-operative ambulationPeri-operative complicationsMajor academic medical centerProlonged bed restAcademic medical centerPT servicesImproved ambulationPerioperative complicationsBaseline characteristicsHospital dischargePatient demographicsReadmission ratesBlood lossAmbulation statusOperative timeRisk stratificationEffects of immediate post-operative pain medication on length of hospital stay: does it make a difference?
Elsamadicy AA, Adogwa O, Fialkoff J, Vuong VD, Mehta AI, Vasquez RA, Cheng J, Bagley CA, Karikari IO. Effects of immediate post-operative pain medication on length of hospital stay: does it make a difference? Journal Of Spine Surgery 2017, 3: 155-162. PMID: 28744495, PMCID: PMC5506320, DOI: 10.21037/jss.2017.04.04.Peer-Reviewed Original ResearchPost-operative pain medicationPatient reported outcomesElective spine surgeryPain medicationUrinary tract infectionSpine surgeryHospital stayComplication ratePatient carePost-operative complication rateSignificant differencesDecreased pain scoresHospital readmission ratesPatient-controlled analgesicMajor academic medical centerAcademic medical centerHealth care costsHealth care dollarsHospital coursePain scoresBaseline characteristicsPatient demographicsReadmission ratesTract infectionsBlood lossAssociation of Intraoperative Blood Transfusions on Postoperative Complications, 30-Day Readmission Rates, and 1-Year Patient-Reported Outcomes
Elsamadicy AA, Adogwa O, Vuong VD, Mehta AI, Vasquez RA, Cheng J, Bagley CA, Karikari IO. Association of Intraoperative Blood Transfusions on Postoperative Complications, 30-Day Readmission Rates, and 1-Year Patient-Reported Outcomes. Spine 2017, 42: 610-615. PMID: 28399073, DOI: 10.1097/brs.0000000000001803.Peer-Reviewed Original ResearchConceptsPerioperative allogeneic RBC transfusionAllogeneic RBC transfusionElective spine surgeryPostoperative complication rateReadmission ratesRBC transfusionSpine surgeryPostoperative complicationsComplication rateThirty-day hospital readmission ratesAllogeneic red blood cell transfusionRed blood cell transfusionMultivariate logistic regression analysisMultivariate logistic regression modelPatient-reported outcome instrumentsHigher perioperative complicationsPostoperative hemoglobin levelsIntraoperative blood transfusionBlood cell transfusionHospital readmission ratesMajor academic medical centerLogistic regression analysisAcademic medical centerQuality of careLogistic regression modelsEffect of Social Support and Marital Status on Perceived Surgical Effectiveness and 30-Day Hospital Readmission
Adogwa O, Elsamadicy AA, Vuong VD, Mehta AI, Vasquez RA, Cheng J, Bagley CA, Karikari IO. Effect of Social Support and Marital Status on Perceived Surgical Effectiveness and 30-Day Hospital Readmission. Global Spine Journal 2017, 7: 774-779. PMID: 29238642, PMCID: PMC5721993, DOI: 10.1177/2192568217696696.Peer-Reviewed Original ResearchElective spine surgerySpine surgeryHospital stayReadmission ratesOutcome measuresLong-term clinical outcomesThirty-day readmission ratesLength of hospitalPostoperative complication rateRetrospective cohort reviewTime of surgeryMarital statusSocial supportMajor academic medical centerAcademic medical centerSignificant differencesBaseline characteristicsCohort reviewPatient demographicsComplication rateHospital readmissionClinical outcomesSurgical outcomesSurgical effectivenessMedical records30-Day Readmission After Spine Surgery
Adogwa O, Elsamadicy AA, Han JL, Karikari IO, Cheng J, Bagley CA. 30-Day Readmission After Spine Surgery. Spine 2017, 42: 520-524. PMID: 28350632, DOI: 10.1097/brs.0000000000001779.Peer-Reviewed Original ResearchConceptsElective spine surgeryUnplanned readmissionSpine surgeryEarly readmissionHospital stayUnplanned early readmissionsCauses of readmissionDays of dischargeRetrospective cohort reviewMajority of patientsCommon primary reasonsPost-discharge careDuke University HospitalSkilled nursing facilitiesQuality of careNonsurgical complicationsRefractory painCohort reviewDischarge careLumbar decompressionSD ageEmergency departmentUniversity HospitalRisk factorsCommon causeEffect of employment status on length of hospital stay, 30-day readmission and patient reported outcomes after spine surgery
Adogwa O, Elsamadicy AA, Fialkoff J, Mehta AI, Vasquez RA, Cheng J, Karikari IO, Bagley CA. Effect of employment status on length of hospital stay, 30-day readmission and patient reported outcomes after spine surgery. Journal Of Spine Surgery 2017, 3: 44-49. PMID: 28435917, PMCID: PMC5386895, DOI: 10.21037/jss.2017.03.08.Peer-Reviewed Original ResearchElective spine surgeryHospital staySpine surgeryReadmission ratesComplication ratePatient cohortFunctional improvementPeri-operative complication ratesPost-operative complication rateEmployment statusUnplanned hospital readmissionDays of dischargeGreater functional improvementMajor academic medical centerAcademic medical centerCause readmissionBaseline characteristicsPatient demographicsBlood lossHospital readmissionPrimary outcomeReadmission preventionUnemployed patientsOperative timeMedical recordsRisk Factors and Independent Predictors of 30-Day Readmission for Altered Mental Status After Elective Spine Surgery for Spine Deformity: A Single-Institutional Study of 1090 Patients
Elsamadicy AA, Adogwa O, Reddy GB, Sergesketter A, Warwick H, Jones T, Cheng J, Bagley CA, Karikari IO. Risk Factors and Independent Predictors of 30-Day Readmission for Altered Mental Status After Elective Spine Surgery for Spine Deformity: A Single-Institutional Study of 1090 Patients. World Neurosurgery 2017, 101: 270-274. PMID: 28192260, DOI: 10.1016/j.wneu.2017.02.001.Peer-Reviewed Original ResearchConceptsElective spine surgeryPostoperative complication rateIndependent predictorsSpine surgeryComplication rateSpine deformityRisk factorsAMS cohortPatient demographicsMental statusInferior surgical outcomesAltered mental statusMultivariate stepwise regression analysisIntensive care unitMajor academic institutionICU transferAdult patientsIntraoperative variablesPulmonary embolismPrimary outcomeCare unitSurgical outcomesMedical recordsReadmissionPatients
2016
Racial Disparities in 30-Day Readmission Rates After Elective Spine Surgery
Adogwa O, Elsamadicy AA, Mehta AI, Cheng J, Bagley CA, Karikari IO. Racial Disparities in 30-Day Readmission Rates After Elective Spine Surgery. Spine 2016, 41: 1677-1682. PMID: 27054453, DOI: 10.1097/brs.0000000000001616.Peer-Reviewed Original ResearchConceptsElective spine surgerySpine surgeryReadmission ratesBlack patientsUnplanned readmissionIndependent predictorsWhite patientsOutcome measuresMultivariate logistic regression modelRacial disparitiesCauses of readmissionDays of dischargeRetrospective cohort reviewRisk-adjusted oddsHigher readmission ratesBody mass indexPost-discharge careMain outcome measuresMultivariate logistic regressionMajor academic medical centerAcademic medical centerLogistic regression modelsHospital stayNonsurgical complicationsBaseline characteristicsPatient 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 surgeryPreoperative Nutritional Status is an Independent Predictor of 30-day Hospital Readmission After Elective Spine Surgery
Adogwa O, Elsamadicy AA, Mehta AI, Cheng J, Bagley CA, Karikari IO. Preoperative Nutritional Status is an Independent Predictor of 30-day Hospital Readmission After Elective Spine Surgery. Spine 2016, 41: 1400-1404. PMID: 26953667, DOI: 10.1097/brs.0000000000001551.Peer-Reviewed Original ResearchConceptsElective spine surgeryPreoperative serum albumin levelDays of dischargeIndependent risk factorSerum albumin levelHospital readmissionSpine surgeryRisk factorsReadmission ratesPreoperative malnutritionMalnourished patientsAlbumin levelsIndependent predictorsThirty-day hospital readmission ratesNutritional statusMultivariate logistic regression analysisPre-operative malnutritionPreoperative nutritional statusUnplanned hospital readmissionModifiable risk factorsPostoperative complication rateRetrospective cohort reviewHospital readmission ratesIdentification of patientsMajor academic medical centerDrivers of 30-Day Readmission in Elderly Patients (>65 Years Old) After Spine Surgery: An Analysis of 500 Consecutive Spine Surgery Patients
Adogwa O, Elsamadicy AA, Han J, Karikari IO, Cheng J, Bagley CA. Drivers of 30-Day Readmission in Elderly Patients (>65 Years Old) After Spine Surgery: An Analysis of 500 Consecutive Spine Surgery Patients. World Neurosurgery 2016, 97: 518-522. PMID: 27474458, DOI: 10.1016/j.wneu.2016.07.032.Peer-Reviewed Original ResearchConceptsElective spine surgerySpine surgeryUnplanned readmissionEarly readmissionElderly patientsHospital stayConsecutive spine surgery patientsCauses of readmissionSpine surgery patientsDays of dischargeMajority of patientsCommon primary reasonsSkilled nursing facilitiesQuality of carePaucity of dataMajor academic hospitalNonsurgical complicationsSD ageSurgery patientsEmergency departmentMental statusAcademic hospitalCommon causeReadmissionNursing facilitiesAssociation Between Baseline Affective Disorders and 30-Day Readmission Rates in Patients Undergoing Elective Spine Surgery
Adogwa O, Elsamadicy AA, Mehta AI, Vasquez RA, Cheng J, Karikari IO, Bagley CA. Association Between Baseline Affective Disorders and 30-Day Readmission Rates in Patients Undergoing Elective Spine Surgery. World Neurosurgery 2016, 94: 432-436. PMID: 27450978, DOI: 10.1016/j.wneu.2016.07.045.Peer-Reviewed Original ResearchConceptsElective spine surgeryDays of dischargeSpine surgeryReadmission ratesPsychiatric comorbidityAffective disordersCause readmissionMultivariate logistic regression modelPatient-reported outcome measuresPatient-reported outcome dataRate of readmissionBody mass indexMajor academic medical centerAcademic medical centerLogistic regression modelsUnplanned readmissionBaseline characteristicsEarly readmissionPatient ageIndependent predictorsPrimary outcomeMass indexPsychologic disordersMedical recordsUnivariate analysis