2022
Assessment of Spinal Metastases Surgery Risk Stratification Tools in Breast Cancer by Molecular Subtype
Duvall J, Massaad E, Siraj L, Kiapour A, Connolly I, Hadzipasic M, Elsamadicy A, Williamson T, Shankar G, Schoenfeld A, Fourman M, Shin J. Assessment of Spinal Metastases Surgery Risk Stratification Tools in Breast Cancer by Molecular Subtype. Neurosurgery 2022, 92: 83-91. PMID: 36305664, PMCID: PMC10158884, DOI: 10.1227/neu.0000000000002180.Peer-Reviewed Original ResearchConceptsHuman epidermal growth factor receptor 2Epidermal growth factor receptor 2Triple-negative breast cancerGrowth factor receptor 2Factor receptor 2Breast cancerHazard ratioSpine metastasesMolecular subtypesReceptor 2Retrospective multi-institutional studyHormone receptorsBreast cancer molecular subtypesPostoperative systemic therapySystemic treatment plansPoor physical activityRisk stratification toolSpinal metastasis surgeryCancer molecular subtypesMulti-institutional studyMassachusetts General HospitalMolecular featuresPostoperative chemotherapyBrain metastasesEndocrine therapy
2021
Patient- and hospital-related risk factors for non-routine discharge after lumbar decompression and fusion for spondylolisthesis
Elsamadicy AA, Freedman IG, Koo AB, David W, Hengartner AC, Havlik J, Reeves BC, Hersh A, Pennington Z, Kolb L, Laurans M, Shin JH, Sciubba DM. Patient- and hospital-related risk factors for non-routine discharge after lumbar decompression and fusion for spondylolisthesis. Clinical Neurology And Neurosurgery 2021, 209: 106902. PMID: 34481141, DOI: 10.1016/j.clineuro.2021.106902.Peer-Reviewed Original ResearchConceptsNon-routine dischargeDependent functional statusAdverse eventsIndependent predictorsUnplanned readmissionLonger LOSSpinal decompressionLumbar spondylolisthesisFemale sexFunctional statusSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseNon-Hispanic black race/ethnicityHospital-related risk factorsQuality Improvement Program databaseNon-Hispanic black raceICD-9-CM diagnosisBlack race/ethnicityMultivariate logistic regression modelNon-home dischargeHospital-related factorsImprovement Program databaseRetrospective cohort studyLength of stayProcedural Coding SystemFenestrated pedicle screws for thoracolumbar instrumentation in patients with poor bone quality: Case series and systematic review of the literature
Ehresman J, Pennington Z, Elsamadicy AA, Hersh A, Lubelski D, Lehner K, Cottrill E, Schilling A, Lakomkin N, Ahmed AK, Lo SF, Sciubba DM. Fenestrated pedicle screws for thoracolumbar instrumentation in patients with poor bone quality: Case series and systematic review of the literature. Clinical Neurology And Neurosurgery 2021, 206: 106675. PMID: 34020324, DOI: 10.1016/j.clineuro.2021.106675.Peer-Reviewed Original ResearchConceptsPulmonary cement embolismFenestrated pedicle screwsCement leakageBone qualityCement embolismInstrumented fusionHardware looseningOsteoporotic fracturesPedicle screwsSystematic reviewSymptomatic pulmonary cement embolismNon-augmented patientsSingle-surgeon seriesDegenerative spine diseaseHigh-quality evidencePoor bone qualityEndpoints of interestLow reported ratesPathologic fractureCase seriesSpine metastasesFenestrated screwsSpine diseasePRISMA guidelinesPatientsPatient Risk Factors Associated With 30- and 90-Day Readmission After Ventriculoperitoneal Shunt Placement for Idiopathic Normal Pressure Hydrocephalus in Elderly Patients: A Nationwide Readmission Study
Koo AB, Elsamadicy AA, Lin IH, David WB, Reeves BC, Santarosa C, Cord B, Malhotra A, Kahle KT, Matouk CC. Patient Risk Factors Associated With 30- and 90-Day Readmission After Ventriculoperitoneal Shunt Placement for Idiopathic Normal Pressure Hydrocephalus in Elderly Patients: A Nationwide Readmission Study. World Neurosurgery 2021, 152: e23-e31. PMID: 33862298, DOI: 10.1016/j.wneu.2021.04.010.Peer-Reviewed Original ResearchConceptsIdiopathic normal pressure hydrocephalusVP shunt surgeryShunt surgeryElderly patientsNormal pressure hydrocephalusPressure hydrocephalusNationwide Readmissions DatabaseVentriculoperitoneal shunt surgeryPatient risk factorsVentriculoperitoneal shunt placementQuality of careMultivariate regression analysisIndex admissionUnplanned readmissionReadmission ratesRenal failureMechanical complicationsPostoperative infectionShunt placementNinth RevisionFemale sexRisk factorsSubdural hemorrhageClinical ModificationReadmission
2020
Withdrawal of Life-supporting Treatment in Severe Traumatic Brain Injury
Williamson T, Ryser MD, Ubel PA, Abdelgadir J, Spears CA, Liu B, Komisarow J, Lemmon ME, Elsamadicy A, Lad SP. Withdrawal of Life-supporting Treatment in Severe Traumatic Brain Injury. JAMA Surgery 2020, 155: 723-731. PMID: 32584926, PMCID: PMC7301301, DOI: 10.1001/jamasurg.2020.1790.Peer-Reviewed Original ResearchConceptsSevere traumatic brain injuryLife-supporting treatmentTraumatic brain injuryBrain injurySurgeons Trauma Quality Improvement Program databaseTrauma Quality Improvement Program databaseLower Glasgow Coma Scale scoreHigher Injury Severity ScoreQuality Improvement Program databaseGlasgow Coma Scale scoreImprovement Program databaseInjury Severity ScoreSelf-pay patientsDependent health statusOlder patientsAdult patientsClinical factorsWhite patientsBlack patientsMultivariable analysisTrauma centerDisseminated cancerSeverity scoreProgram databaseRetrospective analysisLaser interstitial thermal therapy (LITT) vs. bevacizumab for radiation necrosis in previously irradiated brain metastases
Sujijantarat N, Hong CS, Owusu KA, Elsamadicy AA, Antonios JP, Koo AB, Baehring JM, Chiang VL. Laser interstitial thermal therapy (LITT) vs. bevacizumab for radiation necrosis in previously irradiated brain metastases. Journal Of Neuro-Oncology 2020, 148: 641-649. PMID: 32602021, DOI: 10.1007/s11060-020-03570-0.Peer-Reviewed Original ResearchConceptsLaser interstitial thermal therapyLonger overall survivalRadiation necrosisInterstitial thermal therapyBrain metastasesOverall survivalMedian volume decreaseMedian volume increaseBrain metastasis patientsPre-treatment patient characteristicsRetrospective chart reviewResultsTwenty-five patientsPre-treatment factorsBevacizumab patientsChart reviewMetastasis patientsLocal recurrencePatient characteristicsTreatment optionsTreatment responseBevacizumabPatientsLesional volumeThermal therapyStatistical significanceThirty- and 90-Day Readmissions After Treatment of Traumatic Subdural Hematoma: National Trend Analysis
Koo AB, Elsamadicy AA, David WB, Zogg CK, Santarosa C, Sujijantarat N, Robert SM, Kundishora AJ, Cord BJ, Hebert R, Bahrassa F, Malhotra A, Matouk CC. Thirty- and 90-Day Readmissions After Treatment of Traumatic Subdural Hematoma: National Trend Analysis. World Neurosurgery 2020, 139: e212-e219. PMID: 32272271, PMCID: PMC7380544, DOI: 10.1016/j.wneu.2020.03.168.Peer-Reviewed Original ResearchConceptsTraumatic subdural hematomaSubdural hematomaRheumatoid arthritis/collagen vascular diseasesMultivariate logistic regression analysisCollagen vascular diseaseNationwide Readmissions DatabaseCongestive heart failureLikelihood of readmissionPrimary procedure codeTraumatic brain injuryLogistic regression analysisReadmission ratesRenal failureHeart failurePostoperative infectionNinth RevisionSurgical interventionPatient populationVascular diseaseCerebral meningesBrain injuryClinical ModificationPatient managementReadmissionInternational ClassificationTargeting PD-L1 Initiates Effective Antitumor Immunity in a Murine Model of Cushing Disease
Kemeny HR, Elsamadicy AA, Farber SH, Champion CD, Lorrey SJ, Chongsathidkiet P, Woroniecka KI, Cui X, Shen SH, Rhodin KE, Tsvankin V, Everitt J, Sanchez-Perez L, Healy P, McLendon RE, Codd PJ, Dunn IF, Fecci PE. Targeting PD-L1 Initiates Effective Antitumor Immunity in a Murine Model of Cushing Disease. Clinical Cancer Research 2020, 26: 1141-1151. PMID: 31744830, PMCID: PMC7809696, DOI: 10.1158/1078-0432.ccr-18-3486.Peer-Reviewed Original ResearchConceptsCushing's diseasePituitary adenomasPD-L1PD1/PD-L1 axisAdrenocorticotropic hormone plasma levelsTumor-infiltrating T cellsRefractory Cushing's diseasePD-L1 axisPD-L1 expressionCheckpoint blockade therapyNovel therapeutic optionsHormone plasma levelsElevated cortisol levelsLymphocytic hypophysitisAntitumor immunityBlockade therapyCheckpoint blockadeCheckpoint expressionNumerous sequelaeSignificant morbidityTherapeutic optionsPlasma levelsPreclinical modelsT cellsSuccessful therapyIndependent 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
2018
T-Cell Exhaustion Signatures Vary with Tumor Type and Are Severe in Glioblastoma
Woroniecka K, Chongsathidkiet P, Rhodin K, Kemeny H, Dechant C, Farber SH, Elsamadicy AA, Cui X, Koyama S, Jackson C, Hansen LJ, Johanns TM, Sanchez-Perez L, Chandramohan V, Yu YA, Bigner DD, Giles A, Healy P, Dranoff G, Weinhold KJ, Dunn GP, Fecci PE. T-Cell Exhaustion Signatures Vary with Tumor Type and Are Severe in Glioblastoma. Clinical Cancer Research 2018, 24: 4175-4186. PMID: 29437767, PMCID: PMC6081269, DOI: 10.1158/1078-0432.ccr-17-1846.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAnimalsCD8-Positive T-LymphocytesFemaleFlow CytometryGene Expression Regulation, NeoplasticGlioblastomaHumansInterferon-gammaInterleukin-2Lymphocytes, Tumor-InfiltratingMaleMiceMiddle AgedReceptors, Antigen, T-Cell, alpha-betaT-LymphocytesTumor MicroenvironmentTumor Necrosis Factor-alphaConceptsT cell dysfunctionMultiple immune checkpointsT cellsExhaustion signaturesImmune checkpointsT cell exhaustion signaturesTumor-specific T cellsEffective immunotherapeutic strategiesImmune checkpoint blockadeT cell exhaustionImmunocompetent murine modelT cell hyporesponsivenessPeripheral blood lymphocytesClin Cancer ResPoststimulation levelsCheckpoint blockadeImmunotherapeutic strategiesCytokines IFNγHallmark of glioblastomaInhibitory receptorsTIL functionTumor locationMurine glioblastomaBlood lymphocytesMurine modelImpact 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 patientsInterdisciplinary Care Model Independently Decreases Use of Critical Care Services After Corrective Surgery for Adult Degenerative Scoliosis
Adogwa O, Elsamadicy AA, Sergesketter AR, Ongele M, Vuong V, Khalid S, Moreno J, Cheng J, Karikari IO, Bagley CA. Interdisciplinary Care Model Independently Decreases Use of Critical Care Services After Corrective Surgery for Adult Degenerative Scoliosis. World Neurosurgery 2018, 111: e845-e849. PMID: 29317368, DOI: 10.1016/j.wneu.2017.12.180.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCase ManagementClinical ProtocolsCohort StudiesCritical CareDecompression, SurgicalFemaleGeriatricsHumansLumbar VertebraeMaleNeurosurgical ProceduresPatient Care TeamPostoperative CarePostoperative ComplicationsRetrospective StudiesScoliosisSpinal FusionTreatment OutcomeConceptsElderly patientsCritical care servicesICU transferIndependent predictorsCorrective surgeryFusion surgeryComanagement modelSpine surgeryCare servicesComplex lumbar spine surgeryTeam approachIntensive care unit resourcesPeri-operative optimizationSenior Health (POSH) programDuration of surgeryLumbar spine surgeryInterdisciplinary care modelLong-term outcomesLumbar fusion surgeryMajor academic medical centerAdult degenerative scoliosisAcademic medical centerInterdisciplinary team approachPOSH cohortHospital course
2017
Prevalence, healthcare resource utilization and overall burden of fungal meningitis in the United States
Charalambous LT, Premji A, Tybout C, Hunt A, Cutshaw D, Elsamadicy AA, Yang S, Xie J, Giamberardino C, Pagadala P, Perfect JR, Lad SP. Prevalence, healthcare resource utilization and overall burden of fungal meningitis in the United States. Journal Of Medical Microbiology 2017, 67: 215-227. PMID: 29244019, PMCID: PMC6557145, DOI: 10.1099/jmm.0.000656.Peer-Reviewed Original ResearchConceptsHealthcare resource utilizationFungal meningitisCryptococcal meningitisMeningitis patientsTruven Health Analytics MarketScan databaseLong-term morbidityLength of stayLarge longitudinal cohortHealth economic impactCandida meningitisLong followMarketScan databasePrimary diagnosisLongitudinal cohortOverall burdenCandidiasis patientsMeningitisHistoplasmosis patientsMeningitis diagnosisPatientsOriginal diagnosisSingle pathogenPrevalent typeDiagnosisUnited StatesAssociation between baseline cognitive impairment and postoperative delirium in elderly patients undergoing surgery for adult spinal deformity.
Adogwa O, Elsamadicy AA, Vuong VD, Fialkoff J, Cheng J, Karikari IO, Bagley CA. Association between baseline cognitive impairment and postoperative delirium in elderly patients undergoing surgery for adult spinal deformity. Journal Of Neurosurgery Spine 2017, 28: 103-108. PMID: 29125432, DOI: 10.3171/2017.5.spine161244.Peer-Reviewed Original ResearchConceptsConfusion Assessment MethodBaseline cognitive impairmentPreoperative cognitive impairmentPostoperative deliriumElderly patientsCognitive impairmentDegenerative scoliosisRisk factorsSLUMS scoreElderly patients 65 yearsConclusion Cognitive impairmentIncidence of deliriumPatients 65 yearsElective spinal surgeryMonths of dischargeHospital readmission ratesCognitive impairment assessmentAdult spinal deformityAdult degenerative scoliosisSevere cognitive impairmentMental status examinationMild cognitive impairmentSaint Louis University Mental Status ExaminationPreoperative cognitionHospital courseGeriatric comanagement reduces perioperative complications and shortens duration of hospital stay after lumbar spine surgery: a prospective single-institution experience.
Adogwa O, Elsamadicy AA, Vuong VD, Moreno J, Cheng J, Karikari IO, Bagley CA. Geriatric comanagement reduces perioperative complications and shortens duration of hospital stay after lumbar spine surgery: a prospective single-institution experience. Journal Of Neurosurgery Spine 2017, 27: 670-675. PMID: 28960161, DOI: 10.3171/2017.5.spine17199.Peer-Reviewed Original ResearchConceptsLumbar spine surgeryHospital stayPOSH cohortElderly patientsSpine surgeryGeriatric comanagementPerioperative complicationsComplex lumbar spine surgeryElective lumbar spine surgeryMedical comorbid conditionsSenior Health (POSH) programDays of dischargeElective spinal surgerySingle institution experienceMajority of patientsNursing home admissionLumbar fusion surgeryResults One hundred twentyMajor academic medical centerAdult degenerative scoliosisAcademic medical centerHospital complicationsSurgical screeningPostoperative complicationsBaseline characteristicsPost-operative delirium is an independent predictor of 30-day hospital readmission after spine surgery in the elderly (≥65years old): A study of 453 consecutive elderly spine surgery patients
Elsamadicy AA, Wang TY, Back AG, Lydon E, Reddy GB, Karikari IO, Gottfried ON. Post-operative delirium is an independent predictor of 30-day hospital readmission after spine surgery in the elderly (≥65years old): A study of 453 consecutive elderly spine surgery patients. Journal Of Clinical Neuroscience 2017, 41: 128-131. PMID: 28262398, DOI: 10.1016/j.jocn.2017.02.040.Peer-Reviewed Original ResearchConceptsPost-operative deliriumIndependent risk factorSpine surgeryElderly patientsReadmission ratesHospital readmissionRisk factorsDelirium patientsComplication rateIndependent predictorsPost-operative complication rateSuperficial surgical site infectionMultivariate logistic regression analysisDuke University Medical CenterConsecutive elderly patientsSpine surgery patientsSurgical site infectionLogistic regression analysisUniversity Medical CenterLower healthcare costsDSM-V criteriaHospital stayUnplanned readmissionPatient demographicsSurgery patientsRisk 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
Impact of Age on Change in Self-Image 5 Years After Complex Spinal Fusion (≥5 Levels)
Elsamadicy AA, Adogwa O, Sergesketter A, Behrens S, Hobbs C, Bridwell KH, Karikari IO. Impact of Age on Change in Self-Image 5 Years After Complex Spinal Fusion (≥5 Levels). World Neurosurgery 2016, 97: 112-116. PMID: 27713066, DOI: 10.1016/j.wneu.2016.09.095.Peer-Reviewed Original ResearchConceptsPatient-reported outcomesComplex spinal fusionImpact of ageSpinal fusionComplication ratePreoperative variablesSignificant differencesImportant patient-reported outcomeFusion levelsPostoperative complication rateTypes of complicationsDeformity correction surgeryStandard deviation numberSRS-22rAdult patientsBaseline characteristicsEffect of ageIntraoperative variablesPatient demographicsSelf-image scoresYounger patientsPrimary outcomeCorrective surgeryCorrection surgeryPatients' perceptionsDrivers 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 facilities