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 ResearchMeSH KeywordsAdultAgedAnalgesics, OpioidHumansInpatientsRetrospective StudiesSpinal FusionTreatment OutcomeConceptsAdult 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 demographicsCost-effectiveness of thrombectomy in patients with minor stroke and large vessel occlusion: effect of thrombus location on cost-effectiveness and outcomes
Khunte M, Wu X, Koo A, Payabvash S, Matouk C, Heit JJ, Wintermark M, Albers GW, Sanelli PC, Gandhi D, Malhotra A. Cost-effectiveness of thrombectomy in patients with minor stroke and large vessel occlusion: effect of thrombus location on cost-effectiveness and outcomes. Journal Of NeuroInterventional Surgery 2022, 15: 39-45. PMID: 35022300, DOI: 10.1136/neurintsurg-2021-018375.Peer-Reviewed Original ResearchMeSH KeywordsAgedBrain IschemiaCost-Benefit AnalysisEndovascular ProceduresHumansStrokeThrombectomyThrombosisTreatment OutcomeConceptsLarge vessel occlusionProximal M1 occlusionEndovascular thrombectomyMinor strokeM2 occlusionsIntravenous thrombolysisM1 occlusionMedical managementVessel occlusionRankin score 0Markov decision-analytic modelBase-case analysisDecision analytic modelProbabilistic sensitivity analysesProximal M1More patientsPoor outcomeThrombus locationDistal M1Occlusion siteObservational studyScore 0Significant disabilityBetter outcomesPatients
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 decompressionRamifications 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 patients
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 ratePosterior Reversible Encephalopathy Syndrome Caused by Induced Hypertension to Treat Cerebral Vasospasm Secondary to Aneurysmal Subarachnoid Hemorrhage
Elsamadicy AA, Koo AB, Reeves BC, Sujijantarat N, David WB, Malhotra A, Gilmore EJ, Matouk CC, Hebert R. Posterior Reversible Encephalopathy Syndrome Caused by Induced Hypertension to Treat Cerebral Vasospasm Secondary to Aneurysmal Subarachnoid Hemorrhage. World Neurosurgery 2020, 143: e309-e323. PMID: 32721559, DOI: 10.1016/j.wneu.2020.07.135.Peer-Reviewed Original ResearchMeSH KeywordsFemaleHumansHypertensionMiddle AgedPosterior Leukoencephalopathy SyndromeSubarachnoid HemorrhageTreatment OutcomeVasospasm, IntracranialConceptsPosterior reversible encephalopathy syndromeSystolic blood pressure goalBlood pressure goalsReversible encephalopathy syndromeAneurysmal subarachnoid hemorrhageSubarachnoid hemorrhageEncephalopathy syndromeCerebral vasospasmClinical statusFluid-attenuated inversion recovery hyperintensityMiddle cerebral artery syndromeAcute-onset headachePossible ischemic eventsClinical examination findingsInversion recovery hyperintensityPatient's clinical statusTransient clinical improvementArtery aneurysm ruptureMiddle cerebral arteryLevel of arousalMagnetic resonance imagingDigital subtraction angiographyInduced hypertensionClinical improvementIschemic eventsClinical 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 SamplePre-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 demographicsInfluence 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
2016
KDR Amplification Is Associated with VEGF-Induced Activation of the mTOR and Invasion Pathways but does not Predict Clinical Benefit to the VEGFR TKI Vandetanib
Nilsson MB, Giri U, Gudikote J, Tang X, Lu W, Tran H, Fan Y, Koo A, Diao L, Tong P, Wang J, Herbst R, Johnson BE, Ryan A, Webster A, Rowe P, Wistuba II, Heymach JV. KDR Amplification Is Associated with VEGF-Induced Activation of the mTOR and Invasion Pathways but does not Predict Clinical Benefit to the VEGFR TKI Vandetanib. Clinical Cancer Research 2016, 22: 1940-1950. PMID: 26578684, PMCID: PMC4834253, DOI: 10.1158/1078-0432.ccr-15-1994.Peer-Reviewed Original ResearchMeSH KeywordsCarcinoma, Non-Small-Cell LungCell Line, TumorCell MovementCell ProliferationHumansHypoxia-Inducible Factor 1, alpha SubunitLung NeoplasmsP38 Mitogen-Activated Protein KinasesPiperidinesProtein Kinase InhibitorsProto-Oncogene Proteins c-metQuinazolinesSignal TransductionTOR Serine-Threonine KinasesTreatment OutcomeVascular Endothelial Growth Factor AVascular Endothelial Growth Factor Receptor-2ConceptsNon-small cell lung cancerTyrosine kinase inhibitorsVEGFR tyrosine kinase inhibitorsNSCLC cell linesZODIAC studyClinical benefitLung cancerPlatinum-refractory non-small cell lung cancerAdvanced non-small cell lung cancerImproved progression-free survivalDifferent lung cancersObjective response rateProgression-free survivalVEGF pathway inhibitorsCell lung cancerArchival tumor samplesCell linesActivation of mTORVandetanib armOverall survivalNSCLC modelsNSCLC cellsPreclinical studiesPatientsVEGFR inhibition