2024
35. Comparable risk of adverse events following cervicothoracic interlaminar and transforaminal epidural injections: an analysis of 1.29 million patients
Seddio A, McNamara K, Gouzoulis M, Jabbouri S, Ratnasamy P, Rubio D, Grauer J. 35. Comparable risk of adverse events following cervicothoracic interlaminar and transforaminal epidural injections: an analysis of 1.29 million patients. The Spine Journal 2024, 24: s19. DOI: 10.1016/j.spinee.2024.06.478.Peer-Reviewed Original ResearchAdverse eventsSpinal neurologic deficitsStatistically significant differenceCurrent Procedural TerminologyElixhauser Comorbidity IndexEpidural injectionAdult patientsNeurological deficitsAdverse outcomesMultivariate analysisED visitsIncidence of adverse eventsEpidural spinal injectionsTransforaminal epidural injectionsEmergency departmentTransforaminal (TFRisk of adverse eventsSignificant differenceRetrospective cohort studyMinor adverse eventsSampled adult patientsOutcome measures IncidencePotential adverse eventsSpinal injectionPatient ageRisk Factors for Perioperative Nerve Injury Related to Total Hip Arthroplasty
Jayaram R, Day W, Gouzoulis M, Zhu J, Grauer J, Rubin L. Risk Factors for Perioperative Nerve Injury Related to Total Hip Arthroplasty. Arthroplasty Today 2024, 28: 101440. PMID: 39139361, PMCID: PMC11320433, DOI: 10.1016/j.artd.2024.101440.Peer-Reviewed Original ResearchBody mass indexNerve injuryElixhauser Comorbidity IndexRisk factorsMultivariate analysisOdds ratioRisk of nerve injuryTotal hip arthroplastyRevision proceduresObese BMI statusUnderweight body mass indexDecreased odds ratioPatient ageSurgery typeRisk stratificationAdverse eventsBMI statusMass indexFemale sexAdverse outcomesComorbidity indexDecreased riskPatient counselingHip arthroplastyNerveCefazolin Alone Versus Cefazolin with Tobramycin or Gentamicin as Intraoperative Antibiotic Prophylaxis for Single-Level Posterior Lumbar Fusion
Dhodapkar M, Jeong S, Halperin S, Rubio D, Li M, Grauer J. Cefazolin Alone Versus Cefazolin with Tobramycin or Gentamicin as Intraoperative Antibiotic Prophylaxis for Single-Level Posterior Lumbar Fusion. JAAOS Global Research And Reviews 2024, 8: e24.00082. PMCID: PMC11068128, DOI: 10.5435/jaaosglobal-d-24-00082.Peer-Reviewed Original ResearchSingle-level posterior lumbar fusionPosterior lumbar fusionSurgical site infectionElixhauser Comorbidity IndexLumbar fusionAntibiotic prophylaxisAdverse outcomesAntibiotic prophylaxis regimenAntibiotic prophylaxis regimensIntraoperative antibiotic prophylaxisRevision ratePerioperative antibiotic prophylaxisPostoperative adverse outcomesPosterior lumbar fusion patientsMultivariate logistic regressionProphylaxis regimensProphylaxis regimenPatient ageSite infectionUnivariate analysisCefazolinComorbidity indexMultivariate analysisAntibiotic subgroupsTraumatic diagnosesSurgical site infection following isolated lumbar discectomy increases odds of revision lumbar surgery within first 6 months, but not beyond
Kim L, Halperin S, Grauer J. Surgical site infection following isolated lumbar discectomy increases odds of revision lumbar surgery within first 6 months, but not beyond. The Spine Journal 2024, 24: 1459-1466. PMID: 38570035, DOI: 10.1016/j.spinee.2024.03.017.Peer-Reviewed Original ResearchSurgical site infectionRevision lumbar surgeryLumbar discectomyLumbar surgeryElixhauser Comorbidity IndexSite infectionFactors associated with surgical site infectionPreoperative diagnosis of infectionIncidence of secondary surgeryLumbar discectomy patientsDiagnosis of infectionMultivariate logistic regressionPreoperative diagnosisDiscectomy patientsPostoperative complicationsIndex surgeryPatient ageSecondary surgerySpinal surgeryIndependent predictorsAdult patientsLumbar fusionPerforming surgeryDiscectomyI&D
2023
Trends in and Factors Associated With Surgical Management for Closed Clavicle Fractures
Dhodapkar M, Modrak M, Halperin S, Joo P, Luo X, Grauer J. Trends in and Factors Associated With Surgical Management for Closed Clavicle Fractures. JAAOS Global Research And Reviews 2023, 7: e23.00226. PMID: 38149938, PMCID: PMC10752468, DOI: 10.5435/jaaosglobal-d-23-00226.Peer-Reviewed Original ResearchConceptsElixhauser Comorbidity IndexSurgical managementClavicle fracturesAnatomic locationFracture diagnosisClosed clavicle fractureMinority of patientsComorbidity indexAdult patientsClinical factorsPatient ageIndependent predictorsMultivariable analysisNonsurgical managementOpen reductionNonclinical factorsFirst diagnosisInternal fixationSurgical considerationsSuch injuriesPatientsStudy periodDiagnosisInsurance coverageFracturesLow Back Pain: Utilization of Urgent Cares Relative to Emergency Departments
Dhodapkar M, Modrak M, Halperin S, Gouzoulis M, Rubio D, Grauer J. Low Back Pain: Utilization of Urgent Cares Relative to Emergency Departments. Spine 2023, 49: 513-517. PMID: 37982595, DOI: 10.1097/brs.0000000000004880.Peer-Reviewed Original ResearchLow back painElixhauser Comorbidity IndexUrgent care centersEmergency departmentUrgent careBack painED visitsED utilizationCare centerAdvanced imagingUrgent care useUrgent care visitsDays of diagnosisSetting of traumaSpinal cord injuryYears of ageComorbidity indexInfectious diagnosisCare visitsLBP patientsMost patientsRecent surgeryAdult patientsPatient ageED patientsChanges in the Utilization of Cervicothoracic Injections Between 2010 and 2020
Ratnasamy P, Oghenesume O, Maloy G, Grauer J. Changes in the Utilization of Cervicothoracic Injections Between 2010 and 2020. Clinical Spine Surgery A Spine Publication 2023, 37: 210-216. PMID: 37941099, DOI: 10.1097/bsd.0000000000001549.Peer-Reviewed Original ResearchFacet injectionsPatient characteristicsPatient insurance typeElixhauser Comorbidity IndexInsurance reimbursement policiesCurrent Procedural Terminology codingComorbidity indexPatient agePearlDiver databasePatient factorsInterlaminar injectionsTransforaminal injectionsRehabilitation physiciansInsurance typePractice patternsMedicaid patientsEpidemiologic studiesPhysician preferenceProvider typeSpinal pathologyTransforaminalSpine carePhysical medicinePatientsInjection administrationDecline in Separate Incision Autograft for Spine Surgery Over the Past Decade: A Fading “gold standard”
Rudisill K, Ratnasamy P, Maloy G, Grauer J. Decline in Separate Incision Autograft for Spine Surgery Over the Past Decade: A Fading “gold standard”. Journal Of The American Academy Of Orthopaedic Surgeons 2023, 31: 938-944. PMID: 37332184, DOI: 10.5435/jaaos-d-22-01029.Peer-Reviewed Original ResearchConceptsElixhauser Comorbidity IndexSurgeon specialtySpinal fusionComorbidity indexSmoking statusGold standardIliac crest autograftPatient ageIndependent predictorsPatient factorsNonsurgical factorsCrest autograftSpine surgeryBone graftingSpine fusionIliac crestBone graftAutograftYounger ageSurgeryInsurance factorsSpinal boneCommon procedureInsurance plansAgeRheumatoid arthritis patients are at increased risk for adverse events following lumbar discectomy
Ratnasamy P, Rudisill K, Gouzoulis M, Kammien A, Grauer J. Rheumatoid arthritis patients are at increased risk for adverse events following lumbar discectomy. The Spine Journal 2023, 23: 990-996. PMID: 36990283, DOI: 10.1016/j.spinee.2023.03.012.Peer-Reviewed Original ResearchConceptsLumbar discectomy patientsAdverse eventsRheumatoid arthritisLumbar discectomyPatient ageDiscectomy patientsMinor adverse eventsRetrospective cohort studyLumbar spinal surgeryPatient's medication regimenElixhauser Comorbidity IndexExclusion of patientsRA medicationsComorbidity indexCohort studyMedication regimenPrior diagnosisPredictive factorsAdverse outcomesSubgroup analysisSpinal surgeryInfection diagnosisAutoinflammatory diseasesHigher oddsDiscectomy
2022
Ninety-Day Emergency Department Visits After Ankle Fracture Surgery
Kammien A, Ratnasamy P, Joo P, Grauer J. Ninety-Day Emergency Department Visits After Ankle Fracture Surgery. Journal Of The American Academy Of Orthopaedic Surgeons 2022, 31: e51-e57. PMID: 36548157, DOI: 10.5435/jaaos-d-22-00484.Peer-Reviewed Original ResearchConceptsAnkle fracture surgeryElixhauser comorbidity index scoreComorbidity Index scoreED visitsED utilizationFracture surgeryPostoperative weekRisk factorsSurgical siteIndex scoreIncidence of readmissionEmergency department visitsDay of surgeryMultivariate logistic regressionORIF patientsPatient ageAnkle fracturesDepartment visitsOpen reductionConcomitant fracturesMedicaid insuranceEntire cohortEmergency departmentInternal fixationCare pathwayChanges in the Utilization of Lumbosacral Epidural Injections Between 2010 and 2019
Ratnasamy PP, Gouzoulis MJ, Kammien AJ, Holder EK, Grauer JN. Changes in the Utilization of Lumbosacral Epidural Injections Between 2010 and 2019. Spine 2022, 47: 1669-1674. PMID: 36281568, PMCID: PMC9643603, DOI: 10.1097/brs.0000000000004467.Peer-Reviewed Original ResearchConceptsElixhauser Comorbidity IndexEpidural injectionTransforaminal injectionsSpinal epidural injectionDescriptive epidemiologic studyLumbosacral epidural injectionNumber of injectionsCurrent Procedural Terminology codingCaudal injectionComorbidity indexPatient agePatient characteristicsPearlDiver databaseLumbar pathologyTerms of specialtyInsurance authorizationPractice patternsService utilizationAverage patientEpidemiologic studiesMedicaid coveragePatientsTransforaminalMedicare coverageUtilization trendsPatient Demographic and Socioeconomic Factors Associated With Physical Therapy Utilization After Uncomplicated Meniscectomy
Mercier MR, Galivanche AR, Wiggins AJ, Kahan JB, McLaughlin W, Radford ZJ, Grauer JN, Gardner EC. Patient Demographic and Socioeconomic Factors Associated With Physical Therapy Utilization After Uncomplicated Meniscectomy. JAAOS Global Research And Reviews 2022, 6: e22.00135. PMID: 35816646, PMCID: PMC9276169, DOI: 10.5435/jaaosglobal-d-22-00135.Peer-Reviewed Original ResearchConceptsMore PT visitsPT visitsPhysical therapyUse of PTPhysical therapy utilizationPatient demographicsPatient agePearlDiver databaseMale sexTherapy utilizationInsurance statusInsurance typeInclusion criteriaLower oddsPatientsMeniscectomyOlder ageLogistic regressionVisitsSocioeconomic factorsDemographic factorsAgeSexPT useTherapyEmergency department visits within 90 days of single-level anterior cervical discectomy and fusion
Kammien AJ, Galivanche AR, Gouzoulis MJ, Moore HG, Mercier MR, Grauer JN. Emergency department visits within 90 days of single-level anterior cervical discectomy and fusion. North American Spine Society Journal (NASSJ) 2022, 10: 100122. PMID: 35637647, PMCID: PMC9144013, DOI: 10.1016/j.xnsj.2022.100122.Peer-Reviewed Original ResearchED visitsPostoperative week 1ED utilizationPredictive factorsSurgical siteWeek 1Single-level anterior cervical discectomySingle-level ACDF proceduresElixhauser comorbidity index scoreCommon postoperative issuesPrimary ED diagnosisComorbidity Index scoreAnterior cervical discectomyHigh-risk patientsSingle-level ACDFEmergency department visitsDay of surgeryMultivariate logistic regressionIntegrated care pathwayHealthcare spendingPostoperative readmissionsACDF proceduresCervical discectomyPatient ageDepartment visitsEmergency Department Visits Within 90 Days of Anterior Cruciate Ligament Reconstruction
Kammien AJ, Zhu JR, Gouzoulis MJ, Moore HG, Galivanche AR, Medvecky MJ, Grauer JN. Emergency Department Visits Within 90 Days of Anterior Cruciate Ligament Reconstruction. Orthopaedic Journal Of Sports Medicine 2022, 10: 23259671221083586. PMID: 35340726, PMCID: PMC8941698, DOI: 10.1177/23259671221083586.Peer-Reviewed Original ResearchAnterior cruciate ligament reconstructionCruciate ligament reconstructionED visitsElixhauser Comorbidity IndexSurgical siteComorbidity indexED utilizationLigament reconstructionWeek 3Higher Elixhauser comorbidity indexSurgical site painGreater comorbidity burdenEmergency department visitsDescriptive epidemiologic studyMultivariate logistic regressionHealth care systemComorbidity burdenPatient agePostoperative dataYounger patientsDepartment visitsIndependent predictorsPostoperative weekEmergency departmentFemale sex
2021
Temporal Utilization of Physical Therapy Visits After Anterior Cruciate Ligament Reconstruction
Burroughs PJ, Kahan JB, Moore HG, Grauer JN, Gardner EC. Temporal Utilization of Physical Therapy Visits After Anterior Cruciate Ligament Reconstruction. Orthopaedic Journal Of Sports Medicine 2021, 9: 2325967120982293. PMID: 33681401, PMCID: PMC7900793, DOI: 10.1177/2325967120982293.Peer-Reviewed Original ResearchAnterior cruciate ligament reconstructionPT visitsCruciate ligament reconstructionPostoperative periodLigament reconstructionPhysical therapy visitsEarly postoperative periodInterquartile rangeDescriptive epidemiological studySport-specific exercisesPhysical therapy rehabilitationTherapy visitsPatient agePearlDiver databaseFemale patientsStudy cohortKnee functionMean ageNational cohortPatient recoveryInclusion criteriaStage rehabilitationTherapy rehabilitationEpidemiological studiesPatients
2018
Is Discharge Within a Day of Total Knee Arthroplasty Safe in the Octogenarian Population?
Bovonratwet P, Fu MC, Tyagi V, Gu A, Sculco PK, Grauer JN. Is Discharge Within a Day of Total Knee Arthroplasty Safe in the Octogenarian Population? The Journal Of Arthroplasty 2018, 34: 235-241. PMID: 30391051, DOI: 10.1016/j.arth.2018.10.005.Peer-Reviewed Original ResearchConceptsTotal knee arthroplastyNational Surgical Quality Improvement Program databaseQuality Improvement Program databasePrimary total knee arthroplastyImprovement Program databaseIndependent risk factorSerious adverse eventsAdverse eventsRisk factorsProgram databasePerioperative adverse eventsHospital lengthNonhome dischargeOctogenarian populationPerioperative complicationsElderly patientsOlder patientsPatient agePostdischarge careKnee arthroplastyPatient satisfactionProcedural characteristicsHigh riskHealthcare costsPatients