2022
Underweight patients are the highest risk body mass index group for perioperative adverse events following stand-alone anterior lumbar interbody fusion
Ottesen TD, Galivanche AR, Greene JD, Malpani R, Varthi AG, Grauer JN. Underweight patients are the highest risk body mass index group for perioperative adverse events following stand-alone anterior lumbar interbody fusion. The Spine Journal 2022, 22: 1139-1148. PMID: 35231643, DOI: 10.1016/j.spinee.2022.02.012.Peer-Reviewed Original ResearchConceptsBody mass indexNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseAnterior lumbar interbody fusionObese class 1Improvement Program databaseClass 2 patientsAdverse eventsUnderweight patientsBMI categoriesAdverse outcomesBMI spectrumInterbody fusionProgram databaseTwo-level anterior lumbar interbody fusionSurgeons National Surgical Quality Improvement Program databaseMultivariate analysisThirty-day adverse eventsWorld Health Organization categoriesBody mass index groupsPostoperative adverse eventsRetrospective cohort studyPerioperative adverse eventsNormal-weight subjectsPost-operative infectionGeneral Versus Neuraxial Anesthesia in Revision Surgery for Periprosthetic Joint Infection
Serino J, Galivanche AR, Grauer JN, Haynes M, Karas V, Della Valle CJ. General Versus Neuraxial Anesthesia in Revision Surgery for Periprosthetic Joint Infection. The Journal Of Arthroplasty 2022, 37: s971-s976. PMID: 35017049, DOI: 10.1016/j.arth.2022.01.002.Peer-Reviewed Original ResearchConceptsPeriprosthetic joint infectionNeuraxial anesthesiaAdverse eventsGeneral anesthesiaRevision surgeryJoint infectionLower riskNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement Program databaseQuality Improvement Program databaseMinor adverse eventsSerious adverse eventsThirty-day outcomesImprovement Program databasePropensity-score matchingIntraspinal abscessProgram databaseRevision arthroplastyAmerican CollegeAnesthesiaMultivariate analysisProcedural variablesSurgeryPatientsInfection
2021
Does dehydration prior to primary total joint arthroplasty increase risk of perioperative complications?
Moore HG, Justen MA, Kirwin DS, Burroughs PJ, Rubin LE, Grauer JN. Does dehydration prior to primary total joint arthroplasty increase risk of perioperative complications? Arthroplasty 2021, 3: 34. PMID: 35236481, PMCID: PMC8796573, DOI: 10.1186/s42836-021-00090-8.Peer-Reviewed Original ResearchPreoperative dehydrationPerioperative complicationsTotal joint arthroplastyTKA patientsTHA patientsJoint arthroplastyNational Surgical Quality Improvement Program databaseElective total joint arthroplastyQuality Improvement Program databasePrimary total joint arthroplastyTotal knee arthroplasty patientsImprovement Program databaseRisk of transfusionShort-term complicationsTHA/TKAKnee arthroplasty patientsMethodsThe 2012Perioperative outcomesBlood transfusionArthroplasty patientsSpecific complicationsTotal hipProgram databaseBackgroundPrior studiesIncrease riskCenters for Medicare & Medicaid Services' 2018 Removal of Total Knee Arthroplasty From the Inpatient-only List Led to Broad Changes in Hospital Length of Stays
Rankin KA, Freedman IG, Rubin LE, Grauer JN. Centers for Medicare & Medicaid Services' 2018 Removal of Total Knee Arthroplasty From the Inpatient-only List Led to Broad Changes in Hospital Length of Stays. Journal Of The American Academy Of Orthopaedic Surgeons 2021, 29: 1061-1067. PMID: 33960970, DOI: 10.5435/jaaos-d-20-01228.Peer-Reviewed Original ResearchConceptsTotal knee arthroplastyHospital lengthKnee arthroplastyNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseMedicare eligibilityCategorical data comparisonsOverall practice patternsRetrospective cohort studyImprovement Program databaseSame dayRemoval of TKAPearson's chi-squared testChi-squared testMann-Whitney testLOS daysProlonged LOSMost patientsTKA patientsCohort studyMore patientsPractice patternsPatient characterizationProgram databaseActual LOSCement Augmentation of Vertebral Compression Fractures May Be Safely Considered in the Very Elderly
Galivanche AR, Toombs C, Adrados M, David WB, Malpani R, Saifi C, Whang PG, Grauer JN, Varthi AG. Cement Augmentation of Vertebral Compression Fractures May Be Safely Considered in the Very Elderly. Neurospine 2021, 18: 226-233. PMID: 33819949, PMCID: PMC8021820, DOI: 10.14245/ns.2040620.310.Peer-Reviewed Original ResearchVertebral compression fracturesAdverse eventsCompression fracturesCement augmentationAge categoriesNational Surgical Quality Improvement Program databaseInpatient/outpatient statusQuality Improvement Program databaseProcedural variablesMinor adverse eventsImprovement Program databaseSerious adverse eventsMultivariate logistic regressionYear old cohortPeriprocedure complicationsOlder patientsComorbidity statusOutpatient statusRetrospective reviewAdverse outcomesGeriatric populationProcedure typeProgram databaseProvider specialtyChi-square analysisPatients with insulin-dependent diabetes are at greater risk for perioperative adverse outcomes following total hip arthroplasty
Webb ML, Justen MA, Kerbel YE, Scanlon CM, Nelson CL, Grauer JN. Patients with insulin-dependent diabetes are at greater risk for perioperative adverse outcomes following total hip arthroplasty. Hip International 2021, 32: 730-736. PMID: 33566714, DOI: 10.1177/1120700020988834.Peer-Reviewed Original ResearchConceptsTotal hip arthroplastyPerioperative adverse outcomesAdverse outcomesDiabetes mellitusHip arthroplastyNational Surgical Quality Improvement Program databaseQuality Improvement Program databasePrimary total hip arthroplastyAdditional adverse outcomesImprovement Program databaseInsulin-dependent diabeticsPreoperative risk stratificationInsulin-dependent diabetesQuality improvement initiativesInsulin useDependent diabeticsRisk stratificationProgram databasePatientsMultivariate analysisGreater riskImprovement initiativesDiabeticsOutcomesDiabetes
2020
Underweight patients are an often under looked “At risk” population after undergoing posterior cervical spine surgery
Ottesen TD, Bagi PS, Malpani R, Galivanche AR, Varthi AG, Grauer JN. Underweight patients are an often under looked “At risk” population after undergoing posterior cervical spine surgery. North American Spine Society Journal (NASSJ) 2020, 5: 100041. PMID: 35141608, PMCID: PMC8820029, DOI: 10.1016/j.xnsj.2020.100041.Peer-Reviewed Original ResearchBody mass indexPosterior cervical spine surgeryCervical spine surgeryAdverse eventsBMI categoriesBMI spectrumSpine surgeryNational Surgical Quality Improvement Program databaseRisk-adjusted multivariate regressionsQuality Improvement Program databaseHigher body mass indexLower body mass indexOutcomes of patientsImprovement Program databaseNormal-weight subjectsCategory of patientsSpine surgery outcomesUnderweight patientsPatient demographicsBMI groupsMass indexAdverse outcomesSurgery outcomesProgram databaseInclusion criteriaPreoperative High, as well as Low, Platelet Counts Correlate With Adverse Outcomes After Elective Total Hip Arthroplasty
Malpani R, Bovonratwet P, Clark MG, Ottesen TD, Mercier MR, Grauer JN. Preoperative High, as well as Low, Platelet Counts Correlate With Adverse Outcomes After Elective Total Hip Arthroplasty. JAAOS Global Research And Reviews 2020, 4: e20.00049. PMID: 32890010, PMCID: PMC7470002, DOI: 10.5435/jaaosglobal-d-20-00049.Peer-Reviewed Original ResearchConceptsTotal hip arthroplastyNational Surgical Quality Improvement Program databaseQuality Improvement Program databasePreoperative platelet countAbnormal platelet countImprovement Program databasePlatelet countPerioperative complicationsAdverse eventsHospital readmissionTHA patientsAdverse outcomesProgram databaseHip arthroplastyElective primary total hip arthroplastyElective total hip arthroplastyPrimary total hip arthroplastyMulticenter patient populationPreoperative laboratory studiesMinor adverse eventsPostoperative adverse eventsLow platelet countPostoperative complication dataNormal platelet countHigher platelet countsReadmissions After Distal Radius Fracture Open Reduction and Internal Fixation: An Analysis of 11,124 Patients
Malpani R, John TS, Mercier MR, Ottesen TD, Nduaguba AM, Webb ML, Grauer JN. Readmissions After Distal Radius Fracture Open Reduction and Internal Fixation: An Analysis of 11,124 Patients. JAAOS Global Research And Reviews 2020, 4: e20.00110. PMID: 33969951, PMCID: PMC7384800, DOI: 10.5435/jaaosglobal-d-20-00110.Peer-Reviewed Original ResearchConceptsNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseImprovement Program databaseMultivariate analysisAnesthesiologists classOpen reductionInternal fixationRisk factorsProgram databaseMedical reasonsSurgeons National Surgical Quality Improvement Program databasePredictors of readmissionInsulin-dependent diabetesCommon surgical procedureQuality improvement initiativesAmerican SocietyPostoperative readmissionsIndex surgeryInsulin usePerioperative factorsUnplanned readmissionPatient demographicsPerioperative outcomesAdult patientsSurgical reasonsUnderweight patients are at just as much risk as super morbidly obese patients when undergoing anterior cervical spine surgery
Ottesen TD, Malpani R, Galivanche AR, Zogg CK, Varthi AG, Grauer JN. Underweight patients are at just as much risk as super morbidly obese patients when undergoing anterior cervical spine surgery. The Spine Journal 2020, 20: 1085-1095. PMID: 32194246, PMCID: PMC7380546, DOI: 10.1016/j.spinee.2020.03.007.Peer-Reviewed Original ResearchConceptsAnterior cervical spine surgeryBody mass indexCervical spine surgeryNational Surgical Quality Improvement Program databaseSuper morbidly obese patientsQuality Improvement Program databaseWorld Health Organization categoriesMorbidly obese patientsImprovement Program databaseObese patientsAdverse eventsAdverse outcomesSpine surgeryUnderweight patientsPostoperative infectionProgram databaseSurgeons National Surgical Quality Improvement Program databaseMultivariate analysisAnterior cervical spine proceduresOverweight/obese categoriesThirty-day adverse eventsHigher body mass indexLower body mass indexAdverse outcome categoriesNormal BMI patients
2019
The Use of Older Versus Newer Data in the National Surgical Quality Improvement Program Database Influences the Results of Total Hip Arthroplasty Outcomes Studies
Shultz BN, Galivanche AR, Ottesen TD, Bovonratwet P, Grauer JN. The Use of Older Versus Newer Data in the National Surgical Quality Improvement Program Database Influences the Results of Total Hip Arthroplasty Outcomes Studies. JAAOS Global Research And Reviews 2019, 3: e19.00108. PMID: 31773075, PMCID: PMC6855500, DOI: 10.5435/jaaosglobal-d-19-00108.Peer-Reviewed Original ResearchLength of stayUrinary tract infectionPerioperative outcomesTHA patientsPreoperative characteristicsTract infectionsERA groupDeep vein thrombosis/thrombophlebitisNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseArthroplasty outcome studiesImprovement Program databaseMultivariate Poisson regressionNSQIP data setsUnplanned reintubationBlood transfusionNSQIP dataNSQIP variablesProgram databaseOutcome studiesArthroplasty studiesMultivariate analysisPoisson regressionDemographic dataPatientsCardiac Complications Related to Spine Surgery: Timing, Risk Factors, and Clinical Effect.
Bovonratwet P, Bohl DD, Malpani R, Haynes MS, Rubio DR, Ondeck NT, Shultz BN, Mahal AR, Grauer JN. Cardiac Complications Related to Spine Surgery: Timing, Risk Factors, and Clinical Effect. Journal Of The American Academy Of Orthopaedic Surgeons 2019, 27: 256-263. PMID: 30897607, DOI: 10.5435/jaaos-d-17-00650.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overDatabases, FactualFemaleHeart ArrestHumansIncidenceIntraoperative ComplicationsLength of StayMaleMiddle AgedMonitoring, PhysiologicMultivariate AnalysisMyocardial InfarctionOrthopedic ProceduresPatient ReadmissionPerioperative PeriodPostoperative ComplicationsRisk FactorsSpineTime FactorsYoung AdultConceptsCardiac complicationsSpine surgeryRisk factorsPostoperative periodNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramQuality Improvement Program databaseSurgical Quality Improvement ProgramPerioperative cardiac complicationsHigh-risk patientsImprovement Program databaseInsulin-dependent diabetesLarge cohort studyQuality Improvement ProgramPreoperative anemiaPostoperative lengthCohort studyPerioperative periodPrimary outcomeClinical effectsCardiac arrestMyocardial infarctionProgram databaseAmerican CollegeElective Total Shoulder Arthroplasty in Octogenarians: A Safe Procedure.
Bovonratwet P, Malpani R, Ondeck NT, Tyagi V, Grauer JN. Elective Total Shoulder Arthroplasty in Octogenarians: A Safe Procedure. Journal Of The American Academy Of Orthopaedic Surgeons 2019, 27: 145-154. PMID: 30252789, DOI: 10.5435/jaaos-d-17-00364.Peer-Reviewed Original ResearchConceptsPrimary total shoulder arthroplastyTotal shoulder arthroplastyNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseImprovement Program databasePerioperative complicationsHospital stayProgram databaseShoulder arthroplastyElective total shoulder arthroplastyPropensity score-matched comparisonYoung populationRate of readmissionUrinary tract infectionPost-discharge careOctogenarian patientsPreoperative optimizationOctogenarian populationPerioperative coursePatient characteristicsTract infectionsSafe procedureRisk factorsOctogenariansReadmission
2018
Unlike Native Hip Fractures, Delay to Periprosthetic Hip Fracture Stabilization Does Not Significantly Affect Most Short-Term Perioperative Outcomes
Bovonratwet P, Fu MC, Adrados M, Ondeck NT, Su EP, Grauer JN. Unlike Native Hip Fractures, Delay to Periprosthetic Hip Fracture Stabilization Does Not Significantly Affect Most Short-Term Perioperative Outcomes. The Journal Of Arthroplasty 2018, 34: 564-569. PMID: 30514642, DOI: 10.1016/j.arth.2018.11.006.Peer-Reviewed Original ResearchConceptsPeriprosthetic hip fracturesNative hip fracturesIndependent risk factorSerious adverse eventsHip fracturePerioperative complicationsAdverse eventsRisk factorsNational Surgical Quality Improvement Program databaseDependent preoperative functional statusPostoperative serious adverse eventsPreoperative congestive heart failureQuality Improvement Program databaseExtended postoperative stayPreoperative functional statusImprovement Program databaseCongestive heart failureTotal hip arthroplastyPostoperative stayPerioperative outcomesHeart failureHospital admissionPotential confoundersFunctional statusProgram databaseIs 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 costsPatientsSystematic Changes in the National Surgical Quality Improvement Program Database Over the Years Can Affect Comorbidity Indices Such as the Modified Frailty Index and Modified Charlson Comorbidity Index for Lumbar Fusion Studies
Shultz BN, Ottesen TD, Ondeck NT, Bovonratwet P, McLynn RP, Cui JJ, Grauer JN. Systematic Changes in the National Surgical Quality Improvement Program Database Over the Years Can Affect Comorbidity Indices Such as the Modified Frailty Index and Modified Charlson Comorbidity Index for Lumbar Fusion Studies. Spine 2018, 43: 798-804. PMID: 28922281, DOI: 10.1097/brs.0000000000002418.Peer-Reviewed Original ResearchConceptsNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseCharlson Comorbidity IndexImprovement Program databaseComorbidity indexFrailty indexNSQIP databaseProgram databaseSurgeons National Surgical Quality Improvement Program databaseElective posterior lumbar fusionModified Charlson Comorbidity IndexModified Frailty IndexAdverse postoperative outcomesRetrospective cohort studyMean American SocietyMean ASA scorePosterior lumbar fusionAnesthesiologists (ASA) scoreASA scoreCohort studyPostoperative outcomesLumbar fusionBACKGROUND DATAAmerican CollegePatientsDiscrepancies in the Definition of “Outpatient” Surgeries and Their Effect on Study Outcomes Related to ACDF and Lumbar Discectomy Procedures
Bovonratwet P, Webb ML, Ondeck NT, Gala RJ, Nelson SJ, McLynn RP, Cui JJ, Grauer JN. Discrepancies in the Definition of “Outpatient” Surgeries and Their Effect on Study Outcomes Related to ACDF and Lumbar Discectomy Procedures. Clinical Spine Surgery A Spine Publication 2018, 31: e152-e159. PMID: 29351096, DOI: 10.1097/bsd.0000000000000615.Peer-Reviewed Original ResearchConceptsACDF patientsLumbar discectomy patientsDiscectomy procedureDiscectomy patientsSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseACS-NSQIP databaseAnterior cervical discectomyImprovement Program databaseSame-day dischargePossibility of patientsCervical discectomyOutpatient statusRetrospective studyOutpatient surgeryAdverse outcomesOutpatient settingOutpatient procedureProgram databaseBACKGROUND DATADay dischargeAmerican CollegeACDFOutpatientsMissing data may lead to changes in hip fracture database studies: a study of the American College of Surgeons National Surgical Quality Improvement Program.
Basques BA, McLynn RP, Lukasiewicz AM, Samuel AM, Bohl DD, Grauer JN. Missing data may lead to changes in hip fracture database studies: a study of the American College of Surgeons National Surgical Quality Improvement Program. The Bone & Joint Journal 2018, 100-B: 226-232. PMID: 29437066, DOI: 10.1302/0301-620x.100b2.bjj-2017-0791.r1.Peer-Reviewed Original ResearchConceptsAdverse eventsRisk factorsDatabase studyNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramQuality Improvement Program databaseSurgical Quality Improvement ProgramPostoperative adverse eventsImprovement Program databaseNational database studyDifferent risk factorsMultivariate regressionQuality Improvement ProgramElderly patientsNSQIP databaseBone JointProgram databaseLaboratory valuesAmerican CollegePatientsHipFracturesComorbiditiesSurgery
2017
Revision Total Knee Arthroplasty in Octogenarians: An Analysis of 957 Cases
Bovonratwet P, Tyagi V, Ottesen TD, Ondeck NT, Rubin LE, Grauer JN. Revision Total Knee Arthroplasty in Octogenarians: An Analysis of 957 Cases. The Journal Of Arthroplasty 2017, 33: 178-184. PMID: 28844628, DOI: 10.1016/j.arth.2017.07.032.Peer-Reviewed Original ResearchConceptsRevision total knee arthroplastyTotal knee arthroplastyBlood transfusionOctogenarian patientsKnee arthroplastyPatient populationNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseLonger lengthYoung populationHigh rateImprovement Program databaseYoung patient populationNumber of octogenariansLarger patient populationYear oldsHospital stayIntraoperative characteristicsPerioperative complicationsPerioperative coursePropensity matchingAdvanced ageProgram databaseOctogenariansStayOutpatient and Inpatient Unicompartmental Knee Arthroplasty Procedures Have Similar Short-Term Complication Profiles
Bovonratwet P, Ondeck NT, Tyagi V, Nelson SJ, Rubin LE, Grauer JN. Outpatient and Inpatient Unicompartmental Knee Arthroplasty Procedures Have Similar Short-Term Complication Profiles. The Journal Of Arthroplasty 2017, 32: 2935-2940. PMID: 28602533, DOI: 10.1016/j.arth.2017.05.018.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAmbulatory Surgical ProceduresArthroplasty, Replacement, KneeCohort StudiesComorbidityDatabases, FactualFemaleHumansInpatientsLength of StayMaleMiddle AgedOutcome Assessment, Health CareOutpatientsPatient ReadmissionPatient SatisfactionPostoperative ComplicationsPropensity ScoreQuality ImprovementUnited StatesConceptsUnicompartmental knee arthroplastyNational Surgical Quality Improvement Program databaseInpatient Unicompartmental Knee ArthroplastyQuality Improvement Program databaseLength of hospitalImprovement Program databasePerioperative complicationsProgram databaseOutpatient unicompartmental knee arthroplastyShort-term complication profileUnicompartmental knee arthroplasty (UKA) proceduresNational patient populationPerioperative outcome measuresHigh patient satisfactionKnee arthroplasty proceduresPotential confounding factorsInpatient cohortPerioperative outcomesPostdischarge complicationsPatient characteristicsComplication profileOutpatient surgeryPatient populationKnee arthroplastyOutpatient procedure