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
Ambulatory Single-level Posterior Cervical Foraminotomy for Cervical Radiculopathy
Bovonratwet P, Retzky JS, Chen AZ, Ondeck NT, Samuel AM, Qureshi SA, Grauer JN, Albert TJ. Ambulatory Single-level Posterior Cervical Foraminotomy for Cervical Radiculopathy. Clinical Spine Surgery A Spine Publication 2021, 35: e306-e313. PMID: 34654773, DOI: 10.1097/bsd.0000000000001252.Peer-Reviewed Original ResearchConceptsSingle-level posterior cervical foraminotomyPosterior cervical foraminotomyCervical radiculopathyInpatient proceduresCervical foraminotomyPerioperative complicationsAmbulatory proceduresSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databasePropensity scoreRetrospective cohort comparison studyImprovement Program databaseSurgical site infectionCohort comparison studyHospital lengthPain controlPerioperative outcomesPostoperative complicationsThromboembolic eventsWound complicationsNSQIP databasePatient characteristicsSite infectionIndividual complicationsA Matched Comparison of Postoperative Complications Between Smokers and Nonsmokers Following Open Reduction Internal Fixation of Distal Radius Fractures
Galivanche AR, FitzPatrick S, Dussik C, Malpani R, Nduaguba A, Varthi AG, Grauer JN. A Matched Comparison of Postoperative Complications Between Smokers and Nonsmokers Following Open Reduction Internal Fixation of Distal Radius Fractures. The Journal Of Hand Surgery 2021, 46: 1-9.e4. PMID: 33390240, DOI: 10.1016/j.jhsa.2020.09.020.Peer-Reviewed Original ResearchConceptsMinor adverse eventsDistal radius fracturesOpen reduction internal fixationSerious adverse eventsReduction internal fixationAdverse eventsRadius fracturesPropensity-score matchingInternal fixationSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseSTUDY/LEVELImprovement Program databasePerioperative adverse eventsMultivariable logistic analysisDemographic characteristicsSimilar demographic characteristicsHigh rateNonsmoker cohortPostoperative complicationsOperative treatmentPatient characteristicsSmoking groupComorbidity status
2020
Readmissions 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 reasonsCoagulopathies Are a Risk Factor for Adverse Events Following Total Hip and Total Knee Arthroplasty.
Malpani R, Mclynn RP, Bovonratwet P, Bagi PS, Yurter A, Mercier MR, Rubin LE, Grauer JN. Coagulopathies Are a Risk Factor for Adverse Events Following Total Hip and Total Knee Arthroplasty. Orthopedics 2020, 43: 233-238. PMID: 32674174, DOI: 10.3928/01477447-20200624-02.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overArthroplasty, Replacement, HipArthroplasty, Replacement, KneeBlood Coagulation DisordersDatabases, FactualFemaleHumansMaleMiddle AgedMultivariate AnalysisOutcome Assessment, Health CarePatient ReadmissionPostoperative ComplicationsRetrospective StudiesRisk FactorsYoung AdultConceptsHigher international normalized ratioInternational normalized ratioMajor adverse eventsTotal hip arthroplastyPartial thromboplastin timeHigher partial thromboplastin timeMinor adverse eventsAdverse eventsLow plateletsHematological conditionsSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseTotal knee arthroplasty (TKA) populationQuality Improvement Program databasePrimary total hip arthroplastyDependent functional statusImprovement Program databasePostsurgical adverse eventsTotal knee arthroplastyMultiple adverse eventsPreoperative coagulopathyTHA cohortTKA groupTKA patientsHospital readmissionPostoperative Pressure Ulcers After Geriatric Hip Fracture Surgery Are Predicted by Defined Preoperative Comorbidities and Postoperative Complications.
Galivanche AR, Kebaish KJ, Adrados M, Ottesen TD, Varthi AG, Rubin LE, Grauer JN. Postoperative Pressure Ulcers After Geriatric Hip Fracture Surgery Are Predicted by Defined Preoperative Comorbidities and Postoperative Complications. Journal Of The American Academy Of Orthopaedic Surgeons 2020, 28: 342-351. PMID: 31567615, DOI: 10.5435/jaaos-d-19-00104.Peer-Reviewed Original ResearchConceptsPostoperative pressure ulcersHip fracture surgeryPostoperative complicationsPressure ulcersRisk factorsPreoperative comorbiditiesFracture surgerySurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseGeriatric hip fracture patientsGeriatric hip fracture surgeryQuality Improvement Program databaseMultivariate regressionNSQIP Participant Use FilePreoperative risk factorsHip fracture patientsImprovement Program databaseUrinary tract infectionElevated platelet countInsulin-dependent diabetesParticipant Use FilePressure ulcer developmentQuality Improvement ProgramPostoperative deliriumPostoperative pneumoniaUnderweight 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
2018
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
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 CollegePatientsComparison of 30-Day Complications Between Navigated and Conventional Single-level Instrumented Posterior Lumbar Fusion
Bovonratwet P, Nelson SJ, Ondeck NT, Geddes BJ, Grauer JN. Comparison of 30-Day Complications Between Navigated and Conventional Single-level Instrumented Posterior Lumbar Fusion. Spine 2018, 43: 447-453. PMID: 28700450, DOI: 10.1097/brs.0000000000002327.Peer-Reviewed Original ResearchConceptsPosterior lumbar fusionOperative timeLumbar fusionHospital lengthWound infectionSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseShorter mean hospital lengthQuality Improvement Program databaseScrew placementRadiation exposureContamination/infectionLower blood transfusionRetrospective cohort comparison studyMean hospital lengthMost adverse eventsImprovement Program databaseInstrumented posterior lumbar fusionInstrumented lumbar fusionSurgeon radiation exposureCohort comparison studyPotential confounding factorsPedicle screw placementPerioperative complicationsPerioperative outcomesDiscrepancies 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 CollegeACDFOutpatientsTotal Disc Arthroplasty Versus Anterior Interbody Fusion in the Lumbar Spine Have Relatively a Few Differences in Readmission and Short-term Adverse Events
Shultz BN, Wilson AT, Ondeck NT, Bovonratwet P, McLynn RP, Cui JJ, Grauer JN. Total Disc Arthroplasty Versus Anterior Interbody Fusion in the Lumbar Spine Have Relatively a Few Differences in Readmission and Short-term Adverse Events. Spine 2018, 43: e52-e59. PMID: 28723873, DOI: 10.1097/brs.0000000000002337.Peer-Reviewed Original ResearchConceptsAnterior lumbar interbody fusionTotal disc arthroplastyAdverse eventsBlood transfusionOperative timeInterbody fusionRisk factorsSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseShort-term adverse eventsQuality Improvement Program databaseShort-term clinical outcomesLong-term functional outcomeLumbar total disc arthroplastySerious adverse eventsImprovement Program databaseAnterior interbody fusionIndividual adverse eventsStand-alone Anterior Lumbar Interbody FusionGeneral health outcomesPotential risk factorsLumbar interbody fusionMultivariate Poisson regressionPerioperative outcomesPostoperative length
2017
Outpatient elective posterior lumbar fusions appear to be safely considered for appropriately selected patients
Bovonratwet P, Ottesen TD, Gala RJ, Rubio DR, Ondeck NT, McLynn RP, Grauer JN. Outpatient elective posterior lumbar fusions appear to be safely considered for appropriately selected patients. The Spine Journal 2017, 18: 1188-1196. PMID: 29155341, DOI: 10.1016/j.spinee.2017.11.011.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAmbulatory Surgical ProceduresBlood TransfusionCohort StudiesDatabases, FactualElective Surgical ProceduresFemaleHumansInpatientsLumbar VertebraeMaleMiddle AgedPatient ReadmissionPatient SelectionPostoperative ComplicationsPropensity ScoreQuality ImprovementRetrospective StudiesSpinal FusionYoung AdultConceptsPosterior lumbar fusionPerioperative complicationsPostoperative complicationsNSQIP databaseInterbody fusionLumbar fusionNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement Program databaseElective posterior lumbar fusionQuality Improvement Program databasePropensity score-matched comparisonLower blood transfusionMost perioperative complicationsPostoperative adverse eventsRetrospective cohort comparison studyImprovement Program databaseRate of readmissionCareful patient selectionCohort comparison studyPotential confounding factorsInpatient cohortPLF casesHospital lengthPerioperative courseSelect patientsOf 20,376 Lumbar Discectomies, 2.6% of Patients Readmitted Within 30 Days
Webb ML, Nelson SJ, Save A, Cui J, Lukasiewicz AM, Samuel AM, Diaz-Collado PJ, Bohl DD, Ondeck NT, McLynn RP, Grauer JN. Of 20,376 Lumbar Discectomies, 2.6% of Patients Readmitted Within 30 Days. Spine 2017, 42: 1267-1273. PMID: 27926671, DOI: 10.1097/brs.0000000000002014.Peer-Reviewed Original ResearchConceptsSurgical site infectionLumbar discectomyThromboembolic eventsHospital readmissionSite infectionSurgical variablesCommon reasonSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseCauses of readmissionHigher American SocietyImprovement Program databaseRetrospective cohort studyDay of surgeryQuality-based reimbursementQuality improvement initiativesPearson chi-squareAnesthesiologists classPostoperative painPatient demographicsCohort studyOperative timeAffordable Care ActRisk factorsPredicting Postoperative Morbidity and Readmission for Revision Posterior Lumbar Fusion
Basques BA, Ibe I, Samuel AM, Lukasiewicz AM, Webb ML, Bohl DD, Grauer JN. Predicting Postoperative Morbidity and Readmission for Revision Posterior Lumbar Fusion. Clinical Spine Surgery A Spine Publication 2017, 30: e770-e775. PMID: 27280782, DOI: 10.1097/bsd.0000000000000391.Peer-Reviewed Original ResearchConceptsMinor adverse eventsSevere adverse eventsInsulin-dependent diabetesAdverse eventsPosterior lumbar fusionLumbar fusionRisk factorsASA classificationOperative timeSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseMultivariate analysisBody mass index 25Quality Improvement Program databaseImprovement Program databaseRetrospective cohort studySpecific risk factorsAnesthesiologists classificationBMI 30Postoperative complicationsPostoperative morbidityCohort studyPatient characteristicsSicker patientsAdverse outcomesComparison of Perioperative Adverse Event Rates After Total Knee Arthroplasty in Patients With Diabetes: Insulin Dependence Makes a Difference
Webb ML, Golinvaux NS, Ibe IK, Bovonratwet P, Ellman MS, Grauer JN. Comparison of Perioperative Adverse Event Rates After Total Knee Arthroplasty in Patients With Diabetes: Insulin Dependence Makes a Difference. The Journal Of Arthroplasty 2017, 32: 2947-2951. PMID: 28559194, DOI: 10.1016/j.arth.2017.04.032.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedArthroplasty, Replacement, KneeComorbidityDatabases, FactualDiabetes Mellitus, Type 1Diabetes Mellitus, Type 2FemaleHumansInsulinMaleMiddle AgedOrthopedic ProceduresPostoperative ComplicationsPrevalenceQuality ImprovementRetrospective StudiesRisk FactorsTreatment OutcomeUnited StatesYoung AdultConceptsTotal knee arthroplastyInsulin-dependent DMDiabetes mellitusAdverse eventsGreater riskKnee arthroplastySurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databasePerioperative adverse event ratesQuality Improvement Program databaseInsulin-dependent diabetes mellitusPerioperative adverse outcomesRetrospective cohort studyImprovement Program databasePerioperative adverse eventsAdverse event ratesDependent diabetes mellitusPreoperative risk stratificationEffective treatment optionMultivariate Poisson regressionMultiple adverse eventsCohort studyInsulin dependencePostoperative daySurgical complicationsDifferences in Short-Term Outcomes Between Primary and Revision Anterior Cervical Discectomy and Fusion
Basques BA, Ondeck NT, Geiger EJ, Samuel AM, Lukasiewicz AM, Webb ML, Bohl DD, Massel DH, Mayo BC, Singh K, Grauer JN. Differences in Short-Term Outcomes Between Primary and Revision Anterior Cervical Discectomy and Fusion. Spine 2017, 42: 253-260. PMID: 28207667, DOI: 10.1097/brs.0000000000001718.Peer-Reviewed Original ResearchConceptsRevision anterior cervical discectomyAnterior cervical discectomySurgical site infectionACDF proceduresRevision proceduresAdverse eventsPostoperative lengthThromboembolic eventsCervical discectomySite infectionBlood transfusionOperative timeNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement Program databaseQuality Improvement Program databaseOperating roomImprovement Program databaseMinor adverse eventsRetrospective cohort studySevere adverse eventsShort-term morbidityRisk of readmissionAverage operative timeShort-term outcomesMultiple adverse outcomesComparison of Outpatient vs Inpatient Total Knee Arthroplasty: An ACS-NSQIP Analysis
Bovonratwet P, Ondeck NT, Nelson SJ, Cui JJ, Webb ML, Grauer JN. Comparison of Outpatient vs Inpatient Total Knee Arthroplasty: An ACS-NSQIP Analysis. The Journal Of Arthroplasty 2017, 32: 1773-1778. PMID: 28237215, DOI: 10.1016/j.arth.2017.01.043.Peer-Reviewed Original ResearchMeSH KeywordsAgedAmbulatory Surgical ProceduresArthroplasty, Replacement, KneeBlood TransfusionCohort StudiesComorbidityDatabases, FactualFemaleHumansInpatientsMaleMiddle AgedMultivariate AnalysisOutcome Assessment, Health CareOutpatientsPatient ReadmissionPostoperative ComplicationsPropensity ScoreQuality ImprovementConceptsTotal knee arthroplastyOutpatient total knee arthroplastyAdverse eventsKnee arthroplastyOutpatient procedureSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseMultivariate analysisInpatient total knee arthroplastyElective total knee arthroplastyQuality Improvement Program databasePrimary total knee arthroplastyComparison of outpatientPerioperative outcome measuresImprovement Program databasePerioperative adverse eventsIndividual adverse eventsACS-NSQIP AnalysisInpatient cohortHospital lengthLess comorbiditySelect patientsTKA patientsOutpatient cohortPostoperative period
2016
Is Outpatient Total Hip Arthroplasty Safe?
Nelson SJ, Webb ML, Lukasiewicz AM, Varthi AG, Samuel AM, Grauer JN. Is Outpatient Total Hip Arthroplasty Safe? The Journal Of Arthroplasty 2016, 32: 1439-1442. PMID: 28065622, DOI: 10.1016/j.arth.2016.11.053.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedArthroplasty, Replacement, HipBlood TransfusionDatabases, FactualFemaleHumansInpatientsLength of StayLogistic ModelsMaleMiddle AgedMultivariate AnalysisOutpatientsPatient DischargePatient ReadmissionPatient SafetyPoisson DistributionPostoperative ComplicationsPropensity ScoreQuality ImprovementRegression AnalysisRetrospective StudiesYoung AdultConceptsOutpatient total hip arthroplastyTotal hip arthroplastyAdverse eventsPropensity scoreSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseGeneral health outcome measuresDays adverse eventsImprovement Program databaseMultivariate Poisson regressionHealth outcome measuresHospital dischargePostoperative dayBlood transfusionExtended LOSTHA patientsPotential confoundersInpatient proceduresProgram databaseRelative riskHip arthroplastyOutcome measuresSafety dataStudy groupIncidence and Risk Factors for Pneumonia After Posterior Lumbar Fusion Procedures
Bohl DD, Mayo BC, Massel DH, Iantorno SE, Ahn J, Basques BA, Grauer JN, Singh K. Incidence and Risk Factors for Pneumonia After Posterior Lumbar Fusion Procedures. Spine 2016, 41: 1058-1063. PMID: 26679873, DOI: 10.1097/brs.0000000000001389.Peer-Reviewed Original ResearchConceptsDependent diabetes mellitusPosterior lumbar fusionChronic obstructive pulmonary diseaseIndependent risk factorDevelopment of pneumoniaObstructive pulmonary diseaseRisk factorsPostoperative pneumoniaPulmonary diseaseSteroid useAmerican CollegeSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramQuality Improvement Program databaseSurgical Quality Improvement ProgramPosterior lumbar fusion proceduresRate of sepsisImprovement Program databaseIncidence of pneumoniaDevelopment of sepsisDiagnosis of pneumoniaLumbar fusion proceduresFusion procedures