2020
Thirty-Day Readmissions After Aseptic Revision Total Hip Arthroplasty: Rates, Predictors, and Reasons Vary by Surgical Indication
Pathak N, Kahlenberg CA, Moore HG, Sculco PK, Grauer JN. Thirty-Day Readmissions After Aseptic Revision Total Hip Arthroplasty: Rates, Predictors, and Reasons Vary by Surgical Indication. The Journal Of Arthroplasty 2020, 35: 3673-3678. PMID: 32684401, DOI: 10.1016/j.arth.2020.06.069.Peer-Reviewed Original ResearchConceptsNational Surgical Quality Improvement ProgramThirty-day readmissionTotal hip arthroplastyRecurrent dislocationSurgical indicationsAseptic looseningPeriprosthetic fracturesPostoperative dislocationHip arthroplastyAseptic revision total hip arthroplastyMultivariate analysisPatients meeting inclusion criteriaSurgical Quality Improvement ProgramRevision total hip arthroplastyDifferent surgical indicationsPostoperative care pathwaysMeeting inclusion criteriaQuality Improvement ProgramFurther multivariate analysisAseptic indicationsFracture cohortPostoperative predictorsReadmission ratesReadmission riskCare pathway
2019
Preoperative laboratory testing for total hip arthroplasty: Unnecessary tests or a helpful prognosticator
Ondeck NT, Fu MC, McLynn RP, Bovonratwet P, Malpani R, Grauer JN. Preoperative laboratory testing for total hip arthroplasty: Unnecessary tests or a helpful prognosticator. Journal Of Orthopaedic Science 2019, 25: 854-860. PMID: 31668911, DOI: 10.1016/j.jos.2019.09.019.Peer-Reviewed Original ResearchConceptsTotal hip arthroplastyPreoperative laboratory testingBlood urea nitrogenAdverse outcomesCreatinine levelsBUN levelsHip arthroplastySodium levelsNational Surgical Quality Improvement ProgramRoutine preoperative laboratory testingPrimary total hip arthroplastySurgical Quality Improvement ProgramElective arthroplasty proceduresHealth adverse outcomesPatient baseline characteristicsPreoperative creatinine levelPerioperative adverse eventsLower extremity arthroplastyQuality Improvement ProgramLaboratory testingHealth care deliveryHelpful prognosticatorInfectious indicationsPreoperative sodiumAdverse eventsManagement of Degenerative Spondylolisthesis: Analysis of a Questionnaire Study, Correlation With a National Sample, and Perioperative Outcomes of Treatment Options.
Bovonratwet P, Webb ML, Ondeck NT, Cui JJ, McLynn RP, Kadimcherla P, Kim DH, Grauer JN. Management of Degenerative Spondylolisthesis: Analysis of a Questionnaire Study, Correlation With a National Sample, and Perioperative Outcomes of Treatment Options. The International Journal Of Spine Surgery 2019, 13: 169-177. PMID: 31131217, PMCID: PMC6510177, DOI: 10.14444/6023.Peer-Reviewed Original ResearchInstrumented posterior fusionLumbar degenerative spondylolisthesisLong-term outcomesDegenerative spondylolisthesisPerioperative outcomesPosterior fusionSurgical treatmentSurgical approachPractice patternsSurgical techniqueSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramBetter long-term outcomesSurgical Quality Improvement ProgramPerioperative outcome measuresPostoperative adverse eventsACS-NSQIP dataPosterior surgical approachLength of stayCommon surgical treatmentSurgical practice patternsQuality Improvement ProgramConservative treatmentAdverse eventsACS-NSQIPCardiac 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 College
2018
What Associations Exist Between Comorbidity Indices and Postoperative Adverse Events After Total Shoulder Arthroplasty?
Fu MC, Ondeck NT, Nwachukwu BU, Garcia GH, Gulotta LV, Verma NN, Grauer JN. What Associations Exist Between Comorbidity Indices and Postoperative Adverse Events After Total Shoulder Arthroplasty? Clinical Orthopaedics And Related Research® 2018, 477: 881-890. PMID: 30614913, PMCID: PMC6437372, DOI: 10.1097/corr.0000000000000624.Peer-Reviewed Original ResearchConceptsNational Surgical Quality Improvement ProgramBody mass indexTotal shoulder arthroplastyPostoperative adverse eventsComorbidity indexAdverse eventsHighest AUCShoulder arthroplastyAnthropometric variablesSurgical Quality Improvement ProgramReverse total shoulder arthroplastyDiscriminative abilityCharlson Comorbidity IndexThirty-day outcomesSevere adverse eventsPreoperative risk stratificationModerate discriminative abilityYears of ageQuality Improvement ProgramGood discriminative abilityGreater associationCombination of ageAnesthesiologists classificationASA scoreMedical comorbiditiesTiming of Adverse Events Following Geriatric Hip Fracture Surgery: A Study of 19,873 Patients in the American College of Surgeons National Surgical Quality Improvement Program.
Bohl DD, Samuel AM, Webb ML, Lukasiewicz AM, Ondeck NT, Basques BA, Anandasivam NS, Grauer JN. Timing of Adverse Events Following Geriatric Hip Fracture Surgery: A Study of 19,873 Patients in the American College of Surgeons National Surgical Quality Improvement Program. The American Journal Of Orthopedics 2018, 47 PMID: 30296324, DOI: 10.12788/ajo.2018.0080.Peer-Reviewed Original ResearchConceptsSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramGeriatric hip fracture surgerySurgical Quality Improvement ProgramHip fracture surgeryAdverse eventsPostoperative day 30Quality Improvement ProgramFracture surgeryAmerican CollegeDay 30Urinary tract infections 7Median postoperative dayProspective surgical registryPostoperative adverse eventsSpecific adverse eventsInfection 7Mortality 11Pneumonia 4Postoperative dayHip fractureCardiac arrestClinical surveillancePatient counselingMyocardial infarctionLonger Operative Time Is Associated With Increased Adverse Events After Anterior Cervical Diskectomy and Fusion: 15-Minute Intervals Matter.
Ondeck NT, Bohl DD, McLynn RP, Cui JJ, Bovonratwet P, Singh K, Grauer JN. Longer Operative Time Is Associated With Increased Adverse Events After Anterior Cervical Diskectomy and Fusion: 15-Minute Intervals Matter. Orthopedics 2018, 41: e483-e488. PMID: 29708570, DOI: 10.3928/01477447-20180424-02.Peer-Reviewed Original ResearchConceptsAnterior cervical diskectomyOperative timeAdverse eventsCervical diskectomyPerioperative outcomesSurgical durationSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramSurgical Quality Improvement ProgramIndividual adverse outcomesPostoperative adverse eventsLonger operative timeGreater operative timeQuality Improvement ProgramUnplanned intubationHospital stayBaseline characteristicsVenous thromboembolismHospital readmissionAdverse outcomesPatient variablesAmerican CollegeAnesthetic effectSurgical pathologyPhysiologic stressMissing data treatments matter: an analysis of multiple imputation for anterior cervical discectomy and fusion procedures
Ondeck NT, Fu MC, Skrip LA, McLynn RP, Cui JJ, Basques BA, Albert TJ, Grauer JN. Missing data treatments matter: an analysis of multiple imputation for anterior cervical discectomy and fusion procedures. The Spine Journal 2018, 18: 2009-2017. PMID: 29649614, DOI: 10.1016/j.spinee.2018.04.001.Peer-Reviewed Original ResearchConceptsSevere adverse eventsNational Surgical Quality Improvement ProgramAnterior cervical discectomyAdverse eventsPreoperative anemiaPreoperative hypoalbuminemiaPreoperative albuminCervical discectomyHospital readmissionAdverse outcomesComplete case analysisSurgical Quality Improvement ProgramAdverse outcome variablesOne-level ACDFPreoperative laboratory valuesBody mass indexFusion proceduresMultiple imputationLogistic regression analysisQuality Improvement ProgramPreoperative hematocritPostoperative outcomesRetrospective reviewMass indexLaboratory valuesEvaluating the effect of growing patient numbers and changing data elements in the National Surgical Quality Improvement Program (NSQIP) database over the years: a study of posterior lumbar fusion outcomes
Shultz BN, Bovonratwet P, Ondeck NT, Ottesen TD, McLynn RP, Grauer JN. Evaluating the effect of growing patient numbers and changing data elements in the National Surgical Quality Improvement Program (NSQIP) database over the years: a study of posterior lumbar fusion outcomes. The Spine Journal 2018, 18: 1982-1988. PMID: 29649610, DOI: 10.1016/j.spinee.2018.03.016.Peer-Reviewed Original ResearchConceptsNational Surgical Quality Improvement ProgramNSQIP databaseERA groupPreoperative characteristicsPostoperative outcomesBlood transfusionSeptic shockOutcome studiesNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement ProgramQuality Improvement Program databaseSurgical Quality Improvement ProgramPosterior lumbar fusion surgeryLumbar fusion outcomesRetrospective cohort studyImprovement Program databaseYear of surgeryDeep vein thrombosisUrinary tract infectionLumbar fusion surgeryPostoperative day 30Number of patientsMultivariate Poisson regressionQuality Improvement ProgramPerioperative outcomesMissing 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
Definitional Differences of ‘Outpatient’ Versus ‘Inpatient’ THA and TKA Can Affect Study Outcomes
Bovonratwet P, Webb ML, Ondeck NT, Lukasiewicz AM, Cui JJ, McLynn RP, Grauer JN. Definitional Differences of ‘Outpatient’ Versus ‘Inpatient’ THA and TKA Can Affect Study Outcomes. Clinical Orthopaedics And Related Research® 2017, 475: 2917-2925. PMID: 28083753, PMCID: PMC5670045, DOI: 10.1007/s11999-017-5236-6.Peer-Reviewed Original ResearchMeSH KeywordsAmbulatory Surgical ProceduresArthroplasty, Replacement, HipArthroplasty, Replacement, KneeData MiningDatabases, FactualFemaleHumansInpatientsKaplan-Meier EstimateLength of StayMaleMultivariate AnalysisPatient AdmissionProcess Assessment, Health CarePropensity ScoreRetrospective StudiesRisk FactorsTerminology as TopicTime FactorsTreatment OutcomeUnited StatesConceptsNational Surgical Quality Improvement ProgramHospital LOSAdverse eventsNSQIP databaseRisk factorsSurgical Quality Improvement ProgramLength of hospitalSerious adverse eventsBody mass indexTotal joint arthroplastyPotential confounding factorsLarge national databaseQuality Improvement ProgramOutpatient THAPostoperative complicationsTKA cohortSmoking statusMass indexFunctional statusOutpatient procedureJoint arthroplastyActual LOSTherapeutic studiesOutpatientsPatientsWhat Is the Timing of General Health Adverse Events That Occur After Total Joint Arthroplasty?
Bohl DD, Ondeck NT, Basques BA, Levine BR, Grauer JN. What Is the Timing of General Health Adverse Events That Occur After Total Joint Arthroplasty? Clinical Orthopaedics And Related Research® 2017, 475: 2952-2959. PMID: 28054326, PMCID: PMC5670043, DOI: 10.1007/s11999-016-5224-2.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overArthroplasty, Replacement, HipArthroplasty, Replacement, KneeData MiningDatabases, FactualHumansLength of StayMiddle AgedMultivariate AnalysisPatient DischargePostoperative ComplicationsProcess Assessment, Health CareProportional Hazards ModelsRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeUnited StatesYoung AdultConceptsTotal joint arthroplastyAdverse eventsDays of diagnosisDeep vein thrombosisPulmonary embolismPostoperative dayVein thrombosisMyocardial infarctionJoint arthroplastySurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramMultivariate Cox proportional hazardsSurgical Quality Improvement ProgramMedian postoperative dayPulmonary embolism 3Postoperative adverse eventsSurgical site infectionMyocardial infarction 3Different adverse eventsRetrospective database analysisLife-threatening findingsCertain adverse eventsCox proportional hazardsSuch adverse eventsQuality Improvement ProgramTreatments of Missing Values in Large National Data Affect Conclusions: The Impact of Multiple Imputation on Arthroplasty Research
Ondeck NT, Fu MC, Skrip LA, McLynn RP, Su EP, Grauer JN. Treatments of Missing Values in Large National Data Affect Conclusions: The Impact of Multiple Imputation on Arthroplasty Research. The Journal Of Arthroplasty 2017, 33: 661-667. PMID: 29153865, DOI: 10.1016/j.arth.2017.10.034.Peer-Reviewed Original ResearchConceptsUnicompartmental knee arthroplastyPreoperative albuminAdverse outcomesKnee arthroplastyNational Surgical Quality Improvement ProgramComplete case analysisHematocrit valuesSurgical Quality Improvement ProgramDemographics of patientsPreoperative laboratory valuesMultiple imputationQuality Improvement ProgramArthroplasty researchSelection biasHealthy patientsLaboratory valuesPotential selection biasPatientsJoint surgeonsComplete dataArthroplastyOnly caseNational datasetOutcomesConclusionGeneral Health Adverse Events Within 30 Days Following Anterior Cervical Discectomy and Fusion in US Patients: A Comparison of Spine Surgeons’ Perceptions and Reported Data for Rates and Risk Factors
Ondeck NT, Bohl DD, Bovonratwet P, Geddes BJ, Cui JJ, McLynn RP, Samuel AM, Grauer JN. General Health Adverse Events Within 30 Days Following Anterior Cervical Discectomy and Fusion in US Patients: A Comparison of Spine Surgeons’ Perceptions and Reported Data for Rates and Risk Factors. Global Spine Journal 2017, 8: 345-353. PMID: 29977718, PMCID: PMC6022956, DOI: 10.1177/2192568217723017.Peer-Reviewed Original ResearchPostoperative adverse eventsNational Surgical Quality Improvement ProgramAnterior cervical discectomyPatient risk factorsAdverse eventsRisk factorsCervical discectomyPatient factorsSurgical Quality Improvement ProgramSpine surgeons’ perceptionOccurrence of complicationsSurgeons' perceptionsNational dataQuality improvement initiativesQuality Improvement ProgramElective ACDFAccuracy of surgeonsACDF proceduresPerioperative complicationsRetrospective reviewUS patientsNSQIP dataProspective dataSurgeon's assessmentSuch complicationsSimilar 30-Day Complications for Septic Knee Arthritis Treated With Arthrotomy or Arthroscopy: An American College of Surgeons National Surgical Quality Improvement Program Analysis
Bovonratwet P, Nelson SJ, Bellamkonda K, Ondeck NT, Shultz BN, Medvecky MJ, Grauer JN. Similar 30-Day Complications for Septic Knee Arthritis Treated With Arthrotomy or Arthroscopy: An American College of Surgeons National Surgical Quality Improvement Program Analysis. Arthroscopy The Journal Of Arthroscopic And Related Surgery 2017, 34: 213-219. PMID: 28866341, DOI: 10.1016/j.arthro.2017.06.046.Peer-Reviewed Original ResearchConceptsNational Surgical Quality Improvement ProgramSurgery treatment groupPerioperative complicationsSeptic kneeAdverse eventsTreatment groupsTreatment modalitiesOpen arthrotomyAmerican CollegeSurgeons National Surgical Quality Improvement Program analysisNational Surgical Quality Improvement Program analysisSurgeons National Surgical Quality Improvement ProgramMultivariate analysisSurgical Quality Improvement ProgramOperating roomSeptic knee arthritisSimilar perioperative complicationsMinor adverse eventsRate of readmissionSerious adverse eventsRetrospective comparative studyNSQIP data setsSignificant differencesQuality Improvement ProgramPatient demographicsIncidence, Risk Factors, and Impact of Clostridium difficile Colitis Following Primary Total Hip and Knee Arthroplasty
Bovonratwet P, Bohl DD, Malpani R, Nam D, Della Valle CJ, Grauer JN. Incidence, Risk Factors, and Impact of Clostridium difficile Colitis Following Primary Total Hip and Knee Arthroplasty. The Journal Of Arthroplasty 2017, 33: 205-210.e1. PMID: 28870746, DOI: 10.1016/j.arth.2017.08.004.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overArthroplasty, Replacement, HipArthroplasty, Replacement, KneeClostridioides difficileColitisEnterocolitis, PseudomembranousFemaleHumansIncidenceKnee JointMaleMiddle AgedPatient DischargePostoperative ComplicationsQuality ImprovementRetrospective StudiesRisk FactorsUnited StatesConceptsNational Surgical Quality Improvement ProgramSurgical Quality Improvement ProgramDifficile colitisPrimary total hipRisk factorsQuality Improvement ProgramPrimary THATotal hipProcedural risk factorsClostridium difficile colitisHigh-risk patientsUrinary tract infectionInfectious risk factorsPoisson multivariate regressionPreoperative anemiaPerioperative antibioticsPostoperative periodTract infectionsPrimary outcomeSubstantial morbidityKnee arthroplastyColitisPatientsClinical implicationsHospital qualityDiscriminative ability of commonly used indices to predict adverse outcomes after poster lumbar fusion: a comparison of demographics, ASA, the modified Charlson Comorbidity Index, and the modified Frailty Index
Ondeck NT, Bohl DD, Bovonratwet P, McLynn RP, Cui JJ, Shultz BN, Lukasiewicz AM, Grauer JN. Discriminative ability of commonly used indices to predict adverse outcomes after poster lumbar fusion: a comparison of demographics, ASA, the modified Charlson Comorbidity Index, and the modified Frailty Index. The Spine Journal 2017, 18: 44-52. PMID: 28578164, DOI: 10.1016/j.spinee.2017.05.028.Peer-Reviewed Original ResearchConceptsPosterior lumbar fusionPerioperative adverse outcomesNational Surgical Quality Improvement ProgramCharlson Comorbidity IndexComorbidity indexAdverse outcomesAdverse eventsFrailty indexLumbar fusionSurgeons National Surgical Quality Improvement ProgramElective posterior lumbar fusionAnesthesiologists Physical Status Classification SystemDiscriminative abilitySurgical Quality Improvement ProgramPhysical Status Classification SystemAdverse outcome variablesDemographic factorsInfectious adverse eventsOutcome variablesPatient comorbidity indexPredictive demographic factorsMinor adverse eventsSevere adverse eventsBody mass indexHigh-level care
2016
Incidence 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 proceduresPreoperative Nutritional Status as an Adjunct Predictor of Major Postoperative Complications Following Anterior Cervical Discectomy and Fusion
Fu MC, Buerba RA, Grauer JN. Preoperative Nutritional Status as an Adjunct Predictor of Major Postoperative Complications Following Anterior Cervical Discectomy and Fusion. Clinical Spine Surgery A Spine Publication 2016, 29: 167-172. PMID: 25310390, DOI: 10.1097/bsd.0000000000000181.Peer-Reviewed Original ResearchConceptsNational Surgical Quality Improvement ProgramMajor postoperative complicationsPreoperative nutritional statusAnterior cervical discectomySurgical outcomes databaseSerum albumin concentrationPreoperative hypoalbuminemiaPostoperative complicationsNutritional statusAdjunct predictorCervical discectomyACDF casesOutcomes DatabaseAlbumin concentrationAlbumin measurementSurgical Quality Improvement ProgramMultivariable logistic regression modelHigher ASA classPreoperative albumin measurementsHigh-risk patientsPreoperative serum albuminMultiple medical comorbiditiesPreoperative risk assessmentAdjusted odds ratioStrong independent predictorDo we really know our patient population in database research? A comparison of the femoral shaft fracture patient populations in three commonly used national databases.
Samuel AM, Lukasiewicz AM, Webb ML, Bohl DD, Basques BA, Varthi AG, Leslie MP, Grauer JN. Do we really know our patient population in database research? A comparison of the femoral shaft fracture patient populations in three commonly used national databases. The Bone & Joint Journal 2016, 98-B: 425-32. PMID: 26920971, DOI: 10.1302/0301-620x.98b3.36285.Peer-Reviewed Original ResearchConceptsNational Surgical Quality Improvement ProgramCharleston Comorbidity IndexNational Trauma Data BankNationwide Inpatient SampleOrthopaedic trauma researchPatient populationNational databaseLarge national clinical databaseSurgical Quality Improvement ProgramOrthopaedic trauma populationPopulation of patientsFemoral shaft fracturesNational Clinical DatabaseTrauma Data BankQuality Improvement ProgramTrauma researchMore comorbiditiesComorbidity indexShaft fracturesTrauma populationDistribution of ageInpatient SampleInclusion criteriaSD 1.9SD 2.3