2024
Preoperative Anxiety: An Important Risk Factor of Postoperative Adverse Events and Increased Reoperation Rates in Patients Undergoing Single-Level Anterior Cervical Diskectomy and Fusion
Katsnelson B, Rancu A, Winter A, Grauer J. Preoperative Anxiety: An Important Risk Factor of Postoperative Adverse Events and Increased Reoperation Rates in Patients Undergoing Single-Level Anterior Cervical Diskectomy and Fusion. JAAOS Global Research And Reviews 2024, 8: e24.00204. PMCID: PMC11473058, DOI: 10.5435/jaaosglobal-d-24-00204.Peer-Reviewed Original ResearchRevision surgery ratesAnterior cervical diskectomyAdverse eventsACDF patientsCervical diskectomySurgery ratesSingle-level anterior cervical diskectomyAdverse outcomesPreoperative anxietyCervical spine surgeryIncreased reoperation rateAssociated with adverse eventsFusion (ACDFSingle-level ACDFPostoperative adverse eventsPrevalence of mental health disordersImportant risk factorsMultivariate regression analysisReoperation rateMental health disordersSpine surgerySurgical outcomesElixhauser Comorbidity IndexHistory of anxietySurgical procedures35. 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 arthroplastyNerveRobotic-Assisted Versus Navigation-Assisted Posterior Lumbar Fusion
Gouzoulis M, Seddio A, Winter A, Jabbouri S, Zhu J, Rubio D, Varthi A, Grauer J. Robotic-Assisted Versus Navigation-Assisted Posterior Lumbar Fusion. Spine 2024, 49: 1483-1487. PMID: 38717329, DOI: 10.1097/brs.0000000000005032.Peer-Reviewed Original ResearchPosterior lumbar fusionLumbar fusionAdverse eventsLevel posterior lumbar fusionsCPT codesKaplan-Meier survival analysisRate of reoperationNavigation-assisted surgeryRobotic-assisted casesNavigation-assistedMinor adverse eventsPerioperative adverse eventsMultivariate logistic regressionICD-10 procedure codeRobotic cohortRobotic assistanceSpinal navigationReoperation rateAnterior fusionElixhauser Comorbidity IndexPearlDiver databaseNo significant differenceIncremental advantageAdverse outcomesComorbidity indexCefazolin 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 diagnoses
2023
Rheumatoid 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
Admission NarxCare Narcotic Scores Are Associated With Increased Odds of Readmission and Prolonged Length of Hospital Stay After Primary Elective Total Knee Arthroplasty
Galivanche A, Zhu J, Mercier M, McLean R, Wilhelm C, Varthi A, Grauer J, Rubin L. Admission NarxCare Narcotic Scores Are Associated With Increased Odds of Readmission and Prolonged Length of Hospital Stay After Primary Elective Total Knee Arthroplasty. JAAOS Global Research And Reviews 2022, 6: e22.00040. PMID: 36732305, PMCID: PMC9726283, DOI: 10.5435/jaaosglobal-d-22-00040.Peer-Reviewed Original ResearchConceptsPrimary elective total knee arthroplastyElective total knee arthroplastyTotal knee arthroplastyNarcotic scoreOverall opioid usageAdverse eventsTKA patientsHospital stayKnee arthroplastyRisk of AEsOdds of readmissionPrimary TKA patientsPreoperative narcotic useTime of admissionDose-dependent increaseOpioid usagePostoperative outcomesPatient characteristicsProlonged lengthNarcotic useAdverse outcomesSingle institutionRevision surgeryReadmissionPatientsAdverse Events After Posterior Lumbar Fusion Are Not Sufficiently Characterized With 30-day Follow-up: A Database Study
Kammien AJ, Zhu JR, Gillinov SM, Gouzoulis MJ, Grauer JN. Adverse Events After Posterior Lumbar Fusion Are Not Sufficiently Characterized With 30-day Follow-up: A Database Study. Journal Of The American Academy Of Orthopaedic Surgeons 2022, 30: 528-533. PMID: 35234736, DOI: 10.5435/jaaos-d-21-01121.Peer-Reviewed Original ResearchConceptsPosterior lumbar fusionTime of diagnosisAdverse eventsLumbar fusionIndividual adverse outcomesNinety-day ratesAcute kidney injurySurgical site infectionUrinary tract infectionSpecific adverse eventsMultiple adverse eventsPLF patientsKidney injuryCardiac eventsTract infectionsVenous thromboembolismPostoperative periodSite infectionAdverse outcomesPatient counselingAdministrative data setsDatabase studyDay 0Time pointsInterquartile rangeUnderweight 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 infection
2021
Predictors and Sequelae of Postoperative Delirium in a Geriatric Patient Population With Hip Fracture
Haynes MS, Alder KD, Toombs C, Amakiri IC, Rubin LE, Grauer JN. Predictors and Sequelae of Postoperative Delirium in a Geriatric Patient Population With Hip Fracture. JAAOS Global Research And Reviews 2021, 5: e20.00221. PMID: 33989253, PMCID: PMC8133215, DOI: 10.5435/jaaosglobal-d-20-00221.Peer-Reviewed Original ResearchConceptsHip fracture populationPostoperative deliriumPreoperative dementiaHip fractureGeriatric hip fracture populationDependent functional statusFracture populationAdverse postoperative outcomesHigher American SocietyIndependent risk factorPostoperative adverse outcomesGeriatric patient populationNongeneral anesthesiaPreoperative diabetesPostoperative outcomesIndependent predictorsMale sexAdverse outcomesPatient populationFunctional statusRevision surgeryRisk factorsDeliriumHigher oddsRisk subpopulationsLong-term Corticosteroid Use Independently Correlates With Complications After Posterior Lumbar Spine Surgery.
Kebaish KJ, Galivanche AR, Varthi AG, Ottesen TD, Rubin LE, Grauer JN. Long-term Corticosteroid Use Independently Correlates With Complications After Posterior Lumbar Spine Surgery. Orthopedics 2021, 44: 172-179. PMID: 34039214, DOI: 10.3928/01477447-20210416-01.Peer-Reviewed Original ResearchConceptsLong-term corticosteroid usePosterior lumbar spine surgeryPosterior lumbar surgeryLumbar spine surgeryPerioperative adverse outcomesCorticosteroid useAdverse eventsLumbar surgerySpine surgeryPropensity matchingAdverse outcomesNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseMinor adverse eventsEffect of immunosuppressionImprovement Program databaseLong-term corticosteroidsSerious adverse eventsBody mass indexMultiple surgical specialtiesAnesthesiologists classComparable patientsPerioperative outcomesSurgical factorsMore patientsCement 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 initiativesDiabeticsOutcomesDiabetesDiabetes Status Affects Odds of Body Mass Index-dependent Adverse Outcomes After Total Hip Arthroplasty.
Kebaish KJ, Puvanesarajah V, Rao S, Zhang B, Ottesen TD, Grauer JN, Khanuja H. Diabetes Status Affects Odds of Body Mass Index-dependent Adverse Outcomes After Total Hip Arthroplasty. Journal Of The American Academy Of Orthopaedic Surgeons 2021, 29: 71-77. PMID: 32404681, DOI: 10.5435/jaaos-d-20-00028.Peer-Reviewed Original ResearchConceptsBody mass indexSerious adverse eventsTotal hip arthroplastyAdverse eventsAdverse outcomesHip arthroplastyNational Surgical Quality Improvement Program databaseInsulin-dependent diabetes mellitus (IDDM) patientsQuality Improvement Program databaseNormal body mass indexPrimary total hip arthroplastyImprovement Program databaseDiabetes mellitus patientsDependent diabetes mellitusMultivariate logistic regressionPatient's medical historyDiabetes groupPerioperative outcomesPerioperative riskObese patientsDiabetes mellitusMellitus patientsNIDDM patientsBMI cutoffsIncreased odds
2020
Pediatric Supracondylar Humerus Fracture Outcomes by Pediatric and Nonpediatric Orthopedists.
Mets EJ, Grauer JN, McLynn RP, Frumberg DB. Pediatric Supracondylar Humerus Fracture Outcomes by Pediatric and Nonpediatric Orthopedists. Orthopedics 2020, 44: e203-e210. PMID: 33316820, DOI: 10.3928/01477447-20201210-03.Peer-Reviewed Original ResearchConceptsPediatric supracondylar humerus fracturesSupracondylar humerus fracturesHumerus fracturesMultivariate analysisRetrospective comparative cohort analysisLarge national databaseComparative cohort analysisComorbidity burdenHospital lengthPerioperative outcomesAdverse eventsPatient characteristicsPatient factorsFracture outcomesOperative timePatient 1Surgical interventionAdverse outcomesPediatric orthopedistsStudy groupCohort analysisOrthopaedic surgeonsOrthopedistsNational databaseSubspecialty trainingUnderweight 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 criteriaUse of intraoperative navigation for posterior spinal fusion in adolescent idiopathic scoliosis surgery is safe to consider
Moore HG, Samuel AM, Burroughs PJ, Pathak N, Tuason DA, Grauer JN. Use of intraoperative navigation for posterior spinal fusion in adolescent idiopathic scoliosis surgery is safe to consider. Spine Deformity 2020, 9: 403-410. PMID: 33025389, DOI: 10.1007/s43390-020-00218-x.Peer-Reviewed Original ResearchConceptsAdolescent idiopathic scoliosisNon-navigated patientsPerioperative adverse outcomesPosterior spinal fusionUse of navigationPosterior fusionAdverse outcomesSpinal fusionShort-term adverse eventsPost-operative hospital stayAdolescent idiopathic scoliosis surgeryStereotactic navigationNon-navigated casesNSQIP-Pediatric databaseThirty-day outcomesYear of procedureLonger operative timeIdiopathic scoliosis surgeryLength of stayIntraoperative navigationNational pediatric databaseHospital stayPerioperative outcomesAdverse eventsPediatric patientsPreoperative 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 countsVenous thromboembolism in children undergoing surgery: incidence, risk factors and related adverse events
Mets E, McLynn R, Grauer J. Venous thromboembolism in children undergoing surgery: incidence, risk factors and related adverse events. World Journal Of Pediatric Surgery 2020, 3: e000084. PMID: 36474866, PMCID: PMC9716836, DOI: 10.1136/wjps-2019-000084.Peer-Reviewed Original ResearchPostoperative venous thromboembolismVenous thromboembolismAdverse eventsSurgical factorsRisk factorsNational Surgical Quality Improvement Project Pediatric databaseSubsequent venous thromboembolismPerioperative adverse eventsPostoperative adverse outcomesRelated adverse eventsRetrospective cohort analysisLonger operative timePediatric surgical patientsPediatric surgical populationPreventable adverse eventsNon-elective surgeryAnesthesiologists classSurgical populationVTE eventsSurgical patientsPediatric patientsTrauma patientsOperative timeAdverse outcomesCardiothoracic surgeryUnderweight 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