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JOURNAL ARTICLE
Jerry Chang, Danielle S Chun, Christine J Wu, Niall H Cochrane, Billy I Kim, Sean P Ryan, Thorsten M Seyler
BACKGROUND: Long-term survival in patients who receive bone marrow transplantation (BMT) is increasing. However, osteonecrosis and secondary osteoarthritis (OA) of the hip and knee are common complications in this population due to post-transplant steroid treatment to prevent graft vs host disease. The purpose of this study was to evaluate the outcomes of total joint arthroplasty (TJA) in patients with prior BMT and compare them to those of patients undergoing TJA for primary OA. METHODS: Patients with a history of BMT undergoing primary TJA from 2013 to 2021 were retrospectively reviewed...
June 2024: Arthroplasty Today
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JOURNAL ARTICLE
Alisina Shahi, Samantha L Harrer, Jack W Shilling, Matthew L Brown, Nicole Martino, Christopher McFadden
BACKGROUND: Acute kidney injury (AKI) is associated with increased complications after total hip arthroplasty (THA) and total knee arthroplasty (TKA). The purpose of this study was to determine the risk factors for AKI after THA and TKA and evaluate if preoperative use of antihypertensive drugs is a risk factor for AKI. METHODS: A retrospective review of 7406 primary TKAs and THAs (4532 hips and 2874 knees) from 2013 to 2019 was performed. The following preoperative variables were obtained from medical records: medications, chemistry 7 panel, Elixhauser comorbidities, and demographic factors...
June 2024: Arthroplasty Today
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JOURNAL ARTICLE
Shane Shahrestani, Lawrance K Chung, Nolan J Brown, Sofia Reese, Ryan C Liu, R Apurva A Prasad, R Kiran Alluri, Raymond Hah, John C Liu, Michael M Safaee
OBJECTIVE: We evaluated the contributions of chronological age, comorbidity burden, and/or frailty in predicting 90-day readmission in patients undergoing degenerative scoliosis surgery. METHODS: Patients were identified through the Healthcare Cost and Utilization Project Nationwide Readmissions Database. Frailty was assessed using the Johns Hopkins Adjusted Clinical Groups frailty-defining indicator. Comorbidity was assessed using the Elixhauser Comorbidity Index (ECI)...
April 26, 2024: World Neurosurgery
#4
JOURNAL ARTICLE
Aaron J Walker, Jianhui Zhu, Floyd Thoma, Oscar Marroquin, Amber Makani, Martha Gulati, Eugenia Gianos, Salim S Virani, Fatima Rodriguez, Steven E Reis, Christie Ballantyne, Suresh Mulukutla, Anum Saeed
BACKGROUND: Statins are a cost-effective therapy for prevention of atherosclerotic cardiovascular disease (ASCVD). Guidelines on statins for primary prevention are unclear for older adults (>75 years). OBJECTIVE: Investigate statin utility in older adults without ASCVD events, by risk stratifying in a large healthcare network. METHODS: We included 8,114 older adults, without CAD, PVD or ischemic stroke. Statin utilization based on ACC/AHA 10-year ASCVD risk calculation, was evaluated in intermediate (7...
June 2024: American journal of preventive cardiology
#5
JOURNAL ARTICLE
Julian Smith-Voudouris, Lee E Rubin, Jonathan N Grauer
INTRODUCTION: Total knee arthroplasty (TKA) is a common procedure for which patient factors are known to affect perioperative outcomes. Asthma has not been specifically considered in this regard, although it is the most common inflammatory airway disease and predisposes to osteoarthritis. METHODS: Adult patients undergoing TKA were identified from 2015 to 2021-Q3 M157 PearlDiver data sets. Asthma patients were matched to those without 1:1 based on age, sex, and Elixhauser Comorbidity Index (ECI)...
April 18, 2024: Journal of the American Academy of Orthopaedic Surgeons
#6
JOURNAL ARTICLE
Mark Haft, Zachary C Pearson, Uzoma Ahiarakwe, Sarah Y Nelson, Uma Srikumaran
INTRODUCTION: The risks and benefits of including an arthroscopic subacromial decompression (ASD) during arthroscopic rotator cuff repair (RCR) are uncertain. Some studies suggest no difference in revision surgery rates, whereas others have found higher revision surgery rates associated with concomitant ASD. In this study, we compare mid-term revision surgery rates in patients undergoing arthroscopic RCR with or without concomitant ASD. METHODS: A retrospective cohort analysis was conducted using a national all-payer claims database...
April 18, 2024: Journal of the American Academy of Orthopaedic Surgeons
#7
JOURNAL ARTICLE
Alexander J Kammien, Kevin Hu, John Collar, Albert L Rancu, K Lynn Zhao, Jonathan N Grauer, David L Colen
BACKGROUND: Prior studies have compared perioperative opioid prescriptions between carpal tunnel release (CTR) performed wide-awake and with traditional anesthetic techniques, but the association of opioid prescriptions with surgical setting has not been fully explored. The current study assessed the association of opioid prescriptions with surgical setting (office or operating room) for wide-awake CTR. METHODS: Patients with open CTR were identified in an administrative claims database (PearlDiver)...
April 23, 2024: Hand: Official Journal of the American Association for Hand Surgery
#8
JOURNAL ARTICLE
Manu V Venkat, Ling Chen, Jason D Wright, Benjamin Lebwohl
OBJECTIVE: To characterize the frequency and predictors of follow-up endoscopic biopsy in patients with celiac disease. BACKGROUND: The utility of routine follow-up biopsy in patients after a diagnosis of celiac disease is uncertain, especially in patients whose symptoms resolve on the gluten-free diet. PATIENTS AND METHODS: Using the Merative MarketScan U.S. commercial insurance and Medicare databases, we identified 30,737 patients with biopsy-diagnosed celiac disease...
April 23, 2024: Journal of Clinical Gastroenterology
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JOURNAL ARTICLE
Günter Niegisch, Marc-Oliver Grimm, Fraence Hardtstock, Julia Krieger, Alexandra Starry, Ulrike Osowski, Barthold Deiters, Ulf Maywald, Thomas Wilke, Mairead Kearney
AIMS: This retrospective claims data study characterized real-world treatment patterns, healthcare resource utilization (HCRU), and costs in patients with metastatic urothelial carcinoma (mUC) in Germany. MATERIALS AND METHODS: Continuously insured adults with incident mUC diagnosis (=index; ICD-10 : C65-C68/C77-C79) in 2015-2019 were identified from two German claims databases. Patients who received first-line (1 L) treatment within 12 months of index were divided into three mutually exclusive sub-cohorts: platinum-based chemotherapy (PB-CT), non-PB-CT, and immunotherapy (IO)...
2024: Journal of Medical Economics
#10
JOURNAL ARTICLE
Shruti K Gohil, Edward Septimus, Ken Kleinman, Neha Varma, Taliser R Avery, Lauren Heim, Risa Rahm, William S Cooper, Mandelin Cooper, Laura E McLean, Naoise G Nickolay, Robert A Weinstein, L Hayley Burgess, Micaela H Coady, Edward Rosen, Selsebil Sljivo, Kenneth E Sands, Julia Moody, Justin Vigeant, Syma Rashid, Rebecca F Gilbert, Kim N Smith, Brandon Carver, Russell E Poland, Jason Hickok, S G Sturdevant, Michael S Calderwood, Anastasiia Weiland, David W Kubiak, Sujan Reddy, Melinda M Neuhauser, Arjun Srinivasan, John A Jernigan, Mary K Hayden, Abinav Gowda, Katyuska Eibensteiner, Robert Wolf, Jonathan B Perlin, Richard Platt, Susan S Huang
IMPORTANCE: Urinary tract infection (UTI) is the second most common infection leading to hospitalization and is often associated with gram-negative multidrug-resistant organisms (MDROs). Clinicians overuse extended-spectrum antibiotics although most patients are at low risk for MDRO infection. Safe strategies to limit overuse of empiric antibiotics are needed. OBJECTIVE: To evaluate whether computerized provider order entry (CPOE) prompts providing patient- and pathogen-specific MDRO risk estimates could reduce use of empiric extended-spectrum antibiotics for treatment of UTI...
April 19, 2024: JAMA
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JOURNAL ARTICLE
Muhammad Musaab Munir, Selamawit Woldesenbet, Yutaka Endo, Mary Dillhoff, Susan Tsai, Timothy M Pawlik
BACKGROUND: The association of hospital market competition, financial costs, and quality of oncologic care has not been well-defined. This study sought to evaluate variations in patient outcomes and financial expenditures after complex cancer surgery across high- and low-competition markets. METHODS: Medicare 100% Standard Analytic Files were used to identify patients with lung, esophageal, gastric, hepatopancreaticobiliary, or colorectal cancer who underwent surgical resection between 2018 and 2021...
April 18, 2024: Annals of Surgical Oncology
#12
JOURNAL ARTICLE
Ittai Shichman, Vinaya Rajahraman, Utkarsh Anil, Charles C Lin, Joshua C Rozell, Ran Schwarzkopf
INTRODUCTION: Ehlers-Danlos syndromes (EDS) are genetic connective tissue disorders affecting multiple organ systems that frequently result in connective tissue hyperlaxity and early osteoarthritis. Short- and long-term outcomes after primary total hip arthroplasty (THA) in this patient population remain poorly characterised. The primary purpose of this study is to compare postoperative outcomes and survivorship after primary THA in patients with and without EDS. METHODS: The New York Statewide Planning and Research Cooperative System (SPARCS) database was queried for all patients undergoing primary elective THA between September 2009 and December 2020...
April 15, 2024: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
#13
JOURNAL ARTICLE
Kotaro Nishida, HyeJin Park, Mami Ogiri, Anne Rossi
INTRODUCTION: Spinal fusion surgery with instrumentation is a treatment of choice for many spinal disorders; however, there is little data related to factors associated with early and late outcomes, especially among patients with poor bone quality (e.g., osteoporosis). We conducted this study to characterize the epidemiology and outcomes of patients undergoing spinal fusion surgery with instrumentation in Japan, especially in patients with poor bone quality and those needing additional fixation methods...
March 27, 2024: Spine surgery and related research
#14
JOURNAL ARTICLE
Adam M Gordon, Mitchell K Ng, Faisal Elali, Nicolas S Piuzzi, Michael A Mont
INTRODUCTION: Socioeconomic status (SES) has been demonstrated to be an important prognostic risk factor among patients undergoing total joint arthroplasty. We evaluated patients living near neighborhoods with higher socioeconomic risk undergoing total knee arthroplasty (TKA) and if they were associated with differences in: 1) medical complications; 2) emergency department (ED) utilizations; 3) readmissions; and 4) costs of care. METHODS: A query of a national database from 2010 to 2020 was performed for primary TKAs...
April 12, 2024: Journal of Arthroplasty
#15
JOURNAL ARTICLE
Andrew D Thompson, Sarah E Petry, Elizabeth R Hauser, Stephen H Boyle, Gita A Pathak, Julie Upchurch, Ashlyn Press, Melissa G Johnson, Kellie J Sims, Christina D Williams, Elizabeth J Gifford
Objectives: To examine whether severe Gulf War illness (SGWI) case status was associated with longitudinal multimorbidity patterns. Methods: Participants were users of the Veteran Health Administration Health Care System drawn from the Gulf War Era Cohort and Biorepository ( n = 840). Longitudinal measures of multimorbidity were constructed using (1) electronic health records (Charlson Comorbidity Index; Elixhauser; and Veterans Affairs Frailty Index) from 10/1/1999 to 6/30/2023 and (2) self-reported medical conditions (Deficit Accumulation Index) since the war until the survey date...
April 9, 2024: Journal of Aging and Health
#16
JOURNAL ARTICLE
Joseph M Serino, E Bailey Terhune, Robert A Burnett, John D D Higgins, Joshua J Jacobs, Craig J Della Valle, Denis Nam
OBJECTIVES: The ideal timing for patients undergoing bilateral total knee arthroplasty (TKA) remains unknown. The purpose of this study was to compare 90-day outcomes between unilateral, simultaneous bilateral, and staged bilateral TKA. METHODS: The PearlDiver database was used to retrospectively identify 231,119 patients undergoing primary TKA during 2015-2020, of which 67,956 (29.4%) were bilateral. Bilateral TKA patients were divided into cohorts of simultaneous bilateral TKA and staged bilateral TKA at 1-14 days, 15-30 days, 31-90 days, and 91-365 days...
2024: Archives of Bone and Joint Surgery
#17
JOURNAL ARTICLE
Sara Sakowitz, Syed Shahyan Bakhtiyar, Zihan Gao, Saad Mallick, Amulya Vadlakonda, Troy Coaston, Jeffrey Balian, Nikhil Chervu, Peyman Benharash
BACKGROUND: Patients undergoing emergency general surgery (EGS) often require complex management and transfer to higher acuity facilities, especially given increasing national efforts aimed at centralizing care. We sought to characterize factors and evaluate outcomes associated with interhospital transfer using a contemporary national cohort. METHODS: All adult hospitalizations for EGS (appendectomy, cholecystectomy, laparotomy, lysis of adhesions, small/large bowel resection, and perforated ulcer repair) ≤2 days of admission were identified in the 2016-2020 National Inpatient Sample...
April 3, 2024: American Surgeon
#18
JOURNAL ARTICLE
Lucas Y Kim, Scott J Halperin, Jonathan N Grauer
BACKGROUND CONTEXT: Lumbar discectomy is a commonly performed surgery following which surgical site infection (SSI) may occur. Prior literature has suggested that, following SSI related to lumbar fusion, the rate of subsequent lumbar surgeries is increased over prolonged periods of time. This has not been studied specifically for lumbar discectomy. PURPOSE: To define factors associated with SSI following lumbar discectomy and determine if subsequently matched cohorts with and without SSI have differential rates of subsequent lumbar surgery beyond irrigation and debridement (I&Ds) over time...
April 1, 2024: Spine Journal: Official Journal of the North American Spine Society
#19
JOURNAL ARTICLE
Brett R Todd, Yuying Xing, Lili Zhao, An Nguyen, Robert Swor, Lauren Eberhardt, Amit Bahl
BACKGROUND: Hypertension (HTN) is common in discharged emergency department (ED) patients, yet the short-term outcomes of treating HTN at ED discharge are unclear. This study aimed to investigate whether emergency physician (EP) prescription of oral antihypertensive therapy at ED discharge for hypertensive patients is associated with a decreased 30-day risk of the severe adverse events (AEs), death, and revisits to the ED. METHODS: We conducted an observational cohort study assessing the 30-day outcomes of discharged ED patients with HTN, comparing outcomes based on whether antihypertensive therapy was prescribed...
April 2024: Journal of the American College of Emergency Physicians open
#20
JOURNAL ARTICLE
Chen Shen, Jennifer K Shah, Priscila Cevallos, Rahim Nazerali, Joseph M Rosen
INTRODUCTION: Treatment for melanoma after a positive sentinel lymph node biopsy includes nodal observation or lymphadenectomy. Important considerations for management, however, involve balancing the risk of recurrence and the risk of lymphedema after lymphadenectomy. METHODS: From the Merative MarketScan Research Databases, adult patients were queried from 2007 to 2021. International Classification of Disease, Ninth (ICD-9) and Tenth (ICD-10) Editions, diagnosis codes and Current Procedural Terminology codes were used to identify patients with melanoma diagnoses who underwent an index melanoma excision with a positive sentinel lymph node biopsy (SLNB)...
April 1, 2024: Annals of Plastic Surgery
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