Effect of Magnetic Resonance Imaging on Surgical Approach and Outcomes in the Management of Subaxial Cervical Fractures

Chiu, Ryan G.; Siddiqui, Neha; Rosinski, Clayton L.; Nallani, Ankita; Parola, Rown; Behbahani, Mandana; Mehta, Ankit I.

doi:10.1016/j.wneu.2020.02.060

Cited by 6 publications

(3 citation statements)

References 24 publications

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“…It contains data from 20% of all inpatient hospital discharges in the United States, and has been validated as being nationally representative. [11][12][13] NIS core files contain clinical and nonclinical data elements for each hospital discharge, including coded diagnoses, comorbidities, and procedures present during the hospitalization course, length of stay, and total charges. Nonclinical demographic variables include patient race/ethnicity, age, median household income quartile of the patient's zip code, rural/urban location of hospital, and expected primary payment source (e.g., insurance type).…”

Section: Methods Data Sourcementioning

confidence: 99%

“…The National Inpatient Sample (NIS), maintained by the United States Department of Health and Human Services Agency of Healthcare Research and Quality, is the largest all-payer inpatient database in the country. It contains data from 20% of all inpatient hospital discharges in the United States, and has been validated as being nationally representative 11–13 . NIS core files contain clinical and nonclinical data elements for each hospital discharge, including coded diagnoses, comorbidities, and procedures present during the hospitalization course, length of stay, and total charges.…”

Section: Methodsmentioning

confidence: 99%

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Cannabis Abuse and Perioperative Complications Following Inpatient Spine Surgery in the United States

Chiu

Patel

Siddiqui

et al. 2021

Spine

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Study Design. Retrospective cohort analysis of a nationwide administrative database.Objective. The aim of this study was to analyze the association between cannabis abuse and serious adverse events following elective spine surgery. Summary of Background Data. Cannabis is the most popular illicit drug in the United States, and its use has been increasing in light of state efforts to decriminalize and legalize its use for both medical and recreational purposes. Its legal status has long precluded extensive research into its adverse effects, and to date, little research has been done on the sequelae of cannabis on surgical patients, particularly in spine surgery. Methods. The 2012-2015 Nationwide Inpatient Sample was queried for all patients undergoing common elective spine surgery procedures. These patients were then grouped by the presence of concurrent diagnosis of cannabis use disorder and compared with respect to various peri-and postoperative complications, all-cause mortality, discharge disposition, length of stay, and hospitalization costs. Propensity score matching was utilized to control for potential baseline confounders.Results. A total of 423,978 patients met inclusion/exclusion criteria, 2393 (0.56%) of whom had cannabis use disorder. After controlling for baseline characteristics and comorbid tobacco use, these patients similar inpatient mortality, but higher rates of perioperative thromboembolism (odds ratio [OR] 2.2; 95% confidence interval [CI] 1.2-4.0; P ¼ 0.005), respiratory complications (OR 2.0; 95% CI 1.4 -2.9; P < 0.001), neurologic complications such as stroke and anoxic brain injury (OR 2.9; 95% CI 1.2-7.5; P ¼ 0.007), septicemia/sepsis (OR 1.5; 95% CI 1.0 to 2.5; P ¼ 0.031), and nonroutine discharge (P < 0.001), as well as increased lengths of stay (7.1 vs. 5.2 days, P < 0.001) and hospitalization charges ($137,631.30 vs. $116,112.60, P < 0.001). Conclusion. Cannabis abuse appears to be associated with increased perioperative morbidity among spine surgery patients. Physicians should ensure that a thorough preoperative drug use history is taken, and that affected patients be adequately informed of associated risks.

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Section: Methods Data Sourcementioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Cannabis Abuse and Perioperative Complications Following Inpatient Spine Surgery in the United States

Chiu

Patel

Siddiqui

et al. 2021

Spine

Self Cite

View full text Add to dashboard Cite

show abstract

“…As the largest all-payer administrative database available for public use in the United States, the NIS has been nationally validated for the assessment of inhospital mortality, morbidity, disposition, and inpatient outcomes. [14][15][16][17][18] Endpoint and Risk Factors OVCF patients were then grouped by receipt of kyphoplasty or vertebroplasty, defined by ICD-9 procedure codes 81.65 and 81.66 and ICD-10 procedure codes 0QU0, 0QU1, 0QU2, 0QU3, and 0QU4. Patients undergoing "open" procedures such as spinal fusion or laminectomy, were excluded using codes 81.0 (ICD-9), 0RG4, 0RG6, 0RG7, 0RG8, and 0RGA (ICD-10).…”

Section: Methodsmentioning

confidence: 99%

Current Trends and Socioeconomic Disparities in the Utilization of Spine Augmentation for Patients With Osteoporotic Vertebral Compression Fracture: A Nationwide Inpatient Sample Analysis From 2012 to 2016

et al. 2022

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Introduction: Osteoporotic vertebral compression fracture (OVCF) is a growing health care problem in today's aging population. Since the advent of kyphoplasty and vertebroplasty, these interventions have been commonly utilized in the treatment of symptomatic OVCF. However, the use of these interventions varies because there is not a standard of care for the management of OVCF. There remain disparities in the use of these procedures as treatment for OVCFs in the United States.Methods: The 2012 to 2016 Nationwide Inpatient Sample was queried for all patients admitted for OVCF. These patients were then grouped based on whether they received conservative vs surgical (kyphoplasty/vertebroplasty) management and compared with respect to various socioeconomic factors including race, insurance coverage, income quartile, hospital control, and geography. Propensity score matching was utilized to control for potential baseline confounders as well as the influence of other endpoints.Results: The search criteria identified 35,199 patients admitted with OVCF, of whom 7900 (22.4%) received spine augmentation. Blacks/African Americans (risk ratios [RR] = 0.79, P < 0.001), Hispanics/Latinos (RR = 0.82, P < 0.001), Asians/Pacific Islanders (RR = 0.81, P = 0.048), and unknown/other races (RR = 0.88, P = 0.037) were less likely to receive surgical management than whites/Caucasians. When compared with Medicare patients, those with Medicaid (RR = 0.76, P < 0.001) were less likely to receive surgery while privately insured patients were more likely (RR = 1.06, P = 0.42). Patients in the West (RR = 0.90, P < 0.001) were less likely to receive surgery for OVCF than those in the Northeast.Conclusions: A wide variety of socioeconomic disparities exists in the use of spinal augmentation for the management of OVCF in the United States, limiting patient access to a potentially beneficial procedure.Clinical Relevance: Retrospective Analysis.

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Inpatient outcomes of posterior fossa decompression with or without duraplasty for Chiari malformation type I

Fuentes

Chiu

Nie

et al. 2021

Clinical Neurology and Neurosurgery

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Effect of Magnetic Resonance Imaging on Surgical Approach and Outcomes in the Management of Subaxial Cervical Fractures

Cited by 6 publications

References 24 publications

Cannabis Abuse and Perioperative Complications Following Inpatient Spine Surgery in the United States

Cannabis Abuse and Perioperative Complications Following Inpatient Spine Surgery in the United States

Current Trends and Socioeconomic Disparities in the Utilization of Spine Augmentation for Patients With Osteoporotic Vertebral Compression Fracture: A Nationwide Inpatient Sample Analysis From 2012 to 2016

Inpatient outcomes of posterior fossa decompression with or without duraplasty for Chiari malformation type I

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