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1. Management of Extra-articular Deformity

Author

Scuderi, Giles R., Haas, Steven B., Berliner, Jonathan L., Assayag, Michael J., Rozbruch, S. Robert, Khlopas, Anton, Connors, Grayson P., Gwam, Chukwuweike U., Mistry, Jaydev B., Delanois, Ronald E., Mont, Michael A., Parcells, Bertrand W., Bateman, Dexter K., Preston, Jared S., Tria, Alfred J., Tria, Alfred J., editor, Scuderi, Giles R., editor, and Cushner, Fred D., editor

Published
2018
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8. Biologics and Patches

Author

Williams, Phillip N., Mistry, Jaydev B., Dines, Joshua S., Gulotta, Lawrence V., editor, and Craig, Edward V., editor

Published
2015
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29. Recent Smoking History Is Not Associated with Adverse 30-Day Standardized Postoperative Outcomes following Microsurgical Reconstructive Procedures of the Upper Extremity

Author

Oleru, Olachi O., Shah, Neil V., Zhou, Peter L., Sedaghatpour, Dillon, Mistry, Jaydev B., Wham, Bradley C., Kurtzman, Joey, Mithani, Suhail K., and Koehler, Steven M.

Abstract

Background:Upper extremity (UE) microsurgical reconstruction relies upon proper wound healing for optimal outcomes. Cigarette smoking is associated with wound healing complications, yet conclusions vary regarding impact on microsurgical outcomes (replantation, revascularization, and free tissue transfer). We investigated how smoking impacted 30-day standardized postoperative outcomes following UE microsurgical reconstruction. Methods:Utilizing the National Surgical Quality Improvement Program, all patients who underwent (1) UE free flap transfer (n = 70) and (2) replantation/revascularization (n = 270) were identified. For each procedure, patients were stratified by recent smoking history (current smoker ≤1-year preoperatively). Baseline demographics and standardized 30-day complications, reoperations, and readmissions were compared between smokers and nonsmokers. Results:Replantation/revascularization patients had no differences in sex, race, or body mass index between smokers (n = 77) and nonsmokers. Smokers had a higher prevalence of congestive heart failure (5.2% vs 1.0%, P= .036) and nonsmokers were more often on hemodialysis (15.6% vs 10.4%, P= .030). Free flap transfer patients had no differences in age, sex, or race between smokers (n = 14) and nonsmokers. Smokers had a longer length of stay (6.6 vs 4.2 days, P= .001) and a greater prevalence of chronic obstructive pulmonary disorder (COPD; 7.1% vs 0%, P= .044). Recent smoking was not associated with increased odds of any 30-day minor and major standardized surgical complications, readmissions, or reoperations following UE microsurgical reconstruction via free flap transfer or replantation/revascularization. Baseline diagnosis of COPD was also not a predictor of adverse 30-day outcomes following free flap transfer. Conclusion:Recent smoking history was not associated with any 30-day adverse outcomes following UE microsurgical reconstruction via replantation/revascularization or free flap transfer. In light of these findings, further investigation is warranted, with particular focus on adverse events specific to free flaps and replantation/revascularization.

Published
2023
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37. Reply to Editorial by Mamarelis et al

Author

Mistry, Jaydev B., Elmallah, Randa K., Issa, Kimona, Chughtai, Morad, and Mont, Michael A.

Subjects
Letter to the Editor
Published
2016

46. Decline in allogeneic blood transfusion usage in total hip arthroplasty patients: National Inpatient Sample 2009 to 2013.

Author

Gwam, Chukwuweike U., Mistry, Jaydev B., Etcheson, Jennifer I., George, Nicole E., Connors, Grayson, Thomas, Melbin, Adamu, Hephzibah, Patel, Nirav G., and Delanois, Ronald E.

Subjects
*BLOOD transfusion, *HEALTH facilities, *LENGTH of stay in hospitals, *LUNG diseases, *MEDICAL care costs, *OBESITY, *PATIENTS, *RISK assessment, *SURGERY, *SURGICAL complications, *SURGICAL site infections, *TOTAL hip replacement, *COMORBIDITY, *LOGISTIC regression analysis, *DISCHARGE planning, *DISEASE incidence
Abstract

Introduction: Although total hip arthroplasty (THA) is an effective treatment for end-stage arthritis, it is also associated with substantial blood loss that may require allogeneic blood transfusion. However, these transfusions may increase the risk of certain complications. The purpose of our study is to evaluate: (i) the incidence/trends of allogeneic blood transfusion; (ii) the associated risk factors and adverse events; and (iii) the discharge disposition, length of stay (LOS), and costs for these patients between 2009 and 2013. Methods: The National Inpatient Sample database was used to identify 1,542,366 primary THAs performed between 2009 and 2013. Patients were stratified based on demographics, economic data, hospital characteristics, comorbidities, and whether or not allogeneic transfusion was received. Logistic regression was performed to evaluate the risk factors for transfusion and postoperative complications. Results: From 2009 to 2013, allogeneic transfusions were used in 16.9% of primary THAs, with a declining annual incidence. Except for obesity, all comorbidities were associated with increased likelihood of receiving a transfusion. Allogeneic transfusion patients were more likely to experience surgical site infections or pulmonary complications (p<0.001 for all). These patients were more likely to be discharged to a short-term care facility (p<0.001). Additionally, they had a greater mean LOS (p<0.001) and higher median hospital costs and charges when compared to their non-transfused counterparts. Conclusions: While the observed decline in allogeneic transfusion usage is encouraging, further efforts should focus on preoperative patient optimisation. Given the projected increase in demand for primary THAs, orthopaedic surgeons must be familiar with safe and effective blood conservation protocols. [ABSTRACT FROM AUTHOR]

Published
2018
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48. Does gender influence how patients rate their patient experience after total hip arthroplasty?

Author

Delanois, Ronald E., Gwam, Chukwuweike U., Mistry, Jaydev B., Chughtai, Morad, Khlopas, Anton, Yakubek, George, Ramkumar, Prem N., Piuzzi, Nicolas S., and Mont, Michael A.

Subjects
PATIENT satisfaction, SEX distribution, TIME, TOTAL hip replacement, MATHEMATICAL variables
Abstract

Background: Patient satisfaction, as measured by Press Ganey (PG) surveys, partially determines reimbursement rates. Knowing what influences these scores can lead to higher reimbursement for total hip arthroplasty (THA) surgeons. Currently, it is unknown whether gender biases exist in satisfaction surveys post-THA. Therefore, we asked: (i) which PG survey factors most influence hospital ratings among men and women after THA; and (ii) is there a difference in survey element responses and overall hospital ratings between men and women post-THA? Methods: We queried the PG database for patients who underwent THA from November 2009 to January 2015, which yielded 692 patients (277 men, 415 women). Weighted means were analysed for the scores of PG domains between men and women. A multiple regression analysis was performed for each gender, with overall hospital satisfaction as the dependent variable, in order to assess the influence (β-weight) of each PG domain. Results: For men, pain management (β = 0.317, p = 0.021) most influenced overall hospital rating. For women, staff responsiveness (β = 0.451, p<0.001) most influenced overall hospital rating. This was followed by communication with nurses (β = 0.373, p<0.001), and doctors (β = 0.236, p = 0.002). There were no significant differences in mean overall hospital rating between groups. Conclusions: It is advantageous for orthopaedic surgeons to focus on the PG domains most pertinent to each patient gender post-THA. Focusing efforts based on gender may allow for better patient satisfaction, optimised reimbursements, and improved hospital ratings. [ABSTRACT FROM AUTHOR]

Published
2018
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