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1. Predictive Analytics for Determining Extended Operative Time in Corrective Adult Spinal Deformity Surgery.

Author

Passias, Peter G, Poorman, Gregory W, Vasquez-Montes, Dennis, Kummer, Nicholas, Mundis, Gregory, Anand, Neel, Horn, Samantha R, Segreto, Frank A, Passfall, Lara, Krol, Oscar, Diebo, Bassel, Burton, Doug, Buckland, Aaron, Gerling, Michael, Soroceanu, Alex, Eastlack, Robert, Kojo Hamilton, D, Hart, Robert, Schwab, Frank, Lafage, Virginie, Shaffrey, Christopher, Sciubba, Daniel, Bess, Shay, Ames, Christopher, and Klineberg, Eric

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Patient Safety, Clinical Research, Bioengineering, 6.4 Surgery, Evaluation of treatments and therapeutic interventions, adult spinal deformity, operative time, decision trees, predictive analytics, International Spine Study Group, Neurosciences, Clinical sciences
Abstract

BackgroundMore sophisticated surgical techniques for correcting adult spinal deformity (ASD) have increased operative times, adding to physiologic stress on patients and increased complication incidence. This study aims to determine factors associated with operative time using a statistical learning algorithm.MethodsRetrospective review of a prospective multicenter database containing 837 patients undergoing long spinal fusions for ASD. Conditional inference decision trees identified factors associated with skin-to-skin operative time and cutoff points at which factors have a global effect. A conditional variable-importance table was constructed based on a nonreplacement sampling set of 2000 conditional inference trees. Means comparison for the top 15 variables at their respective significant cutoffs indicated effect sizes.ResultsIncluded: 544 surgical ASD patients (mean age: 58.0 years; fusion length 11.3 levels; operative time: 378 minutes). The strongest predictor for operative time was institution/surgeon. Center/surgeons, grouped by decision tree hierarchy, a and b were, on average, 2 hours faster than center/surgeons c-f, who were 43 minutes faster than centers g-j, all P < 0.001. The next most important predictors were, in order, approach (combined vs posterior increases time by 139 minutes, P < 0.001), levels fused (

Published
2022

2. Predictive model for achieving good clinical and radiographic outcomes at one-year following surgical correction of adult cervical deformity

Author

Passias, Peter Gust, Horn, Samantha R, Oh, Cheongeun, Poorman, Gregory W, Bortz, Cole, Segreto, Frank, Lafage, Renaud, Diebo, Bassel, Scheer, Justin K, Smith, Justin S, Shaffrey, Christopher I, Eastlack, Robert, Sciubba, Daniel M, Protopsaltis, Themistocles, Kim, Han Jo, Hart, Robert A, Lafage, Virginie, and Ames, Christopher P

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Patient Safety, Clinical Research, Rehabilitation, Cervical deformity, clinical outcomes, predictive modeling, radiographic alignment, surgical correction, International Spine Study Group, Neurosciences, Clinical sciences
Abstract

BackgroundFor cervical deformity (CD) surgery, goals include realignment, improved patient quality of life, and improved clinical outcomes. There is limited research identifying patients most likely to achieve all three.ObjectiveThe objective is to create a model predicting good 1-year postoperative realignment, quality of life, and clinical outcomes following CD surgery using baseline demographic, clinical, and radiographic factors.MethodsRetrospective review of a multicenter CD database. CD patients were defined as having one of the following radiographic criteria: Cervical sagittal vertical axis (cSVA) >4 cm, cervical kyphosis/scoliosis >10°° or chin-brow vertical angle >25°. The outcome assessed was whether a patient achieved both a good radiographic and clinical outcome. The primary analysis was stepwise regression models which generated a dataset-specific prediction model for achieving a good radiographic and clinical outcome. Model internal validation was achieved by bootstrapping and calculating the area under the curve (AUC) of the final model with 95% confidence intervals.ResultsSeventy-three CD patients were included (61.8 years, 58.9% F). The final model predicting the achievement of a good overall outcome (radiographic and clinical) yielded an AUC of 73.5% and included the following baseline demographic, clinical, and radiographic factors: mild-moderate myelopathy (Modified Japanese Orthopedic Association >12), no pedicle subtraction osteotomy, no prior cervical spine surgery, posterior lowest instrumented vertebra (LIV) at T1 or above, thoracic kyphosis >33°°, T1 slope

Published
2021

3. Classifying Complications: Assessing Adult Spinal Deformity 2-Year Surgical Outcomes.

Author

Klineberg, Eric O, Passias, Peter G, Poorman, Gregory W, Jalai, Cyrus M, Atanda, Abiola, Worley, Nancy, Horn, Samantha, Sciubba, Daniel M, Hamilton, D Kojo, Burton, Douglas C, Gupta, Munish Chandra, Smith, Justin S, Soroceanu, Alexandra, Hart, Robert A, Neuman, Brian, Ames, Christopher P, Schwab, Frank J, and Lafage, Virginie

Subjects
Clavien-Dindo Scale, adult spinal deformity, complication classification, complications, major-minor, outcomes, patient-reported outcomes
Abstract

Study designRetrospective review of prospective database.ObjectiveComplication rates for adult spinal deformity (ASD) surgery vary widely because there is no accepted system for categorization. Our objective was to identify the impact of complication occurrence, minor-major complication, and Clavien-Dindo complication classification (Cc) on clinical variables and patient-reported outcomes.MethodsComplications in surgical ASD patients with complete baseline and 2-year data were considered intraoperatively, perioperatively (6 weeks). Primary outcome measures were complication timing and severity according to 3 scales: complication presence (yes/no), minor-major, and Cc score. Secondary outcomes were surgical outcomes (estimated blood loss [EBL], length of stay [LOS], reoperation) and health-related quality of life (HRQL) scores. Univariate analyses determined complication presence, type, and Cc grade impact on operative variables and on HRQL scores.ResultsOf 167 patients, 30.5% (n = 51) had intraoperative, 48.5% (n = 81) had perioperative, and 58.7% (n = 98) had postoperative complications. Major intraoperative complications were associated with increased EBL (P < .001) and LOS (P = .0092). Postoperative complication presence and major postoperative complication were associated with reoperation (P < .001). At 2 years, major perioperative complications were associated with worse ODI, SF-36, and SRS activity and appearance scores (P < .02). Increasing perioperative Cc score and postoperative complication presence were the best predictors of worse HRQL outcomes (P < .05).ConclusionThe Cc Scale was most useful in predicting changes in patient outcomes; at 2 years, patients with raised perioperative Cc scores and postoperative complications saw reduced HRQL improvement. Intraoperative and perioperative complications were associated with worse short-term surgical and inpatient outcomes.

Published
2020

4. Development of New-Onset Cervical Deformity in Nonoperative Adult Spinal Deformity Patients With 2-Year Follow-Up.

Author

Passias, Peter G, Jalai, Cyrus M, Worley, Nancy, Vira, Shaleen, Scheer, Justin K, Smith, Justin S, Ramachandran, Subaraman, Soroceanu, Alexandra, Horn, Samantha R, Poorman, Gregory W, Protopsaltis, Themistocles S, Klineberg, Eric O, Sciubba, Daniel M, Kim, Han Jo, Hamilton, D Kojo, Lafage, Renaud, Lafage, Virginie, Ames, Christopher P, and INTERNATIONAL SPINE STUDY GROUP (ISSG)

Subjects
INTERNATIONAL SPINE STUDY GROUP, adult spinal deformity, cervical deformity, new-onset cervical deformity, nonoperative, Clinical Research, Pediatric, Neurosciences
Abstract

PurposeEvaluate the presence of new-onset cervical deformity (CD) in nonoperative adult spinal deformity (ASD) patients with extended follow-up, with consideration for predictors, prevalence, and impact on patient-reported outcomes.MethodsRetrospective review of a prospective nonoperative ASD cohort. New onset CD patients at 1- (CD-1Y) and 2-year (CD-2Y) follow-up were defined as displaying baseline cervical alignment. Univariate analyses determined differences in radiographic parameters and outcome scores of CD and maintained-cervical-alignment patients. Multivariate binary logistic regression models determined new-onset CD predictors.ResultsA total of 143 patients were included (mean age 54 years, mean body mass index 25.6 kg/m2, 86% female). Cervical deformity rate was 38.5% at baseline. New-onset CD incidence at 1- and 2-year follow-up was 30.0% and 41.7%, respectively. Global sagittal profile comparison of CD-1Y/CD-2Y versus maintained cervical alignment cases revealed no differences (P > .05) at any interval. Baseline C2-C7 sagittal vertical axis (SVA) was associated with increased new-onset CD risk at 1 (odds ratio [OR] 1.14, P = .025) and 2 years (OR 1.04, P = .032); prior spine surgical history was associated with CD risk at 1-year follow-up (OR 6.75, P = .047); baseline C2 slope was associated with increased CD risk at 2-year follow-up (OR 1.12, P = .041). CD development did not significantly impact health-related quality of life (P > .05).ConclusionsCervical deformity can manifest in nonoperative ASD patients: 30.0% at 1-year follow-up, and 41.7% at 2-year follow-up. Progressive CD manifested independently of thoracolumbar profile changes. Increased baseline C2-C7 SVA, C2 slope, and prior surgical history increased new-onset CD odds at 1 and 2 years.

Published
2018

5. Evaluating cervical deformity corrective surgery outcomes at 1-year using current patient-derived and functional measures: are they adequate?

Author

Passias, Peter G, Horn, Samantha R, Oh, Cheongeun, Ramchandran, Subaraman, Burton, Douglas C, Lafage, Virginie, Lafage, Renaud, Poorman, Gregory W, Steinmetz, Leah, Segreto, Frank A, Bortz, Cole A, Smith, Justin S, Ames, Christopher, Shaffrey, Christopher I, Kim, Han Jo, Soroceanu, Alexandra, Klineberg, Eric O, and International Spine Study Group (ISSG)

Subjects
International Spine Study Group, Cervical deformity, alignment, cervical spine, health-related quality of life metrics, myelopathy, outcomes, sagittal malalignment, spinal deformity, spino-pelvic alignment, surgical correction, Clinical Research, Patient Safety
Abstract

BackgroundCurrent health-related quality of life (HRQL) metrics used to assess patient outcomes following surgical correction of cervical deformity (CD) are not deformity-specific and thus cannot capture all aspects of a patient's deformity and outcomes. The purpose of this study is to evaluate the sensitivity of different HRQL outcome measures in assessing CD patients' outcomes 1-year post-operatively.MethodsRetrospective review of prospective multi-center database. Inclusion criteria: CD patients ≥18 yrs with pre- and 1-year post-operative radiographs and HRQLs [modified Japanese Orthopaedic Association (mJOA), EuroQol five-dimensions (EQ-5D), neck disability index (NDI)]. Associations between changes in EQ5D and NDI with improvement at 1-year in mJOA scores were assessed by whether or not the patient met the minimum clinically important difference (MCID) as well as whether or not they improved by one or more categories (i.e., change from moderate to mild). Odds ratios reported with 95% confidence intervals.ResultsSixty-three CD patients were included (mean 62 y, 55.6% F). Average baseline NDI scores were 46.75, mJOA was 13.68, and EQ-5D 0.74. Overall baseline myelopathy breakdown: none-9.5%, mild-30.2%, moderate-42.9%, high-17.5%. At 1-year, 46% of patients improved in mJOA, 71.4% NDI, and 65.1% EQ-5D. 19% of patients met mJOA MCID, 44.4% NDI MCID, 19% EQ-5D MCID. One-point improvement in NDI increased the odds of mJOA improvement and reaching mJOA MCID (improvement: OR, 1.06, CI: 1.01-1.10, P=0.01; MCID: OR, 1.06, CI: 1.02-1.11, P=0.006). Improvement in EQ-5D by 0.1 increased the odds of improving in mJOA and reaching mJOA MCID at 1-year (improvement: OR, 3.85, CI: 1.51-9.76, P=0.005; MCID: OR, 3.88, CI: 1.52-9.88, P=0.005). While correlations exist between outcome measures, when modeling these outcomes while controlling for confounders including cSVA change, surgical invasiveness, age and CCI, these HRQLs were not strongly correlated.ConclusionsImprovements in functional outcomes, as defined by mJOA score, were correlated with changes in neck based disability and general health state, defined by NDI and EQ-5D respectively. In an adjusted model, however, these direct relationships were not maintained. A CD-specific HRQL might be more useful for surgeons in assessing patient outcomes using a single metric.

Published
2018

6. Improvement in some Ames-ISSG cervical deformity classification modifier grades may correlate with clinical improvement

Author

Horn, Samantha R., Passias, Peter G., Passfall, Lara, Lafage, Renaud, Smith, Justin S., Poorman, Gregory W., Steinmetz, Leah M., Bortz, Cole A., Segreto, Frank A., Diebo, Bassel, Hart, Robert, Burton, Douglas, Shaffrey, Christopher I., Sciubba, Daniel M., Klineberg, Eric O., Protopsaltis, Themistocles S., Schwab, Frank J., Bess, Shay, Lafage, Virginie, and Ames, Christopher

Published
2021
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7. Effect of Obesity on Radiographic Alignment and Short-Term Complications After Surgical Treatment of Adult Cervical Deformity

Author

Passias, Peter G., Poorman, Gregory W., Horn, Samantha R., Jalai, Cyrus M., Bortz, Cole, Segreto, Frank, Diebo, Bassel M., Daniels, Alan, Hamilton, D. Kojo, Sciubba, Daniel, Smith, Justin, Neuman, Brian, Shaffrey, Christopher I., LaFage, Virginie, LaFage, Renaud, Schwab, Frank, Bess, Shay, Ames, Christopher, Hart, Robert, Soroceanu, Alexandra, Mundis, Gregory, and Eastlack, Robert

Published
2019
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9. Predicting the occurrence of complications following corrective cervical deformity surgery: Analysis of a prospective multicenter database using predictive analytics

Author

Passias, Peter G., Oh, Cheongeun, Horn, Samantha R., Kim, Han Jo, Hamilton, D. Kojo, Sciubba, Daniel M., Neuman, Brian J., Buckland, Aaron J., Poorman, Gregory W., Segreto, Frank A., Bortz, Cole A., Brown, Avery E., Protopsaltis, Themistocles S., Klineberg, Eric O., Ames, Christopher, Smith, Justin S., and Lafage, Virginie

Published
2019
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13. Clinical and radiographic presentation and treatment of patients with cervical deformity secondary to thoracolumbar proximal junctional kyphosis are distinct despite achieving similar outcomes: Analysis of 123 prospective CD cases

Author

Passias, Peter G., Horn, Samantha R., Poorman, Gregory W., Daniels, Alan H., Hamilton, D. Kojo, Kim, Han Jo, Diebo, Bassel G., Steinmetz, Leah, Bortz, Cole A., Segreto, Frank A., Sciubba, Daniel M., Smith, Justin S., Neuman, Brian J., Shaffrey, Christopher I., Lafage, Renaud, Lafage, Virginie, Ames, Christopher, Hart, Robert, Mundis, Gregory, Eastlack, Robert K., and Schwab, Frank J.

Published
2018
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16. Body mass index predicts risk of complications in lumbar spine surgery based on surgical invasiveness

Author

Bono, Olivia J., Poorman, Gregory W., Foster, Norah, Jalai, Cyrus M., Horn, Samantha R., Oren, Jonathan, Soroceanu, Alexandra, Ramachandran, Subaraman, Purvis, Taylor E., Jain, Deeptee, Vira, Shaleen, Diebo, Bassel G., Line, Breton, Sciubba, Daniel M., Protopsaltis, Themistocles S., Buckland, Aaron J., Errico, Thomas J., Lafage, Virginie, Bess, Shay, and Passias, Peter G.

Published
2018
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18. Full-Body Analysis of Adult Spinal Deformity Patients' Age-Adjusted Alignment at 1 Year

Author

Passias, Peter G., Horn, Samantha R., Frangella, Nicholas J., Poorman, Gregory W., Vasquez-Montes, Dennis, Diebo, Bassel G., Bortz, Cole A., Segreto, Frank A., Moon, John Y., Zhou, Peter L., Vira, Shaleen, Sure, Akhila, Beaubrun, Bryan, Tishelman, Jared C., Ramchandran, Subaraman, Jalai, Cyrus M., Bronson, Wesley, Wang, Charles, Lafage, Virginie, Buckland, Aaron J., and Errico, Thomas J.

Published
2018
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19. Traumatic Fractures of the Cervical Spine: Analysis of Changes in Incidence, Cause, Concurrent Injuries, and Complications Among 488,262 Patients from 2005 to 2013

Author

Passias, Peter G., Poorman, Gregory W., Segreto, Frank A., Jalai, Cyrus M., Horn, Samantha R., Bortz, Cole A., Vasquez-Montes, Dennis, Diebo, Bassel G., Vira, Shaleen, Bono, Olivia J., De La Garza-Ramos, Rafael, Moon, John Y., Wang, Charles, Hirsch, Brandon P., Zhou, Peter L., Gerling, Michael, Koller, Heiko, and Lafage, Virginie

Published
2018
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20. Patient profiling can identify patients with adult spinal deformity (ASD) at risk for conversion from nonoperative to surgical treatment: initial steps to reduce ineffective ASD management

Author

Passias, Peter G., Jalai, Cyrus M., Line, Breton G., Poorman, Gregory W., Scheer, Justin K., Smith, Justin S., Shaffrey, Christopher I., Burton, Douglas C., Fu, Kai-Ming G., Klineberg, Eric O., Hart, Robert A., Schwab, Frank, Lafage, Virginie, and Bess, Shay

Published
2018
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21. Correction to: Prior bariatric surgery lowers complication rates following spine surgery in obese patients

Author

Passias, Peter G., Horn, Samantha R., Vasquez-Montes, Dennis, Shepard, Nicholas, Segreto, Frank A., Bortz, Cole A., Poorman, Gregory W., Jalai, Cyrus M., Wang, Charles, Stekas, Nicholas, Frangella, Nicholas J., Deflorimonte, Chloe, Diebo, Bassel G., Raad, Micheal, Vira, Shaleen, Horowitz, Jason A., Sciubba, Daniel M., Hassanzadeh, Hamid, Lafage, Renaud, Afthinos, John, and Lafage, Virginie

Published
2019
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25. Bariatric Surgery Population at Significantly Increased Risk of Spinal Disorders and Surgical Intervention Compared With Morbidly Obese Patients

Author

Passias, Peter G., Horn, Samantha R., Ihejirika, Yael U., Vasques-Montes, Dennis, Segreto, Frank A., Bortz, Cole A., Brown, Avery E., Pierce, Katherine E., Alas, Haddy, Poorman, Gregory W., Jalai, Cyrus M., Wang, Charles, Buza, John A., III, Steinmetz, Leah, Varlotta, Christopher G., Vira, Shaleen, Diebo, Bassel G., Hassanzadeh, Hamid, Lafage, Renaud, and Lafage, Virginie

Published
2020
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26. Prior bariatric surgery lowers complication rates following spine surgery in obese patients

Author

Passias, Peter G., Horn, Samantha R., Vasquez-Montes, Dennis, Shepard, Nicholas, Segreto, Frank A., Bortz, Cole A., Poorman, Gregory W., Jalai, Cyrus M., Wang, Charles, Stekas, Nicholas, Frangella, Nicholas J., Deflorimonte, Chloe, Diebo, Bassel G., Raad, Micheal, Vira, Shaleen, Horowitz, Jason A., Sciubba, Daniel M., Hassanzadeh, Hamid, Lafage, Renaud, Afthinos, John, and Lafage, Virginie

Published
2018
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28. Congenital Etiology Is an Independent Risk Factor for Complications in Adolescents Undergoing Corrective Scoliosis Surgery: Comparison of In-hospital Comorbidities Using Nationwide KID’s Inpatient Database

Author

Poorman, Gregory W., Jalai, Cyrus M., Diebo, Bassel, Vira, Shaleen, Buza, John, Baker, Joe, Tishelman, Jared, Horn, Samantha, Bono, Olivia, Shenoy, Kartik, Hasan, Saqib, Paul, Justin, Isaacs, Evan, Kaye, Ian, Atanda, Abiola, Buckland, Aaron J., LaFage, Virginie, Errico, Thomas, and Passias, Peter G.

Published
2019
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29. Incidence of Congenital Spinal Abnormalities Among Pediatric Patients and Their Association With Scoliosis and Systemic Anomalies

Author

Passias, Peter G., Poorman, Gregory W., Jalai, Cyrus M., Diebo, Bassel G., Vira, Shaleen, Horn, Samantha R., Baker, Joseph F., Shenoy, Kartik, Hasan, Saqib, Buza, John, Bronson, Wesley, Paul, Justin C., Kaye, Ian, Foster, Norah A., Cassilly, Ryan T., Oren, Jonathan H., Moskovich, Ronald, Line, Breton, Oh, Cheongeun, Bess, Shay, LaFage, Virginie, and Errico, Thomas J.

Published
2019
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31. Cervical Versus Thoracolumbar Spinal Deformities: A Comparison of Baseline Quality-of-Life Burden

Author

Passias, Peter G., Poorman, Gregory W., Lafage, Virginie, Smith, Justin, Ames, Christopher, Schwab, Frank, Shaffrey, Chris, Segreto, Frank A., Horn, Samantha R., Bortz, Cole A., Varlotta, Christopher G., Hockley, Aaron, Wang, Charles, Daniels, Alan, Neuman, Brian, Hart, Robert, Burton, Douglas, Javidan, Yashar, Line, Breton, LaFage, Renaud, Bess, Shay, and Sciubba, Daniel

Published
2018
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33. The Relationship Between Improvements in Myelopathy and Sagittal Realignment in Cervical Deformity Surgery Outcomes

Author

Passias, Peter Gust, Horn, Samantha R., Bortz, Cole A., Ramachandran, Subaraman, Burton, Douglas C., Protopsaltis, Themistocles, Lafage, Renaud, Lafage, Virginie, Diebo, Bassel G., Poorman, Gregory W., Segreto, Frank A., Smith, Justin S., Ames, Christopher, Shaffrey, Christopher I., Kim, Han Jo, Neuman, Brian, Daniels, Alan H., Soroceanu, Alexandra, and Klineberg, Eric

Published
2018
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34. A comparative analysis of the prevalence and characteristics of cervical malalignment in adults presenting with thoracolumbar spine deformity based on variations in treatment approach over 2 years

Author

Jalai, Cyrus M., Passias, Peter G., Lafage, Virginie, Smith, Justin S., Lafage, Renaud, Poorman, Gregory W., Diebo, Bassel, Liabaud, Barthélemy, Neuman, Brian J., Scheer, Justin K., Shaffrey, Christopher I., Bess, Shay, Schwab, Frank, Ames, Christopher P., and International Spine Study Group (ISSG)

Published
2016
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36. Evaluating the Cost-Effectiveness of Celecoxib versus Ibuprofen and Naproxen in Patients with Osteoarthritis in United Arab Emirates Based on the PRECISION Trial

Author

Chirikov,Viktor V, Walker,Chris, Stephens,Jennifer M, Schepman,Patricia, Chambers,Richard, Bakir,Mahmoud, Poorman,Gregory W, Haider,Seema, Farghaly,Mohammed, Chirikov,Viktor V, Walker,Chris, Stephens,Jennifer M, Schepman,Patricia, Chambers,Richard, Bakir,Mahmoud, Poorman,Gregory W, Haider,Seema, and Farghaly,Mohammed

Abstract

Viktor V Chirikov,1 Chris Walker,2 Jennifer M Stephens,1 Patricia Schepman,3 Richard Chambers,4 Mahmoud Bakir,5 Gregory W Poorman,1 Seema Haider,6 Mohammed Farghaly7 1OPEN Health, Bethesda, MD, USA; 2Global Medical Affairs, Viatris, Tadworth, UK; 3Global Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USA; 4Biostatistics, Pfizer Inc, Collegeville, PA, USA; 5Upjohn Export B.V., Jeddah, Saudi Arabia; 6Pfizer Inc., Groton, CT, USA; 7Dubai Medical College, Dubai, United Arab EmiratesCorrespondence: Jennifer M StephensOPEN Health, Bethesda, MD, USATel +1 703 625 5943Email jstephens@pharmerit.comObjective: Data on osteoarthritis patients from the PRECISION trial were used to evaluate the cost-effectiveness of celecoxib (100 mg twice daily) versus ibuprofen (600– 800 mg three times daily) and naproxen (375– 500 mg twice daily). The perspective was that of the United Arab Emirates (UAE) healthcare system.Methods: Discrete-state Markov model with monthly cycles, 30-month horizon, and 3% discount rate was constructed to assess incremental costs per quality adjusted life year (QALYs) gained from reduced incidence of three safety domains examined in PRECISION: renal, serious gastrointestinal (GI), and major adverse cardiovascular events (MACE). Costs for managing these toxicities were derived from Dubai Administrative Billing Claims (2018). Median monthly drug costs were derived from UAE Ministry of Health and Prevention’s published prices ($26.98 celecoxib; $20.25 ibuprofen; $20.50 naproxen). Health utility and excess mortality associated with toxicities were sourced from the literature. The willingness-to-pay thresholds used were 1 and 3 GDP per capita ($40,000–$120,000).Results: The total average cost per patient was $812.88 for celecoxib, $775.26 for ibuprofen, and $731.17 for naproxen while cost components attributed to toxicities were lowest with celecoxib ($360.26, $438.31, and $388.60, respectively). Patients on

Published
2021

37. Economic and Humanistic Burden Associated with Depression and Anxiety Among Adults with Non-Communicable Chronic Diseases (NCCDs) in the United States

Author

Armbrecht,Eric, Shah,Ruchit, Poorman,Gregory W, Luo,Linlin, Stephens,Jennifer M, Li,Benjamin, Pappadopulos,Elizabeth, Haider,Seema, McIntyre,Roger S, Armbrecht,Eric, Shah,Ruchit, Poorman,Gregory W, Luo,Linlin, Stephens,Jennifer M, Li,Benjamin, Pappadopulos,Elizabeth, Haider,Seema, and McIntyre,Roger S

Abstract

Eric Armbrecht,1 Ruchit Shah,2 Gregory W Poorman,2 Linlin Luo,2 Jennifer M Stephens,2 Benjamin Li,3 Elizabeth Pappadopulos,4 Seema Haider,5 Roger S McIntyre6– 9 1Saint Louis University Center for Health Outcomes Research, Saint Louis University, Saint Louis, MO, USA; 2Pharmerit International, Bethesda, MD, USA; 3Pfizer Inc., New York, NY, USA; 4Viatris Inc., New York, NY, USA; 5Pfizer Inc., Groton, CT, USA; 6Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, ON, Canada; 7Department of Psychiatry, University of Toronto, Toronto, ON, Canada; 8Department of Pharmacology, University of Toronto, Toronto, ON, Canada; 9Brain and Cognition Discovery Foundation, Toronto, ON, CanadaCorrespondence: Jennifer M StephensPharmerit International, 4350 East West Hwy #1100, Bethesda, MD, 20814, USATel +1-240-821-1290Email JenniferStephens@openhealthgroup.comIntroduction: Patients with both major depressive disorder (MDD) and generalized anxiety disorder (GAD) in addition to one or multiple comorbid non-communicable chronic diseases (NCCDs) face unique challenges. However, few studies have characterized how the burden of co-occurring MDD and GAD differs from that of only MDD or only GAD among patients with NCCDs.Methods: In this study, we used Medical Expenditures Panel Survey data from 2010– 2017 to understand how the economic and humanistic burden of co-occurring MDD and GAD differs from that of MDD or GAD alone among patients with NCCDs. We used generalized linear models to investigate this relationship and controlled for patient sociodemographics and clinical characteristics.Results: Co-occurring MDD and GAD was associated with increases in mean annual per patient inpatient visits, office visits, emergency department visits, annual drug costs, and total medical costs. Among patients with 3+ NCCDs, MDD or GAD only was associated with lower odds ratios (ORs) of limitations in activities of daily living (ADL

Published
2021

39. Suboptimal Age-Adjusted Lumbo-Pelvic Mismatch Predicts Negative Cervical-Thoracic Compensation in Obese Patients

Author

HORN, SAMANTHA R., primary, BORTZ, COLE A., additional, RAMACHANDRAN, SUBARAMAN, additional, POORMAN, GREGORY W., additional, SEGRETO, FRANK, additional, SIOW, MATT, additional, SURE, AKHILA, additional, VASQUEZ-MONTES, DENNIS, additional, DIEBO, BASSEL, additional, TISHELMAN, JARED, additional, MOON, JOHN, additional, ZHOU, PETER, additional, BEAUBRUN, BRYAN, additional, VIRA, SHALEEN, additional, JALAI, CYRUS, additional, WANG, CHARLES, additional, SHENOY, KARTIK, additional, BEHERY, OMAR, additional, ERRICO, THOMAS, additional, LAFAGE, VIRGINIE, additional, BUCKLAND, AARON, additional, and PASSIAS, PETER G., additional

Published
2019
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40. Full-Body Radiographic Analysis of Postoperative Deviations From Age-Adjusted Alignment Goals in Adult Spinal Deformity Correction and Related Compensatory Recruitment

Author

PASSIAS, PETER G., primary, JALAI, CYRUS M., additional, DIEBO, BASSEL G., additional, CRUZ, DANA L., additional, POORMAN, GREGORY W., additional, BUCKLAND, AARON J., additional, DAY, LOUIS M., additional, HORN, SAMANTHA R., additional, LIABAUD, BARTHÉLEMY, additional, LAFAGE, RENAUD, additional, SOROCEANU, ALEXANDRA, additional, BAKER, JOSEPH F., additional, MCCLELLAND, SHEARWOOD, additional, OREN, JONATHAN H., additional, ERRICO, THOMAS J., additional, SCHWAB, FRANK J., additional, and LAFAGE, VIRGINIE, additional

Published
2019
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42. Traumatic Fracture of the Pediatric Cervical Spine: Etiology, Epidemiology, Concurrent Injuries, and an Analysis of Perioperative Outcomes Using the Kids' Inpatient Database

Author

POORMAN, GREGORY W., primary, SEGRETO, FRANK A., additional, BEAUBRUN, BRYAN M., additional, JALAI, CYRUS M., additional, HORN, SAMANTHA R., additional, BORTZ, COLE A., additional, DIEBO, BASSEL G., additional, VIRA, SHALEEN, additional, BONO, OLIVIA J., additional, DE LA GARZA-RAMOS, RAFAEL, additional, MOON, JOHN Y., additional, WANG, CHARLES, additional, HIRSCH, BRANDON P., additional, TISHELMAN, JARED C., additional, ZHOU, PETER L., additional, GERLING, MICHAEL, additional, and PASSIAS, PETER G., additional

Published
2019
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43. Tethered Cord Syndrome in the United States: Cluster Analysis of Presenting Anomalies and Associated Conditions.

Author

Horn, Samantha R., Moses, Michael, Vasquez-Montes, Dennis, Hockley, Aaron, Poorman, Gregory W., Bortz, Cole, Segreto, Frank A., Brown, Avery E., Pierce, Katherine E., Alas, Haddy, Ihejirika, Yael U., Moon, John, Varlotta, Christopher G., Ge, David H., Vira, Shaleen, Diebo, Bassel G., De la Garza Ramos, Rafael, Lafage, Renaud, Lafage, Virginie, and Sciubba, Daniel M.

Published
2020

44. Recovery Kinetics of Radiographic and Implant-Related Revision Patients Following Adult Spinal Deformity Surgery

Author

Passias, Peter G, primary, Jalai, Cyrus M, additional, Lafage, Virginie, additional, Poorman, Gregory W, additional, Vira, Shaleen, additional, Horn, Samantha R, additional, Scheer, Justin K, additional, Hamilton, D Kojo, additional, Line, Breton G, additional, Bess, Shay, additional, Schwab, Frank J, additional, Ames, Christopher P, additional, Burton, Douglas C, additional, Hart, Robert A, additional, and Klineberg, Eric O, additional

Published
2018
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45. Primary Drivers of Adult Cervical Deformity

Author

Passias, Peter G, primary, Jalai, Cyrus M, additional, Lafage, Virginie, additional, Lafage, Renaud, additional, Protopsaltis, Themistocles, additional, Ramchandran, Subaraman, additional, Horn, Samantha R, additional, Poorman, Gregory W, additional, Gupta, Munish, additional, Hart, Robert A, additional, Deviren, Vedat, additional, Soroceanu, Alexandra, additional, Smith, Justin S, additional, Schwab, Frank, additional, Shaffrey, Christopher I, additional, and Ames, Christopher P, additional

Published
2018
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46. Cervical Alignment Changes in Patients Developing Proximal Junctional Kyphosis Following Surgical Correction of Adult Spinal Deformity

Author

Passias, Peter G, primary, Horn, Samantha R, additional, Jalai, Cyrus M, additional, Ramchandran, Subaraman, additional, Poorman, Gregory W, additional, Kim, Han Jo, additional, Smith, Justin S, additional, Sciubba, Daniel, additional, Soroceanu, Alexandra, additional, Ames, Christopher P, additional, Hamilton, D Kojo, additional, Eastlack, Robert, additional, Burton, Douglas, additional, Gupta, Munish, additional, Bess, Shay, additional, Lafage, Virginie, additional, and Schwab, Frank, additional

Published
2018
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47. Arm Pain Versus Neck Pain: A Novel Ratio as a Predictor of Post-Operative Clinical Outcomes in Cervical Radiculopathy Patients

Author

PASSIAS, PETER G., primary, HASAN, SAQIB, additional, RADCLIFF, KRIS, additional, ISAACS, ROBERT, additional, BIANCO, KRISTINA, additional, JALAI, CYRUS M., additional, POORMAN, GREGORY W., additional, WORLEY, NANCY J., additional, HORN, SAMANTHA R., additional, BONIELLO, ANTHONY, additional, ZHOU, PETER L., additional, ARNOLD, PAUL M., additional, HSIEH, PATRICK, additional, VACCARO, ALEXANDER R., additional, and GERLING, MICHAEL C., additional

Published
2018
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48. Friday, September 28, 2018 3:00 PM–4:00 PM abstracts: the gravity of obesity

Author

Horn, Samantha R., primary, Vasquez-Montes, Dennis, additional, Bortz, Cole, additional, Segreto, Frank A., additional, Poorman, Gregory W., additional, Jalai, Cyrus M., additional, Wang, Charles, additional, Buza, John A., additional, Liu, Tiffany C., additional, Steinmetz, Leah, additional, Varlotta, Christopher, additional, Vira, Shaleen N., additional, Diebo, Bassel G., additional, Horowitz, Jason A., additional, Hassanzadeh, Hamid, additional, Lafage, Renaud, additional, Lafage, Virginie, additional, Afthinos, John, additional, and Passias, Peter G., additional

Published
2018
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49. Friday, September 28, 2018 3:00 PM–4:00 PM abstracts: the gravity of obesity

Author

Passias, Peter G., primary, Horn, Samantha R., additional, Vasquez-Montes, Dennis, additional, Segreto, Frank A., additional, Bortz, Cole, additional, Poorman, Gregory W., additional, Jalai, Cyrus M., additional, Wang, Charles, additional, Frangella, Nicholas J., additional, Stekas, Nicholas, additional, Deflorimonte, Chloe, additional, Raad, Micheal, additional, Diebo, Bassel G., additional, Vira, Shaleen N., additional, Horowitz, Jason A., additional, Hassanzadeh, Hamid, additional, Lafage, Renaud, additional, Afthinos, John, additional, and Lafage, Virginie, additional

Published
2018
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50. Differences in primary and revision deformity surgeries: following 1,063 primary thoracolumbar adult spinal deformity fusions over time

Author

Poorman, Gregory W., primary, Zhou, Peter L., additional, Vasquez-Montes, Dennis, additional, Horn, Samantha, additional, Bortz, Cole, additional, Segreto, Frank, additional, Auerbach, Joshua, additional, Moon, John Y., additional, Tishelman, Jared C., additional, Gerling, Michael C., additional, Diebo, Bassel G., additional, De La Garza-Ramos, Rafael, additional, Paul, Justin C., additional, and Passias, Peter G., additional

Published
2018
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