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RISS 인기검색어
- 검색키워드
- 저자 : Jomar N. Aryee (검색결과 3 건)
- 무료
- 기관 내 무료
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Lawal Labaran,Jomar N.A. Aryee,Joshua Bell,Nikhil Jain,Varun Puvanesarajah,Michael Raad,Amit Jain,Jonathan Carmouche,Hamid Hassanzadeh 대한척추신경외과학회 2020 Neurospine Vol.17 No.1
Objective: The aim of the study was to compare trends and differences in preoperative and prolonged postoperative opioid use following spinal cord stimulator (SCS) implantation and to determine factors associated with prolonged postoperative opioid use. Methods: A database of private-payer insurance records was queried to identify patients who underwent a primary paddle lead SCS placement via a laminectomy (CPT-C3655) from 2008–2015. Our resulting cohort was stratified into those with prolonged postoperative opioid use, opioid use between 3- and 6-month postoperation, and those without. Multivariate logistic regression was used to determine the effect preoperative opioid use and other factors of interest had on prolonged postoperative opioid use. Subgroup analysis was performed on preoperative opioid users to further quantify the effect of differing magnitudes of preoperative opioid use. Results: A total of 2,374 patients who underwent SCS placement were identified. Of all patients, 1,890 patients (79.6%) were identified as having prolonged narcotic use. Annual rates of preoperative (p=0.023) and prolonged postoperative narcotic use (p<0.001) decreased over the study period. Significant independent predictors of prolonged postoperative opioid use were age <65 years (odds ratio [OR], 1.52; p=0.004), male sex (OR, 1.33; p=0.037), preoperative anxiolytic (OR, 1.55; p=0.004) and muscle relaxant (OR, 1.42; p=0.033), and narcotic use (OR, 15.04; p<0.001). Increased number of preoperative narcotic prescriptions correlated with increased odds of prolonged postoperative use. Conclusion: Patients with greater number of preoperative opioid prescriptions may not attain the same benefit from SCSs as patients with less opioid use. The most significant predictor of prolonged narcotic use was preoperative opioid use.
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Surajudeen A. Bolarinwa,Jomar N. Aryee,Lawal A. Labaran,Brian C. Werner,James A. Browne 대한고관절학회 2020 Hip and Pelvis Vol.32 No.1
Purpose: Arthroscopy for repair of femoroacetabular impingement (FAI) and related conditions is technically challenging, but remains the preferred approach for management of these hip pathologies. The incidence of this procedure has increased steadily for the past few years, but little is known about its potential long-term effects on future interventions. The purpose of this study was to evaluate whether prior arthroscopic correction of FAI pathology impacts postoperative complication rates in patients receiving subsequent ipsilateral total hip arthroplasty (THA) on a national scale. Materials and Methods: A commercially available national database – PearlDiver Patients Records Database – identified primary THA patients from 2005 to 2014. Patients who had prior arthroscopic FAI repair (post arthroscopy group) were separated from those who did not (native hip group). Prior FAI repair was examined as a risk factor for complications following THA and a multivariable logistic regression analysis was applied to identify risk factors for complications following THA. Results: A total of 11,061 patients met all inclusion and exclusion criteria; 10,951 in the native hip group and 110 in the post arthroscopy group. Prior FAI repair was not significantly associated with higher rates of 90-day readmission (P=0.585), aseptic dislocation/revision within 3 years (P=0.409), surgical site infection within 3 years (P=0.796), or hip stiffness within 3 years (P=0.977) after THA. Conclusion: Arthroscopic FAI repair is not an independent risk factor for complications following subsequent ipsilateral THA (level of evidence: III).
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Lawal Labaran,Joshua Bell,Varun Puvanesarajah,Nikhil Jain,Jomar N. Aryee,Micheal Raad,Amit Jain,Jonathan Carmouche,Hamid Hassanzadeh 대한척추신경외과학회 2020 Neurospine Vol.17 No.2
Objective: Although spinal cord stimulators (SCS) continue to gain acceptance as a viable nonpharmacologic option for the treatment of chronic back pain, recent trends are not well established. The aim of this study was to evaluate recent overall demographic and regional trends in paddle lead SCS placement and to determine if differences in trends exist between private-payer and Medicare beneficiaries. Methods: A retrospective review of Medicare and private-payer insurance records from 2007–2014 was performed to identify patients who underwent a primary paddle lead SCS placement via a laminectomy (CPT-63655). Each study cohort was queried to determine the annual rate of SCS placements and demographic characteristics. Yearly SCS implanta�tion rates within the study cohorts were adjusted per 100,000 beneficiaries. A chi-square analysis was used to compare changes in annual rates. Results: A total of 31,352 Medicare and 2,935 private-payer patients were identified from 2007 to 2014. Paddle lead SCS placements ranged from 5.9 to 17.5 (p<0.001), 1.9 to 5.9 (p<0.001), and 5.2 to 14.5 (p<0.001) placements per 100,000 Medicare, private-payer, and overall beneficiaries respectively from 2007 to 2014. SCS placements peaked in 2013 with 19.6, 7.1, and 16.8 placements per 100,000 Medicare, private-payer, and overall patients. Conclusion: There was an overall increase in the annual rate of SCS placements from 2007 to 2014. Paddle lead SCS placements peaked in 2013 for Medicare, private-payer, and over�all beneficiaries. The highest incidence of implantation was in the Southern region of the United States and among females. Yearly adjusted rates of SCSs were higher among Medi�care patients at all time points.
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