Abstract:
OBJECTIVE:Understanding the clinical and economic impact of opioid-related adverse drug events (ORADEs) within spine surgery may guide both the clinician's and hospital administration's approach to treating perioperative pain, thus improving patient care and reducing hospital costs. The objective of this analysis is to understand how potential ORADEs after spine surgery in elderly patients affect length of stay, hospital revenue and their association with comorbid conditions. PATIENTS AND METHODS:We conducted a retrospective study utilizing the Center for Medicare/Medicaid Services Administrative Database to analyze Medicare discharges between April 2016 and March 2017 involving 14 spine surgery DRGs for major spine procedures in order to identify potential ORADEs. An analysis was conducted using this database to identify the incidence of potential ORADEs as well as their impact on mean hospital length of stay and hospital revenue. RESULTS:There were 177,432 discharges during the study period. The ORADE rate in patients undergoing spine surgery was 13.9% (24,642/177,432). The mean length of stay (LOS) for discharges with an ORADE was 3.13 days longer than without an ORADE (6.29 days with an ORADE vs 3.16 days without an ORADE). The adverse post-operative outcomes most strongly associated with potential ORADEs included shock, pneumonia, and septicemia. The mean hospital revenue per day with an ORADE was $3,076 less than without an ORADE ($7,263 with an ORADE vs $10,339 without an ORADE). CONCLUSION:Potential ORADEs in spine surgery in elderly patients are common and are associated with longer hospitalizations and decreased hospital revenue. Perioperative pain management strategies that reduce ORADEs may improve patient care and increase hospital revenue.
journal_name
Clin Neurol Neurosurgjournal_title
Clinical neurology and neurosurgeryauthors
Jones MR,Brovman EY,Novitch MB,Rao N,Urman RDdoi
10.1016/j.clineuro.2019.105550subject
Has Abstractpub_date
2019-11-01 00:00:00pages
105550eissn
0303-8467issn
1872-6968pii
S0303-8467(19)30346-4journal_volume
186pub_type
杂志文章abstract::Electroencephalography (EEG) is routinely used during elective carotid endarterectomy (CEA) for monitoring cerebral perfusion. The period most frequently associated with cerebral hypoperfusion is the one during the clamping of the carotid artery. We present a case whereby acute hypoperfusion, as detected by ipsilatera...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2010.01.009
更新日期:2010-06-01 00:00:00
abstract::Progressive multifocal leukoencephalopathy (PML) is a demyelinating neurologic disorder caused by a polyomavirus, called JC virus. PML affects mainly immunocompromised hosts. We report a case of PML as first manifestation of sarcoidosis in a previously healthy man. Treatment with cidofovir, resulted in a neurological ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2007.09.012
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:To investigate the impact of intensive blood pressure control on progressive intracerebral hemorrhage and outcome in patients with high blood pressure and intracerebral hemorrhage. PATIENTS AND METHODS:A retrospective study was conducted recruiting 659 patients with acute hemorrhagic stroke between Jan. 2012...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2019.02.021
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVES:Cerebrospinal fluid leaks are a frequent complication of spinal surgery, with reported rates between 2 and 20%. Management is highly variable and dependent on comorbidities, complexity of the index procedure, and surgeons' experience. Treatment options include primary or delayed repair, with or without spina...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2018.04.017
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:The present study aims to investigate the relationship between transcallosal interhemispheric connectivity (IC) and hemispheric language lateralization by using a novel approach including repetitive navigated transcranial magnetic stimulation (rTMS), hemispheric dominance ratio (HDR) calculation, and rTMS-bas...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2015.12.010
更新日期:2016-02-01 00:00:00
abstract::Ten patients with epilepsy of unknown origin, starting after the age of 50 years, and without clear evidence of cognitive decline were studied with positron emission tomography, using the steady state technique with 15O. Cerebral blood flow and oxygen metabolism were significantly decreased in all cortical areas. No f...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(95)00046-m
更新日期:1995-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The prognosis of malignant middle cerebral artery infarctions (MCA) is poor. The poor prognosis is attributable to the severe cerebral edema that causes a brain herniation and death. Decompressive surgery reduces mortality and may further improve patient outcomes. However, the safety and effectiv...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2014.04.011
更新日期:2014-07-01 00:00:00
abstract::Arachnoid cysts are rare lesions responsible for spinal cord compression. Five cases of congenital intraspinal arachnoid cysts are reported. Three cases of thoracic and two cases of thoracolumbar region were encountered. The clinical presentation was one of progressive spastic paraparesis. The characteristic radiologi...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(84)90188-4
更新日期:1984-01-01 00:00:00
abstract::This study attempts to establish which sensitivity test is to be preferred for final assessment of recovery of sensibility after nerve grafting. For this purpose seven sensibility tests were performed on patients who had been treated by median nerve transplantation. The findings revealed that the stereognosis test is ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(83)90002-1
更新日期:1983-01-01 00:00:00
abstract::Bilateral Symmetrical Calcifications (B.S.C.) in cerebro represent calcium deposits usually found in the basal ganglia and/or dentate nucleus. They can be the result of diverse disorders, but can also present themselves without any underlying disease. Most often they are asymptomatic, but if the calcifications are ext...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(88)80036-2
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:The incidence of chronic opioid use (COU) is increasing with health related complications impacting both patients and healthcare services. OBJECTIVE:The aim of this study was to identify the impact of COU on postoperative urinary retention (PUR) in patients following lumbar fusion surgery as well as its imp...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2020.106161
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:This study provides the first United States (US) national data regarding frequency, cost and mortality rate of epidural hematoma (EDH) and determines the factors affecting the morbidity and deaths in the patients with EDH undergoing surgical evacuation. METHODS:A retrospective analysis was performed by searc...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2015.07.021
更新日期:2015-11-01 00:00:00
abstract::This study aims to achieve the complete removal of trigeminal schwannoma (TS) while preserving cranial nerve function. We focused on the outcomes of different surgical approaches and address the contributions of different operative techniques. Forty-two TS cases, treated surgically in Qilu Hospital during a 12-year pe...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2008.10.014
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVES:Updated multi-institutional database studies assessing perioperative risk factors on 30-day morbidity and mortality after skull base surgeries are limited. We aim to identify perioperative risk factors and report the incidence of 30-day morbidity and mortality in adult patients after skull base surgery. PAT...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2018.06.015
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:The aim of this hospital-based study is to get an insight into the efficacy and tolerability of antiepileptic drugs (AED) in Omani epileptic patients. PATIENTS AND METHODS:All Omani patients (aged 14 years and above) suffering from epileptic seizures for at least 2 years and followed-up by board-certified ne...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2005.08.007
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVES:Fish oil is claimed to improve outcome in multiple sclerosis (MS) through anti-inflammatory and antioxidant effects by reducing cytokines including TNF-α, IFN-γ, IL6, and IL-1β. We aimed to evaluate the efficacy of adding fish oil to Fingolimod on these serum cytokines. PATIENTS AND METHODS:This double-blin...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.clineuro.2017.10.004
更新日期:2017-12-01 00:00:00
abstract::Vestibular schwannomas (VS) are benign tumors stemming from the eighth cranial nerve. Treatment options for VS include conservative management, microsurgery, stereotactic radiosurgery, and fractionated radiotherapy. Though microsurgery has been the standard of care for larger lesions, hypo-fractionated stereotactic ra...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,meta分析
doi:10.1016/j.clineuro.2018.01.005
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:Shunt obstructions may partly be caused by brain debris, which intrude into the ventricular catheter during ventricle puncture. Avoiding contact between the catheter and brain tissue, by using a peel-away sheath, should reduce the number of shunt failures caused by obstruction. To test this hypothesis, we con...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.clineuro.2011.11.020
更新日期:2012-05-01 00:00:00
abstract::Common neurological problems in family practice were determined to assess what knowledge of neurology is essential to the graduating medical student. The family practitioner's difficulties in managing these problems and needs for referral, were studied. Types of problems seen in a teaching hospital neurology service w...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(76)80022-4
更新日期:1977-01-01 00:00:00
abstract::Intraventricular cavernomas are extremely infrequent and only 11 cases of cavernous hemangioma to occur at the foramen of Monro have been reported in the literature. This 56 years old patient was admitted with progressive and intractable headache of 10 days of evolution. He was known to suffer familial multiple cavern...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2008.05.011
更新日期:2008-09-01 00:00:00
abstract::We report a 38-year-old male patient who developed a Miller Fisher syndrome following a respiratory tract disorder associated with a serologically proven Mycoplasma pneumoniae infection. Although several neurologic manifestations have been reported after Mycoplasma pneumonia infection, Miller Fisher syndrome has not b...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(94)90038-8
更新日期:1994-02-01 00:00:00
abstract::All classical operative approaches for pineal tumours have important disadvantages. A lateral-paramedian infratentorial approach in lateral decubitus is proposed. It has the advantage that one can reach the pineal region by way of a shorter distance and over a lower situated part of the upper cerebellar surface. Lifti...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(90)90056-b
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to explore the differences in clinical outcome between short-segment fixation (SSF; occiput-C2) and multi-segment fixation (MSF; occiput-C2, 3). METHODS:From January 2008 to January 2012, patients who underwent surgery for instability at the occipitocervical junction were incl...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2014.10.013
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:Atrial fibrillation (AF) is associated with poor outcome after intravenous thrombolysis probably due to greater pretreatment stroke severity. We conducted this retrospective study to determine whether AF is an independent predictor for clinical outcome in patients stratified by initial stroke severity. METHO...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2012.08.034
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVES:Intraoperative direct electrical stimulation (DES) is increasingly used in patients operated on for tumours in critical language areas. Although a positive impact of DES on postoperative linguistic outcome is generally advocated, the literature is only scantily documented with information about the linguisti...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.clineuro.2012.09.015
更新日期:2013-02-01 00:00:00
abstract::A rare case of basal ganglionic angioleiomyoma in a 12-year-old girl is reported. She presented with features of raised intracranial tension, multifocal seizures, left hemidystonia and apraxia of eyelid closure. Cranial CT scan showed a large hypodense lesion with an enhancing mural nodule in the region of head of the...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(96)00021-2
更新日期:1996-08-01 00:00:00
abstract:OBJECTIVE:To compare clinical evaluation, electrophysiological investigation and magnetic resonance findings in assessing the severity of idiopathic carpal tunnel syndrome. PATIENTS AND METHODS:Seventy-four patients with idiopathic carpal tunnel syndrome were prospectively recruited. Clinical evaluation included sympt...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2007.08.025
更新日期:2008-01-01 00:00:00
abstract::While intervention for ruptured arteriovenous malformations (AVMs) of the brain is typically warranted, the management of unruptured AVMs remains controversial. Despite numerous retrospective studies, only one randomized controlled trial has been conducted, comparing the role of medical management alone to medical man...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.clineuro.2016.09.007
更新日期:2016-11-01 00:00:00
abstract::The origin and course of the nerval innervation of the levator scapulae and rhomboid muscles was studied in four human cadavers. Special attention was given to surgical anatomy. The levator scapulae muscle receives two small segmental nerves from C3 and C4, respectively. The rhomboid muscle receives two segmental nerv...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(93)90029-g
更新日期:1993-01-01 00:00:00
abstract::Stroke in patients with cancer is different in terms of its etiology from stroke in the general population. Clinicians should be altered to the possibility of non-bacterial thrombotic endocarditis (NBTE), associated coagulopathy, and viable treatment options. We review the case of a 42-year-old woman with cerivcal car...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/0303-8467(93)90108-s
更新日期:1993-12-01 00:00:00