Is Dexamethasone Administration During Total Hip and Knee Arthroplasty Safe in Diabetic Patients?

Introduction: Dexamethasone is used extensively during total hip and knee arthroplasty total joint arthroplasty (TJA) to control pain and decrease the risk of nausea and vomiting. However, the safety of dexamethasone utilization in diabetic patients is poorly understood. Therefore, this study aims to evaluate complications associated with perioperative dexamethasone administration during primary TJA in diabetic patients.

Is There Utility to Requiring Spine MRI Pre-authorizations? Pre-authorizations: A Single Institution's Perspective.

Study Design: A retrospective cohort study of a patient undergoing treatment at a single institution's Spine Center.

Objective: The current study assessed the rates and eventual disposition of pre-authorizations required before spine MRIs are ordered from an academic spine center.

Summary Of Background Data: Spine magnetic resonance imaging (MRI) often requires preauthorization by insurance carriers.

Does Prednisone Dose Affect Rates of Periprosthetic Joint Infection Following Primary Total Hip and Total Knee Arthroplasty?

Background: Prednisone use is associated with higher rates of periprosthetic joint infection (PJI) following total joint arthroplasty (TJA). However, the relationship between prednisone dosage and infection risk is ill-defined. Therefore, this study aimed to assess the relationship between prednisone dosage and rates of PJI following TJA.

Current and Future Advanced Imaging Modalities for the Diagnosis of Early Osteoarthritis of the Hip.

Hip osteoarthritis (OA) can be idiopathic or develop secondary to structural joint abnormalities of the hip joint (alteration of normal anatomy) and/or due to a systemic condition with joint involvement. Early osteoarthritic changes to the hip can be completely asymptomatic or may cause the development hip symptomatology without evidence of OA on radiographs. Delaying the progression of hip OA is critical due to the significant impact of this condition on the patient's quality of life.

Spine Surgery HCAHPS Patient Satisfaction Survey Results Inversely Correlate with Survey Response Time.

Study Design: Retrospective review.

Objective: The aim of this study was to understand the potential correlation of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey response time on reported satisfaction following spine surgery hospitalization.

Summary Of Background Data: With increasing emphasis on patient satisfaction metrics, such as HCAHPS, hospital reputations, and reimbursements are being affected by the results of such surveys.

Long-term Corticosteroid Use Independently Correlates With Complications After Posterior Lumbar Spine Surgery.

With the increasing medical complexity of patients undergoing posterior lumbar surgery, more patients are pharmacologically immunosuppressed to manage chronic conditions. The effects of immunosuppression have become of greater interest across multiple surgical specialties. The goal of the current study was to investigate whether long-term corticosteroid use is independently associated with perioperative adverse outcomes among patients undergoing posterior lumbar surgery.

Transparency in Prior Authorization: The Under-recognized Precedent Set by Arkansas.

Prior Authorization (PA) is an insurance policy that requires providers to obtain permission before delivery of certain medical services. The aim is to ensure appropriate utilization of health care on the basis of clinical guidelines and to minimize costly procedures. The overall impact of PAs has not been well studied; however, many arguments exist in support and opposition to this practice.

Diabetes Status Affects Odds of Body Mass Index-dependent Adverse Outcomes After Total Hip Arthroplasty.

Introduction: Obesity and diabetes have independently been shown to predispose to adverse outcomes after total hip arthroplasty (THA). These may have a coupled effect on perioperative risks. The purpose of this study was to evaluate the effect of body mass index (BMI) on adverse outcomes in nondiabetic (ND), non-insulin-dependent diabetes mellitus (NIDDM), and insulin-dependent diabetes mellitus (IDDM) patients.

Postoperative Pressure Ulcers After Geriatric Hip Fracture Surgery Are Predicted by Defined Preoperative Comorbidities and Postoperative Complications.

Introduction: The current study sought to determine the factors predictive of postoperative pressure ulcer development by analyzing extensive multicenter outcomes data from the 2016 American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database.

Methods: The 2016 NSQIP Participant Use File and Hip Fracture Procedure Targeted file were used to identify the risk factors for the development of postoperative pressure ulcers after hip fracture surgery in a geriatric cohort. Multivariate regressions were performed to identify preoperative comorbidities and postoperative complications that are risk factors for developing postoperative pressure ulcers.

The Cost of Complications Following Major Resection of Malignant Neoplasia.

Background: Rising healthcare costs have led to increased focus on the need to achieve a higher "value of care." As value-maximization efforts expand to include more complex surgical patients, evidence to support meaningful implementation of complication-based initiatives is lacking. The objective of this study was to compare incremental costs of complications following major gastrointestinal (GI) resections for organ-specific malignant neoplasia using nationally representative data.