The revised risk analysis index outperforms the 5-factor modified frailty index in predicting postoperative morbidity after pilon fracture fixation.

Background: Pilon fractures often result from high energy mechanisms resulting in long-term morbidity and postoperative complications. While there is extensive literature investigating frailty scales as tools for preoperative risk stratification in orthopedic surgery, there is no literature regarding their use in fixation of pilon fractures. The objective of this study was to compare the predictive ability and discriminative accuracy of the Revised Risk Analysis Index (RAI-rev) and the 5-Item Modified Frailty (mFI-5) in 30-day postoperative outcomes following surgical fixation of pilon fractures.

Predictive Value of Geriatric Nutritional Risk Index and Risk Analysis Index for Post-operative Outcomes in Spine Surgery Patients: A Comprehensive Analysis.

Study DesignRetrospective cohort study.ObjectivesFrailty and nutritional status are predictors of adverse spine surgery outcomes. This study evaluated the predictive utility of a combined Risk Analysis Index (RAI) and Geriatric Nutritional Risk Index (GNRI) model, and introduced a compound score integrating RAI, GNRI, American Society of Anesthesiologists (ASA) classification, and Preoperative Acute Severe Condition (PACS).

Predictive value of the risk analysis index for 30-day mortality following surgical management of thoracolumbar vertebral body fractures.

Purpose: Frailty has emerged as a key predictor of postoperative outcomes, with indices like the revised Risk Analysis Index (RAI) and the modified Frailty Index (mFI-5) used for assessment. The purpose of this study was to compare the predictive value and discriminatory accuracy of the mFI-5 and RAI for adverse outcomes following surgical management of thoracolumbar (TL) spine fractures.

Methods: This was a retrospective cohort study utilizing data from the 2015-2019 years of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database.

Patients with History of Metastasis Have Differing Surgical Indications and Increased Perioperative Risk Following Revision Total Joint Arthroplasty.

Introduction: Revision arthroplasty is an invasive procedure with increased morbidity relative to primary joint arthroplasty. Therefore, patients with metastatic cancer (Met) undergoing revision total joint arthroplasty (rTJA) may be at greater risk. This study assesses early postoperative outcomes among Met patients undergoing rTJA.

ChatGPT-4 in Neurosurgery: Improving Patient Education Materials.

Background And Objectives: Adequate understanding of health information has been shown to be a stronger determinant of health than several demographic factors, including age, income, or employment status. However, existing neurosurgical patient education materials (PEMs) may be too complex for the average American and may contribute to poor health literacy. Large language model chatbots may provide a rapid and low-cost means of rewriting existing PEMs at a lower reading level to improve patient understanding and overall health literacy.

Utility of Revised Risk Analysis Index as a Predictor of Mortality and Morbidity in Orthopaedic Trauma.

Objectives: The aim of this study was to determine the applicability of the Revised Risk Analysis Index (RAI-Rev) in orthopaedic trauma and compare the predictive discrimination for the RAI-Rev and the 5-Item Modified Frailty Index (mFI-5) for 30-day postoperative outcomes.

Design: This is a retrospective cohort study.

Setting: The American College of Surgeons National Surgical Quality Improvement database was used.

The risk analysis index as a predictor of 30-day mortality for elderly obese patients undergoing elective total joint arthroplasty.

Introduction: The older population of the United States of America is continuing to increase, leading to rising rates of degenerative joint disease. Combined with the high prevalence of obesity in the US, orthopaedic surgeons are performing record numbers of elective total joint arthroplasty (TJA) procedures in higher risk patients. As age and obesity are risk factors for mortality following TJA, preoperative risk stratification tools such as frailty may be used to optimize surgical candidate selection to mitigate adverse outcomes.

Risk Analysis Index for Estimation of 30-Day Postoperative Mortality in Hip Fractures.

Importance: Hip fractures present a substantial public health challenge, with projections of more than 500 000 per year by 2040. As such, frailty indices such as the Revised Risk Analysis Index (RAI) and the Modified Five-Item Frailty Index (mFI-5) have been recently investigated as metrics for preoperative risk stratification for these patients.

Objective: To understand the accuracy of frailty, as measured by the RAI and the mFI-5, for estimating 30-day mortality following surgically managed hip fractures.

Discriminatory Value of the Risk Analysis Index Versus the 5-Factor Modified Frailty Index for Major Outcome Measures in Degenerative Cervical Myelopathy.

Study DesignObservational Retrospective Cohort Study.ObjectivesTo compare the discriminatory abilities of the Revised Risk Analysis Index (RAI-Rev) and the 5-Factor Modified Frailty Index (mFI-5) to predict major postoperative outcomes in DCM patients overall, and by anterior (ADF) or posterior (PDF) approaches for decompression and fusion.MethodsThe American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for DCM patients undergoing ADF or PDF from 2015-2020.

Carotid webs and stroke: a comprehensive overview of clinical characteristics, risk factors, and treatment modalities.

Introduction: Carotid web (CW) refers to an atypical manifestation of fibromuscular dysplasia that affects the intimal layer of the internal carotid artery (ICA) and carotid bulb. CWs involve a shelf-like intraluminal projection within the ICA, increasing the risk of thrombus formation in young patients without known cardiovascular risk factors. The relative lack of literature regarding CWs may cause this pathology to go largely underdiagnosed.

Temporal and regional trends of fractures in the United States: A review of the global burden of disease database.

Background: Musculoskeletal diseases, including bone fractures, are a significant contributor to global disability. Understanding temporal and regional trends in bone fractures is crucial for effective healthcare planning and resource allocation. We sought to analyze recent epidemiological trends of different types of fractures in the United States and determine correlations and associations between fracture trends and potential influencing demographic factors (i.

Longitudinal management trends of basilar thumb arthritis: A national epidemiologic analysis.

Purpose: Osteoarthritis (OA) of the first carpometacarpal (CMC) joint, or basilar thumb arthritis, is the most common symptomatic hand arthritis, leading to significant healthcare costs. This study analyzed trends in managing basilar thumb arthritis and determined approaches linked to favorable outcomes to guide future treatments.

Methods: This retrospective cohort study queried the TriNetX United States Collaborative Network from 2013 to 2023.

Trigeminal nerve stimulation in drug-resistant epilepsy: A systematic review.

Introduction: Trigeminal Nerve Stimulation (TNS) is a technique that may be useful to reduce seizure burden in drug-resistant epilepsy (DRE), but its efficacy is not well characterized. This study sought to understand the application of TNS in DRE by providing a comprehensive overview of the current use and efficacy of TNS for neuromodulation in DRE.

Methods: A systematic review examining the use of TNS for DRE was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Orthopedic frailty risk stratification (OFRS): a systematic review of the frailty indices predicting adverse outcomes in orthopedics.

Background: With a growing number of elderly patients requiring elective and non-elective procedures, frailty-based preoperative risk stratification is an emerging tool in orthopedic surgery to minimize adverse postoperative outcomes. This paper sought to understand the current literature regarding preoperative Orthopedic Frailty Risk Stratification (OFRS) and describe the disparate frailty indices and their capabilities for discrimination in predicting adverse postoperative outcomes.

Methods: A literature search was conducted in Pubmed, Cochrane, and Scopus for articles published during or prior to February 2024 assessing frailty following surgery for orthopedic pathologies.

Recent and future trends in osteopathic orthopedic surgery residency match rates following the transition to a single accreditation system.

Context: Medical education in the United States has undergone significant changes, specifically within the osteopathic community. In 2020, a merger occurred between the American Osteopathic Association (AOA) and the Accreditation Council for Graduate Medical Education (ACGME), forming a single accreditation system (SAS) for graduate medical education and residency placement, with the purpose to create consistency within graduate medical education and to provide equal opportunities for applicants pursuing all specialties in medicine. However, osteopathic medical students, especially students applying to competitive residencies including orthopedic surgery, have faced challenges, raising concerns about future implications within this field.

Complementary effects of postoperative delirium and frailty on 30-day outcomes in spine surgery.

Background Context: With an increasingly older population, the number of frail patients requiring surgical management for degenerative spine diseases is rapidly increasing. Older patients are at increased risk of developing postoperative delirium (POD), which increases the odds of postoperative morbidity and mortality in spine surgery patients. Therefore, frail spine surgery patients may be at greater risk of developing POD and subsequent adverse outcomes.

Temporal Trends in the Epidemiology of Lower Back Pain in the United States.

Study Design: This was an observational study.

Objective: This study aims to explore sociodemographic and regional geographic variations in lower back pain (LBP) incidence, prevalence, and burden in the United States (US from 2000 to 2019).

Summary Of Background Data: LBP is a major contributor to lost wages and disability in the United States.

Evaluating the impact of tubular retractors in glioma surgery: A systematic review and meta-analysis.

Background: Achieving safe, maximal tumor resection in gliomas can be challenging due to the tumor's intricate relationship with surrounding structures. Tubular retractors offer a minimally invasive approach, preserving functional pathways and reducing complications. To assess their efficacy and safety, we conducted a systematic review and meta-analysis.

The Use of Extracellular Vesicles in Achilles Tendon Repair: A Systematic Review.

Achilles tendon (AT) pathologies are common musculoskeletal conditions that can significantly impair function. Despite various traditional treatments, recovery is often slow and may not restore full functionality. The use of extracellular vesicles (EVs) has emerged as a promising therapeutic option due to their role in cell signaling and tissue regeneration.

Frailty in intracranial meningioma resection: the risk analysis index demonstrates strong discrimination for predicting non-home discharge and in-hospital mortality.

Purpose: Frailty is an independent risk factor for adverse postoperative outcomes following intracranial meningioma resection (IMR). The role of the Risk Analysis Index (RAI) in predicting postoperative outcomes following IMR is nascent but may inform preoperative patient selection and surgical planning.

Methods: IMR patients from the Nationwide Inpatient Sample were identified using diagnostic and procedural codes (2019-2020).