Severe gonadal steroid deficiency induces bone loss in adult men; however, the specific roles of androgen and estrogen hypogonadal are unclear. Additionally, threshold levels testosterone estradiol that initiate uncertain.One hundred ninety-eight healthy men, ages 20-50, received goserelin acetate, which suppresses endogenous production, were randomized to treatment with 0, 1.25, 2.5, 5, or 10 grams gel daily for 16 weeks. An additional cohort 202 men was receive these treatments plus...

Retrospective review of the prospective American College Surgeons National Surgical Quality Improvement Project (ACS NSQIP) database with 30-day follow-up 2164 patients undergoing elective anterior cervical discectomy and fusion (ACDF).To determine factors independently associated increased length stay (LOS) complications after ACDF to facilitate preoperative planning setting realistic expectations for providers.The effect individual on LOS has been evaluated in small-scale studies. Large...

Study Design. A retrospective cohort. Objective. The aim of this study was to characterize spinal fractures in patients with ankylosing spondylitis. Summary Background Data. Patients spondylitis are susceptible the column, even from minor trauma. However, literature describing and consists largely case reports small series. purpose is better ankylosed spine, including patient population, locations fracture, outcomes a large, nationally representative sample. Methods. All diagnoses both...

Industry payments made to physicians by drug and device manufacturers or group purchasing organizations are now reported the Centers for Medicare Medicaid Services (CMS) as a part of Physician Payments Sunshine Act. Initial reports from program show that orthopaedic surgeons lead all physician specialties in total average industry payments. However, before further discussion these their implications can take place, it remains be seen whether figures true reflection field surgery general,...

There has been great interest in performing outpatient THA and TKA. Studies have compared such procedures done as outpatients versus inpatients. However, stated "outpatient" status defined by large national databases the National Surgical Quality Improvement Program (NSQIP) may not be a consistent entity, actual lengths of stay those patients categorized NSQIP specifically ascertained fact include some who are "observed" for one or more nights. Current regulations United States allow these...

BACKGROUND Mortality reduction from mammographic screening is controversial. Individual randomized trials and meta‐analyses demonstrate statistically significant mortality reductions in all age groups invited to screening. In women actually screened, are greater. show varying rates of reduction, leading questions about screening's value whether treatment advances have diminished the importance early detection. This study hypothesized that breast cancer deaths predominantly occurred...

Study Design. Retrospective cohort study. Objective. To identify factors associated with blood transfusion for primary posterior lumbar fusion surgery, and to associations between other postoperative complications. Summary of Background Data. Blood is a relatively common occurrence patients undergoing fusion. There limited information available describing which are at increased risk transfusion, the relationship short-term outcomes poorly characterized. Methods. The American College Surgeons...

Surgery for subdural hematoma (SDH) is a commonly performed neurosurgical procedure. This study identifies patient characteristics associated with adverse outcomes and prolonged length of stay (LOS) in patients who underwent surgical treatment SDH.All the American College Surgeons National Surgical Quality Improvement Program (ACS NSQIP) were treated via craniotomy or craniectomy SDH between 2005 2012 identified. Patient demographics, comorbidities, 30-day described. Multivariate regression...

Retrospective cohort analysis of anterior cervical discectomy and fusion (ACDF) surgical procedures using a prospectively collected database.To characterize the 30-day postoperative outcomes in elderly patients undergoing ACDF after adjustment for comorbidities multi-institutional database.Prior studies on effect age have mostly focused in-hospital complications, come from single institutions, or included pooled analyses not distinctly analyzed specific complications associated with...

In Brief Study Design. A retrospective study of surgically treated patients with acute traumatic central cord syndrome (ATCCS) from the National Trauma Data Bank Research Set. Objective. To determine association time to surgery, pre-existing comorbidities, and injury severity on mortality adverse events in ATCCS. Summary Background Data. Although earlier surgery has been shown be beneficial for other spinal injuries, literature is mixed regarding appropriate timing after Traditionally, this...

In Brief Study Design. Retrospective cohort study. Objective. To characterize the timing of complications after spinal fusion procedures. Summary Background Data. Despite many publications on risk factors for spine surgery, there are few at which such occur. Methods. Patients undergoing anterior cervical decompression and (ACDF) or posterior lumbar (PLF; with without interbody) procedures during 2011–2013 were identified in American College Surgeons National Surgical Quality Improvement...

A population-based case-control design was employed to quantify the risk of injury after consumption alcohol as a function setting, concurrent activity and usual drinking habits.A total 797 cases (66.6% men) controls (57.7% women) were interviewed. The response rate 83% for eligible approached an interview. Cases injured patients from hospital emergency department. Community used each paired with case on suburb residence, interviewed regarding their activities in 6-hour period preceding...

Retrospective cohort study of 13,927 patients, 820 whom received iliac crest bone graft (ICBG).To compare adverse events, length stay (LOS), and readmission for patients receiving ICBG with those who did not using multivariate analysis to control potentially confounding factors.The use in spinal fusion has been associated increased surgical time, LOS, donor site morbidity. Development expensive substitutes predicated on these issues. Data the effect harvest LOS rate are sparse, used...

Retrospective cohort.To evaluate whether myelopathy is associated with increased morbidity and mortality after anterior cervical discectomy fusion (ACDF) compared other indications for this procedure.ACDF the most common surgical procedure management of a spectrum spine pathologies. As more advanced condition, generally thought to be higher procedure, but there limited evidence support supposition. The current study compares outcomes ACDF procedures performed those indications, controlling...

To identify factors that are associated with short-term outcomes after open reduction and internal fixation (ORIF) for tibial plateau fracture.Patients who underwent ORIF fracture from 2009 to 2012 were identified in the American College of Surgeons National Surgical Quality Improvement Program database. Patient characteristics tested association any adverse event (AAE), severe events (SAEs), infectious complications, extended length stay (LOS), readmission within 30 days.A total 519...

Background: Quality improvement in orthopaedic surgery has received increasing attention; however, there is insufficient information available about the perioperative safety of many common pediatric procedures. This study aimed to characterize incidence adverse events a national patient sample understand risk profiles procedures, and identify patients operations that are associated with increased rates outcomes. Methods: A retrospective cohort was conducted using prospectively collected...

Study Design: Retrospective cohort study. Objective: The primary aim of this study was to determine the incidence and risk factors for 30-day adverse events after revision posterior lumbar fusion. secondary readmission Summary Background Data: need a fusion is an unfortunate occurrence, there little known about specific morbidity procedure. purpose use large, national sample identify patient operative that may contribute development these outcomes. Methods: American College Surgeons National...

The use of large national databases for clinical research has increased recently in the field trauma care as they allow study rare events without logistical difficulties a prospective study. However, many these administrative billing codes, such International Classification Disease-9th Rev. (ICD-9) to identify preexisting patient comorbidities. While accuracy codes purposes previously been called into question, this not studied population.All patients with proximal tibia fractures 2011 and...