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Nabil Elkassabany

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https://www.readbyqxmd.com/read/27362927/low-albumin-is-a-risk-factor-for-complications-after-revision-total-knee-arthroplasty
#1
Atul F Kamath, Charles L Nelson, Nabil Elkassabany, Zhenggang Guo, Jiabin Liu
Low serum albumin has been shown in the primary joint arthroplasty setting to increase the rate of perioperative complications. Our present work examined a large national inpatient administrative dataset to study the relationship between serum albumin level and key outcome measures after revision total knee arthroplasty (RTKA). Our hypothesis was that lower serum albumin would be an independent risk factor for poor outcomes after RTKA. We analyzed the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database from 2006 to 2014, specifically evaluating patients undergoing RTKA...
June 30, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27351297/hospital-characteristics-inpatient-processes-of-care-and-readmissions-of-older-adults-with-hip-fractures
#2
Nabil M Elkassabany, Molly Passarella, Samir Mehta, Jiabin Liu, Mark D Neuman
OBJECTIVES: To determine hospital-level predictors of readmission after hip fracture or potentially related inpatient care processes. DESIGN: Retrospective cohort study. SETTING: U.S. acute care hospitals. PARTICIPANTS: Fee-for-service Medicare beneficiaries who underwent hip fracture surgery between 2007 and 2009 (N = 458,526). MEASUREMENTS: Information was obtained on hospital case volumes, teaching status, bed count, nurse staffing, and technological capabilities from Medicare files, and multivariable logistic regression was used to measure the association between these factors and an endpoint of readmission or death at 30 days and between these factors and the timing of surgery...
August 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27076229/effect-of-local-anesthetic-concentration-0-2-vs-0-1-ropivacaine-on-pulmonary-function-and-analgesia-after-ultrasound-guided-interscalene-brachial-plexus-block-a-randomized-controlled-study
#3
Andrew K Wong, Lauren Georgiades Keeney, Liting Chen, Rebekah Williams, Jiabin Liu, Nabil M Elkassabany
OBJECTIVE: This study aims to assess diaphragmatic excursion and measure pulmonary functions as measures of the degree to which the phrenic nerve is blocked after ISB with two different concentrations of ropivacaine: 0.2% and 0.1%. DESIGN: Randomized, double-blinded study. SETTING AND PATIENTS: Ambulatory surgical facility. SUBJECTS: Fifty patients undergoing shoulder arthroscopy for rotator cuff repair. METHODS: Patients were randomized to receive ultrasound-guided ISB with 20 mL of either 0...
April 13, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27007076/the-risk-of-falls-after-total-knee-arthroplasty-with-the-use-of-a-femoral-nerve-block-versus-an-adductor-canal-block-a-double-blinded-randomized-controlled-study
#4
RANDOMIZED CONTROLLED TRIAL
Nabil M Elkassabany, Sean Antosh, Moustafa Ahmed, Charles Nelson, Craig Israelite, Ignacio Badiola, Lu F Cai, Rebekah Williams, Christopher Hughes, Edward R Mariano, Jiabin Liu
BACKGROUND: Adductor canal block (ACB) has emerged as an appealing alternative to femoral nerve block (FNB) that produces a predominantly sensory nerve block by anesthetizing the saphenous nerve. Studies have shown greater quadriceps strength preservation with ACB compared with FNB, but no advantage has yet been shown in terms of fall risk. The Tinetti scale is used by physical therapists to assess gait and balance, and total score can estimate a patient's fall risk. We designed this study to test the primary hypothesis that FNB results in a greater proportion of "high fall risk" patients postoperatively using the Tinetti score compared with ACB...
May 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26925513/sleep-apnea-in-total-joint-arthroplasty-patients-and-the-role-for-cardiac-biomarkers-for-risk-stratification-an-exploration-of-feasibility
#5
M Melanie Lyons, Nitin Y Bhatt, Elizabeth Kneeland-Szanto, Brendan T Keenan, Joanne Pechar, Branden Stearns, Nabil M Elkassabany, Stavros G Memtsoudis, Allan I Pack, Indira Gurubhagavatula
Obstructive sleep apnea (OSA) is highly prevalent in patients undergoing total joint arthroplasty (TJA) and is a major risk factor for postoperative cardiovascular complications and death. Recognizing this, the American Society of Anesthesiologists urges clinicians to implement special considerations in the perioperative care of OSA patients. However, as the volume of patients presenting for TJA increases, resources to implement these recommendations are limited. This necessitates mechanisms to efficiently risk stratify patients having OSA who may be susceptible to post-TJA cardiovascular complications...
2016: Biomarkers in Medicine
https://www.readbyqxmd.com/read/26148837/hypoalbuminemia-more-than-morbid-obesity-is-an-independent-predictor-of-complications-after-total-hip-arthroplasty
#6
Jason D Walls, Daniel Abraham, Charles L Nelson, Atul F Kamath, Nabil M Elkassabany, Jiabin Liu
Health care reform is directing clinical practice towards improving outcomes and minimizing complications. Preoperative identification of high-risk patients and modifiable risk factors present opportunity for clinical research. A total of 49,475 total hip arthroplasty patients were identified from National Surgical Quality Improvement Program between 2006 and 2013. We compared morbidly obese patients (BMI≥40 kg/m(2)) and non-morbidly obese patients (BMI 18.5-40 kg/m(2)). We also compared patients with hypoalbuminemia (serum albumin <3...
December 2015: Journal of Arthroplasty
https://www.readbyqxmd.com/read/26023678/outcome-of-carotid-endarterectomy-after-regional-anesthesia-versus-general-anesthesia-a-retrospective-study-using-two-independent-databases
#7
Jiabin Liu, Hecter Martinez-Wilson, Mark D Neuman, Nabil Elkassabany, Edward Andrew Ochroch
BACKGROUND: Carotid endarterectomy (CEA) is effective in reducing stroke risk in selected patient groups. The ideal anesthetic technique remains controversial in light of literature between general anesthesia (GA) and regional anesthesia (RA) for CEA. METHODS: We studied the NSQIP data from 2005 to 2012. There were 32,718 patients receiving general anesthesia (GA) and 5,384 patients receiving regional anesthesia, local anesthesia, or monitored anesthesia care (RA)...
2014: Translational Perioperative and Pain Medicine
https://www.readbyqxmd.com/read/25995174/low-albumin-levels-more-than-morbid-obesity-are-associated-with-complications-after-tka
#8
Charles L Nelson, Nabil M Elkassabany, Atul F Kamath, Jiabin Liu
BACKGROUND: Morbid obesity and malnutrition are thought to be associated with more frequent perioperative complications after TKA. However, morbid obesity and malnutrition often are co-occurring conditions. Therefore it is important to understand whether morbid obesity, malnutrition, or both are independently associated with more frequent perioperative complications. In addition, assessing the magnitude of an increase in complications and whether these complications are major or minor is important for both conditions...
October 2015: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/25882965/does-regional-anesthesia-improve-the-quality-of-postoperative-pain-management-and-the-quality-of-recovery-in-patients-undergoing-operative-repair-of-tibia-and-ankle-fractures
#9
Nabil Elkassabany, Lu Fan Cai, Samir Mehta, Jaimo Ahn, Lauren Pieczynski, Rosemary C Polomano, Stephanie Picon, Rosemary Hogg, Jiabin Liu
OBJECTIVES: To determine whether the use of peripheral nerve blocks (PNBs) as part of an analgesic protocol for operative repair of tibia and ankle fractures can improve the quality of postoperative pain management and the quality of recovery (QOR). STUDY DESIGN: Prospective cohort study. SETTING: Orthopedic trauma service in an academic tertiary care center. PATIENTS: Ninety-three consecutive patients undergoing operative repair of fractures of the ankle and tibia...
September 2015: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/25856078/dexamethasone-as-adjuvant-to-bupivacaine-prolongs-the-duration-of-thermal-antinociception-and-prevents-bupivacaine-induced-rebound-hyperalgesia-via-regional-mechanism-in-a-mouse-sciatic-nerve-block-model
#10
Ke An, Nabil M Elkassabany, Jiabin Liu
BACKGROUND: Dexamethasone has been studied as an effective adjuvant to prolong the analgesia duration of local anesthetics in peripheral nerve block. However, the route of action for dexamethasone and its potential neurotoxicity are still unclear. METHODS: A mouse sciatic nerve block model was used. The sciatic nerve was injected with 60ul of combinations of various medications, including dexamethasone and/or bupivacaine. Neurobehavioral changes were observed for 2 days prior to injection, and then continuously for up to 7 days after injection...
2015: PloS One
https://www.readbyqxmd.com/read/25724110/staging-bilateral-total-knee-arthroplasty-during-the-same-hospitalization-the-impact-of-timing
#11
Jiabin Liu, Nabil Elkassabany, Lazaros Poultsides, Charles L Nelson, Stavros G Memtsoudis
The concept of staging during the same hospitalization for bilateral total knee arthroplasty (BTKA) has emerged as a practice to minimize perioperative risks, although with few data providing an evidence base. A total of 41,664 BTKA patients from Nationwide Inpatient Sample data between 1998 and 2010 were identified, and categorized into three groups, same day, staging 1-3 days, and staging 4-7 days BTKA. Staging BTKA 1-3 days apart was associated with increased rates for complications compared to same day BTKA, while staging 4-7 days BTKA was associated with similar complication profiles compared to same day BTKA...
July 2015: Journal of Arthroplasty
https://www.readbyqxmd.com/read/25637938/is-there-a-dose-response-of-dexamethasone-as-adjuvant-for-supraclavicular-brachial-plexus-nerve-block-a-prospective-randomized-double-blinded-clinical-study
#12
RANDOMIZED CONTROLLED TRIAL
Jiabin Liu, Kenneth A Richman, Samuel R Grodofsky, Siya Bhatt, George Russell Huffman, John D Kelly, David L Glaser, Nabil Elkassabany
STUDY OBJECTIVE: The study objective is to examine the analgesic effect of 3 doses of dexamethasone in combination with low concentration local anesthetics to determine the lowest effective dose of dexamethasone for use as an adjuvant in supraclavicular brachial plexus nerve block. DESIGN: The design is a prospective randomized double-blinded clinical study. SETTING: The setting is an academic medical center. PATIENTS: The patients are 89 adult patients scheduled for shoulder arthroscopy...
May 2015: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/25453673/orthopedic-anesthesia-preface
#13
Nabil M Elkassabany, Edward R Mariano
No abstract text is available yet for this article.
December 2014: Anesthesiology Clinics
https://www.readbyqxmd.com/read/25453664/optimizing-perioperative-care-for-patients-with-hip-fracture
#14
REVIEW
Jiabin Liu, Jaimo Ahn, Nabil M Elkassabany
Hip fracture is one of the most common orthopedic conditions associated with significant morbidity and mortality. Patients with hip fracture are usually older, with significant comorbidities. Delayed surgical treatment beyond 48 hours after admission is associated with significantly higher mortality. Hereby clinicians are presented with the challenge to optimize the complex hip fracture within a short time period. This article reviews the evidence regarding preoperative, intraoperative, and postoperative considerations, and provides insights into the best strategies with which to optimize the patient's condition and improve perioperative outcomes...
December 2014: Anesthesiology Clinics
https://www.readbyqxmd.com/read/25110156/provocation-of-atrial-fibrillation-triggers-during-ablation-does-the-use-of-general-anesthesia-affect-inducibility
#15
Stavros E Mountantonakis, Nabil Elkassabany, Lavanya Kondapalli, Francis E Marchlinski, Jeff E Mandel, Mathew D Hutchinson
INTRODUCTION: The autonomic nervous system exerts important effects upon atrial fibrillation (AF) initiation. The strategy of anesthesia used during AF ablation may impact the provocation of AF triggers. We hypothesized that the use of general anesthesia (GA) would reduce the incidence of provokable AF triggers in patients undergoing AF ablation compared to patients studied while receiving only conscious sedation (CS). METHODS AND RESULTS: We performed a prospective, case control study comparing the incidence of provokable AF triggers in a consecutive series of patients undergoing AF ablation under GA using a standard trigger induction protocol...
January 2015: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/24069030/preoperative-screening-and-case-cancellation-in-cocaine-abusing-veterans-scheduled-for-elective-surgery
#16
Nabil Elkassabany, Rebecca M Speck, David Oslin, Mary Hawn, Khan Chaichana, John Sum-Ping, Jorge Sepulveda, Mary Whitley, Yasser Sakawi
Background. Perioperative management of cocaine-abusing patients scheduled for elective surgery varies widely based on individual anecdotes and personal experience. Methods. Chiefs of the anesthesia departments in the Veterans Affairs (VA) health system were surveyed to estimate how often they encounter surgical patients with cocaine use. Respondents were asked about their screening criteria, timing of screening, action resulting from positive screening, and if they have a formal policy for management of these patients...
2013: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/24023024/neuraxial-anesthesia-decreases-postoperative-systemic-infection-risk-compared-with-general-anesthesia-in-knee-arthroplasty
#17
COMPARATIVE STUDY
Jiabin Liu, Chenjuan Ma, Nabil Elkassabany, Lee A Fleisher, Mark D Neuman
BACKGROUND: Surgical stress has been shown to result in immune disturbance. Neuraxial anesthesia (NA) has long been hypothesized to blunt undesired surgical insults and thus limit immune compromise and improve surgical outcomes. We hypothesized that NA would decrease postoperative infectious complications compared with general anesthesia (GA) among knee arthroplasty patients. METHODS: We studied the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2010...
October 2013: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/23965191/comparison-between-the-analgesic-efficacy-of-transversus-abdominis-plane-tap-block-and-placebo-in-open-retropubic-radical-prostatectomy-a-prospective-randomized-double-blinded-study
#18
RANDOMIZED CONTROLLED TRIAL
Nabil Elkassabany, Moustafa Ahmed, S Bruce Malkowicz, Daniel F Heitjan, Joshua A Isserman, E Andrew Ochroch
STUDY OBJECTIVE: To compare the efficacy of ultrasound-guided tansversus abdominis plane (TAP) block with placebo for postoperative analgesia after retropubic radical prostatectomy (RRP). DESIGN: Prospective, randomized, double-blinded study. SETTING: Tertiary-care Veterans Affairs (VA) hospital. PATIENTS: ASA physical status 1, 2, and 3 patients scheduled for RRP. INTERVENTIONS: Patients were randomized to two groups: the TAP group and the control group...
September 2013: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/23688960/perioperative-management-of-a-patient-scheduled-for-bilateral-hand-transplant
#19
Nabil M Elkassabany, Caroline D Fosnot, Abraham Shaked, Suhail K Kanchwala, Stephen J Kovach, Benjamin Chang, Ines C Lin, Edward A Ochroch, Dimitry Y Baranov, L Scott Levin
The perioperative management of a patient receiving a bilateral hand transplant is presented. The anesthetic management required careful fluid administration, homeothermic temperature maintenance, and postoperative analgesia. The role of different anesthesia subspecialties is highlighted.
May 2013: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/23128019/efforts-to-enhance-catheter-stability-improve-atrial-fibrillation-ablation-outcome
#20
COMPARATIVE STUDY
Mathew D Hutchinson, Fermin C Garcia, Jeff E Mandel, Nabil Elkassabany, Erica S Zado, Michael P Riley, Joshua M Cooper, Rupa Bala, David S Frankel, David Lin, Gregory E Supple, Sanjay Dixit, Edward P Gerstenfeld, David J Callans, Francis E Marchlinski
BACKGROUND: Contemporary techniques to enhance anatomical detail and catheter contact during atrial fibrillation (AF) ablation include (1) the integration of preacquired tomographic reconstructions with electroanatomical mapping (3-dimensional image integration [I-EAM]), (2) the use of steerable introducers (SIs), and (3) high-frequency jet ventilation (HFJV). OBJECTIVE: To prove that using these stabilizing techniques during AF ablation improves 1-year procedural outcome...
March 2013: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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