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Nabil M Elkassabany

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
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
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
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
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
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
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
Nabil M Elkassabany, Edward R Mariano
No abstract text is available yet for this article.
December 2014: Anesthesiology Clinics
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
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
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
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
Gaurav Malhotra, Nabil M Elkassabany, Jonathan Frogel, Amit R Patel, Gary Steinberg, Shahzad Shaefi, Feroze Mahmood
No abstract text is available yet for this article.
December 2012: Journal of Cardiothoracic and Vascular Anesthesia
Mark D Neuman, Jeffrey H Silber, Nabil M Elkassabany, Justin M Ludwig, Lee A Fleisher
BACKGROUND: Hip fracture is a common, morbid, and costly event among older adults. Data are inconclusive as to whether epidural or spinal (regional) anesthesia improves outcomes after hip fracture surgery. METHODS: The authors examined a retrospective cohort of patients undergoing surgery for hip fracture in 126 hospitals in New York in 2007 and 2008. They tested the association of a record indicating receipt of regional versus general anesthesia with a primary outcome of inpatient mortality and with secondary outcomes of pulmonary and cardiovascular complications using hospital fixed-effects logistic regressions...
July 2012: Anesthesiology
Nabil Elkassabany, Fermin Garcia, Cory Tschabrunn, Jesse Raiten, William Gao, Khan Chaichana, Sanjay Dixit, Rebecca M Speck, Erica Zado, Francis Marchlinski, Jeff Mandel
OBJECTIVES: The aim of this study was to describe anesthetic management and perioperative complications in patients undergoing pulmonary vein isolation for the treatment of atrial fibrillation under general anesthesia using high-frequency jet ventilation. The authors also identified variables associated with longer ablation times in this patient cohort. DESIGN: A retrospective observational study. SETTING: The electrophysiology laboratory in a major university hospital...
June 2012: Journal of Cardiothoracic and Vascular Anesthesia
Nabil M Elkassabany, Jeff E Mandel
No abstract text is available yet for this article.
June 2011: Journal of Cardiothoracic and Vascular Anesthesia
Nabil M Elkassabany, Jasmine Bhatia, Anupa Deogaonkar, Gene H Barnett, Michelle Lotto, Marco Maurtua, Zeyd Ebrahim, Armin Schubert, Sandra Ference, Ehab Farag
Blood brain barrier disruption enhances drug delivery in primary central nervous system lymphoma. In this study, we report adverse events that were encountered intraoperatively and in the postoperative period in these patients. A retrospective analysis of 17 patients documenting demographic data, preprocedure medical history, intraoperative, and postoperative anesthetic complications was conducted between January 2002 and December 2004. Seventeen patients underwent 210 treatments under general anesthesia with a mean of 12...
January 2008: Journal of Neurosurgical Anesthesiology
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