Serene Mirza - Academia.edu (original) (raw)

Papers by Serene Mirza

Abstracts Accepted for Publication, 2019

Background: Utilization rates of total joint replacements (TJR) are high and rising to treat adva... more Background: Utilization rates of total joint replacements (TJR) are high and rising to treat advanced symptomatic arthritis, but there is little qualitative research to define the most important outcomes from the patient perspective. Objectives: To assess the most important outcomes of TJR from the patients' perspective using nominal group technique (NGT). Methods: Recruited patients were 18 and had received total hip (THR) or total knee replacements (TKR). Participants completed a questionnaire including demographics and pain and function measures, and answered "What result/results matter the most to a patient undergoing/having a knee or hip replacement?". Outcomes were independently selected, listed in a round robin, and ranked by the group using NGT. Results: 36 patients participated in 6 nominal groups in January 2019. 42% were men (Table 1). For THR, 94% reported no/mild pain. For TKR, 81% reported no/mild pain pivoting or on stairs, 1 patient reported severe pain. Satisfaction was high, 97% reported very/somewhat satisfied with pain relief. Of 216 total votes, A) pain received 98 votes, B) function 52; C) quality of life 40; D) adverse events 16 votes and E) revision 2 votes, the remainder 8 votes were distributed to post-op concerns including access to rehabilitation or education (Table 2). Conclusion: Pain, function, quality of life, and adverse events are the outcomes ranked highest by patients, supporting their inclusion in TJR clinical trials.

The Journal of rheumatology, 2018

Rates of total knee arthroplasty (TKA) and total hip arthroplasty (THA) remain high for patients ... more Rates of total knee arthroplasty (TKA) and total hip arthroplasty (THA) remain high for patients with rheumatoid arthritis (RA), who are at risk of flaring after surgery. We aimed to describe rates, characteristics, and risk factors of RA flare within 6 weeks of THA and TKA. Patients with RA were recruited prior to elective THA and TKA surgery and prospectively followed. Clinicians evaluated RA clinical characteristics 0-2 weeks before and 6 weeks after surgery. Patients answered questions regarding disease activity including self-reported joint counts and flare status weekly for 6 weeks. Per standard of care, biologics were stopped before surgery, while glucocorticoids and methotrexate (MTX) were typically continued. Multivariable logistic regression was used to identify baseline characteristics associated with postsurgical RA flares. Of 120 patients, the mean age was 62 years and the median RA duration 14.8 years. Ninety-eight (82%) met 2010/1987 American College of Rheumatology/E...

JAMA Network Open, 2021

Key Points Question Are there racial disparities in both septic and aseptic revision total knee r... more Key Points Question Are there racial disparities in both septic and aseptic revision total knee replacement (TKR) risk? Findings In this cohort study of 722 492 patients, Black patients were 1.1 times as likely to undergo septic revision TKR and were 1.4 times as likely to undergo aseptic revision TKR compared with White patients. Racial disparities in aseptic revision TKR risk were greatest at hospitals with a high volume of TKRs. Meaning These findings suggest that racial disparities in revision TKR are greater for aseptic than for septic revision and are also associated with characteristics of the hospital where the primary TKR was performed.

Total knee arthroplasty (TKA) outcomes are linked to surgical volume,1 despite the increase in TK... more Total knee arthroplasty (TKA) outcomes are linked to surgical volume,1 despite the increase in TKA utilization, racial disparities in TKA outcomes persist. Blacks in the US are at a higher risk of aseptic revision of TKA (R-TKA) when compared to Whites, yet the reasons for this are not understood.The objective of this study is to examine the relationship between hospital and surgeon annual TKA volume and R-TKA outcomes by race.This is an observational cohort study. New York Statewide Planning and Research Cooperative System data for 2004 – 2013 was used to identify patients who underwent primary TKA. Data through 2015 was used to identify R-TKA within 2 years of the index TKA. Hospital characteristics were obtained from the AHA Annual Survey. Surgeon data was collected from New York State Education Department and New York State Physician Profile. Surgeon annual TKA volume was categorized based on cutoffs established by Wilson et al1 as </=12, 13-59, 60-145 or >/= 146, and hosp...

The Journal of Arthroplasty

JCR: Journal of Clinical Rheumatology

The American Journal of Surgical Pathology

The Journal of Rheumatology

Objective To perform a qualitative study to define the patient perspective of what constitutes a ... more Objective To perform a qualitative study to define the patient perspective of what constitutes a failure of total joint replacement (TJR). Methods We used the nominal group technique (NGT) with participants who had undergone elective total hip replacements (THR) and/or total knee replacements (TKR) to answer the question “When would you consider a knee or hip replacement to be a failure?” Results We performed eight nominal groups with 42 participants, all of whom had undergone THR and/or TKR between 2016 and 2018. Of these, 48% were male, 17% black, 79% had college education or above, and 76% had had osteoarthritis as the underlying diagnosis. The nominated responses/themes that were ranked the highest by the participants were: (1) refractory index joint pain (80 votes); (2) occurrence of post-operative adverse events (54 votes); (3) Unable to resume normal activities or go back to work (38 votes); (4) little or no improvement in quality of life (QOL; 35 votes); (5) early revision s...

Arthritis Care & Research

Abstracts Accepted for Publication

The implementation of this profile of auto-antibodies in patients without ILD and those without c... more The implementation of this profile of auto-antibodies in patients without ILD and those without clinical and/or analytical characteristics associated with MII, did not provide any.

BMC Rheumatology, Jan 13, 2020

BackgroundWhile total joint replacements (TJR) are frequently performed, there is little qualitat... more BackgroundWhile total joint replacements (TJR) are frequently performed, there is little qualitative research to define the outcomes most important to patients.MethodsPatients who had received total hip (THR) or total knee replacements (TKR) participated in 8 nominal groups to answer the question “What result/results matter the most to a patient undergoing/having a knee or hip replacement?” Total 270 votes were allocated.ResultsEight nominal groups were performed with 45 patients, 6 groups with mean age (71.1 ± 9.3), and 2 with 9 younger patients (mean age 36.8 ± 7.4). All had TJR between 2016 and 2018; overall, 40% were male, 15.6% were Black, and 75% were performed for osteoarthritis. While all groups ranked the same top 3 outcomes, responses varied with age: 1) relief of pain (46% vs. 35% in the young groups); 2) improved function including mobility (29% vs. 18% in the young groups); 3) restored quality of life (13% vs 33% of votes in the younger group).ConclusionRelief of pain and restoration of function, and improved quality of life are the 3 outcomes ranked highest by patients, confirming their inclusion in TJR clinical trials.

Vascular and endovascular surgery, Jan 6, 2016

To evaluate the diagnostic role of venous and arterial duplex scanning in neurogenic thoracic out... more To evaluate the diagnostic role of venous and arterial duplex scanning in neurogenic thoracic outlet syndrome (NTOS). Retrospective review of patients who underwent duplex ultrasonography prior to first rib resection and scalenectomy (FRRS) for NTOS from 2005 to 2013. Abnormal scans included ipsilateral compression (IC) with abduction of the symptomatic extremity (>50% change in subclavian vessel flow), contralateral (asymptomatic side) compression (CC) or bilateral compression (BC). A total of 143 patients (76% female, average age 34, range 13-59) underwent bilateral preoperative duplex scanning. Ipsilateral compression was seen in 44 (31%), CC in 12 (8%), and BC in 14 (10%). Seventy-three (51%) patients demonstrated no compression. Patients with IC more often experienced intraoperative pneumothoraces (49% vs. 25%, P < .05) and had positive Adson tests (86% vs. 61%, P < .02). Compression of the subclavian vein or artery on duplex ultrasonography can assist in NTOS diagnosi...

Vascular and endovascular surgery, Jan 27, 2015

To evaluate our extensive experience over a decade in the treatment of patients with neurogenic t... more To evaluate our extensive experience over a decade in the treatment of patients with neurogenic thoracic outlet syndrome (NTOS) who underwent first rib resection and scalenectomy (FRRS). Patients treated with FRRS for NTOS from 2003 to 2013 were retrospectively reviewed using a prospectively maintained database. Over 10 years, 286 patients underwent 308 FRRS. During the first 5-year period, 127 FRRS were performed (96 F, 31 M), with an average age of 36.9 years. During the second 5-year period, 181 FRRS were performed (143 F, 38 M), with an average age of 33 years. A total of 24 children (age ≤18years) underwent FRRS, 9 during the first 5 years and 15 during the second 5 years. When comparing the second 5-year period to the first 5-year period, patients were younger (P = .066), reported a significantly shorter length of preoperative symptoms (35.4 vs 52.1 months, P < .01), prior narcotic use decreased from 31.5% to 23.8% (P < .05), and a history of prior surgical intervention ...

Journal of Vascular Surgery, 2014

Journal of the American College of Surgeons, 2015

BACKGROUND: Our aim was to evaluate the outcomes of patients who underwent first rib resection (F... more BACKGROUND: Our aim was to evaluate the outcomes of patients who underwent first rib resection (FRR) for all 3 forms of thoracic outlet syndrome (TOS) during a period of 10 years. STUDY DESIGN: Patients treated with FRR from August 2003 through July 2013 were retrospectively reviewed using a prospectively maintained database. RESULTS: Five hundred and thirty-eight patients underwent 594 FRRs for indications of neurogenic (n ¼ 308 [52%]), venous (n ¼ 261 [44%]), and arterial (n ¼ 25 [4%]) TOS. Fifty-six (9.4%) patients had bilateral FRR. Fifty-two (8.8%) patients had cervical ribs. Three hundred and ninety-eight (67%) FRRs were performed on female patients, with a mean age of 33 years (range 10 to 71 years). Three hundred and forty (57%) were right-sided procedures. Seventy-five children (aged 18 years or younger) underwent FRRs; 25 during the first 5 years and 50 during the second 5 years. When comparing the second 5-year period with the first 5-year period, more patients had venous TOS (48% vs 37%; p < 0.02); fewer patients had neurogenic TOS (48% vs 58%; p < 0.05), and improved or fully resolved symptoms increased from 93% to 96%. Complications included 2 vein injuries, 2 hemothoraces, 4 hematomas, 138 pneumothoraces (23%), and 8 (1.3%) wound infections. Mean length of stay was 1 day. CONCLUSIONS: Excellent results were seen in this surgical series of neurogenic, venous, and arterial TOS due to appropriate selection of neurogenic patients, use of a standard protocol for venous patients, and expedient intervention in arterial patients. There is an increasing role for surgical intervention in children. (J Am Coll Surg 2015;220:934e939. Ó