The risk tool developed and validated from our study cohort identified 5 risk factors: age ≤ 3 years (versus >3 years), ASA physical status II and III (versus ASA physical status I), morbid obesity, preexisting pulmonary disorder, and surgery (versus radiology) for PRAE. This tool can be used to provide an individual risk score for each patient to predict the risk of PRAE in the preoperative period.

P revious reports have found that in-hospital famotidine use in coronavirus disease 2019 (COVID-19) patients was associated with reduced risk of death or intubation. 1,2 In 1 of these studies the authors proposed that famotidine inhibits the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) protease, 3-chymotrypsin-like protease, that is essential for breakdown of the immature SARS-CoV-2 protein particles that contribute to the inflammatory response seen in some COVID-19-infected individuals, 1 which in turn can lead to acute respiratory distress syndrome, multiorgan dysfunction, physiologic deterioration, and death. 3 In a global pandemic with a lack of US Food and Drug Administration-approved targeted therapeutic agents, identification and repurposing of well-established drugs with a proven track record of safety, affordability, and widespread availability are necessary. 4 The purpose of this study was to evaluate the reported protective effect of famotidine on mortality in hospitalized COVID-19 patients. MethodsRefer to Supplementary Methods for complete details. In brief, admitted adults to affiliated hospitals who tested positive for SARS-CoV-2 by reverse transcriptase polymerase chain reaction between February 11, 2020 and May 8, 2020 were included. Exclusion criteria were death or intubation within 48 hours of admission or if famotidine was received >24 hours after admission. The primary outcome was 30-day all-cause mortality. Primary exposure was in-hospital famotidine use, regardless of dose and route, within 24 hours of admission.To mitigate bias from nonrandomized assignment of treatment, a coarsened exact matching (CEM) 5 technique was used for famotidine users and nonusers on age (by 10-year intervals), sex, race, ethnicity, body mass index, comorbidities, and in-hospital hydroxychloroquine (HCQ) use. A multivariable logistic regression model within the CEM cohort and adjusted for baseline World Health Organization (WHO) severity and use of other medications was performed to evaluate the association between famotidine use and 30-day mortality.

A better understanding of the consequences of spine surgery complications is warranted to optimize patient-reported outcomes and contain the rising health care costs associated with the management of adult spinal deformity (ASD). We systematically searched PubMed and Scopus databases using keywords "adult spinal deformity surgery," "complications," and "cost" for published studies on costs of complications associated with spinal surgery, with a particular emphasis on ASD and scoliosis. In the 17 articles reviewed, we identified 355,354 patients with 11,148 reported complications. Infection was the most commonly reported complication, with an average treatment cost ranging from $15,817 to $38,701. Hospital costs for patients with deep venous thrombosis, pulmonary thromboembolism, and surgical site infection were 2.3 to 3.1 times greater than for patients without those complications. An effort to collect and characterize data on cost of complications is encouraged, which may help health care providers to identify potential resources to limit complications and overall costs.

We previously published rates of pediatric stroke using our population-based Greater Cincinnati Northern Kentucky Stroke Study (GCNK) for periods July 1993-June 1994 and 1999. We report population-based rates from 2 additional study periods: 2005 and 2010. We identified all pediatric strokes for residents of the GCNK region that occurred in July 1, 1993-June 30, 1994, and calendar years 1999, 2005, and 2010. Stroke cases were ascertained by screening discharge ICD-9 codes, and verified by a physician. Pediatric stroke was defined as stroke in those <20 years of age. Stroke rates by study period, overall, by age and by race, were calculated. Eleven children died within 30 days, yielding an all-cause case fatality rate of 15.7% (95% confidence interval 1.1%, 26.4%) with 3 (27.3%) ischemic, 6 (54.5%) hemorrhagic, and 2 (18.2%) unknown stroke type. The pediatric stroke rate of 4.4 per 100 000 in the GCNK study region has not changed over 17 years.