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Article ; Online: Letter to the Editor. For profit, or not for profit.

Piatt, Joseph H

2021 Volume 29, Issue 2, Page(s) 232–233

Language	English
Publishing date	2021-10-01
Publishing country	United States
Document type	Journal Article ; Letter
ZDB-ID	2403985-8
ISSN	1933-0715 ; 1933-0707
ISSN (online)	1933-0715
ISSN	1933-0707
DOI	10.3171/2021.6.PEDS21333
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Uk I Zs.135 -Pediatrics-: Show issues

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Book: Pediatric neurosurgery

Piatt, Joseph H.

(The pediatric clinics of North America ; 51,2)

2004

Author's details	guest ed. Joseph H. Piatt
Series title	The pediatric clinics of North America ; 51,2
Collection
Language	English
Size	XII S., S. 237 - 538 : zahlr. Ill.
Publisher	Saunders
Publishing place	Philadelphia u.a.
Publishing country	United States
Document type	Book
HBZ-ID	HT014015443
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Article ; Online: Adults with myelomeningocele and other forms of spinal dysraphism: hospital care in the United States since the turn of the millennium.

Piatt, Joseph H

Journal of neurosurgery. Spine

2016 Volume 25, Issue 1, Page(s) 69–77

Abstract: OBJECTIVE The natural history and management of myelomeningocele (MM) in children is fairly well understood. There is a deficiency of knowledge regarding the care of adults, however, even though there are now more adults than children living with MM. The ...

Abstract	OBJECTIVE The natural history and management of myelomeningocele (MM) in children is fairly well understood. There is a deficiency of knowledge regarding the care of adults, however, even though there are now more adults than children living with MM. The purpose of this study was to characterize the hospital care of adults with MM and hydrocephalus on a nationwide population base. Adults with other forms of spina bifida (SB) were studied for contrast. METHODS The Nationwide Inpatient Sample for the years 2001, 2004, 2007, and 2010 was queried for admissions with diagnostic ICD-9-CM codes for MM with hydrocephalus and for other forms of SB. RESULTS There were 4657 admissions of patients with MM and 12,369 admissions of patients with SB in the sample. Nationwide rates of admission increased steadily for both MM and SB patients throughout the study period. Hospital charges increased faster than the health care component of the Consumer Price Index. Patients with MM were younger than patients with SB, but annual admissions of MM patients older than 40 years increased significantly during the study period. With respect to hospital death and discharge home, outcomes of surgery for hydrocephalus were superior at high-volume hospitals. Patients with MM and SB were admitted to the hospital more frequently than the general population for surgery to treat degenerative spine disease. CONCLUSIONS Patients with MM and SB continue to require neurosurgical attention in adulthood, and the demand for services for older patients with MM is increasing. Management of hydrocephalus at high-volume centers is advantageous for this population. Patients with MM or SB may experience high rates of degenerative spine disease.
MeSH term(s)	Adult ; Age Factors ; Aged ; Aged, 80 and over ; Female ; Health Care Costs/statistics & numerical data ; Hospitalization/economics ; Hospitalization/statistics & numerical data ; Humans ; Hydrocephalus/complications ; Hydrocephalus/epidemiology ; Hydrocephalus/surgery ; Incidence ; Male ; Meningomyelocele/complications ; Meningomyelocele/epidemiology ; Meningomyelocele/therapy ; Middle Aged ; Neurosurgical Procedures/economics ; Spinal Dysraphism/complications ; Spinal Dysraphism/epidemiology ; Spinal Dysraphism/therapy ; United States/epidemiology ; Young Adult
Language	English
Publishing date	2016-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2158643-3
ISSN	1547-5646 ; 1547-5654
ISSN (online)	1547-5646
ISSN	1547-5654
DOI	10.3171/2015.9.SPINE15771
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Article ; Online: Response.

Piatt, Joseph H

Journal of neurosurgery. Pediatrics

2015 Volume 15, Issue 5, Page(s) 544–545

MeSH term(s)	Cerebrospinal Fluid Shunts/statistics & numerical data ; Equipment Failure ; Female ; Hospitalization/statistics & numerical data ; Humans ; Hydrocephalus/surgery ; Male ; Risk Adjustment
Language	English
Publishing date	2015-05
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	2403985-8
ISSN	1933-0715 ; 1933-0707
ISSN (online)	1933-0715
ISSN	1933-0707
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Article ; Online: Pediatric spinal injury in the US: epidemiology and disparities.

Piatt, Joseph H

Journal of neurosurgery. Pediatrics

2015 Volume 16, Issue 4, Page(s) 463–471

Abstract: Object: In the US, race and economic status have pervasive associations with mechanisms of injury, severity of injury, management, and outcomes of trauma. The goal of the current study was to examine these relationships on a large scale in the setting ... ...

Abstract	Object: In the US, race and economic status have pervasive associations with mechanisms of injury, severity of injury, management, and outcomes of trauma. The goal of the current study was to examine these relationships on a large scale in the setting of pediatric spinal injury. Methods: Admissions for spinal fracture without or with spinal cord injury (SCI), spinal dislocation, and SCI without radiographic abnormality were identified in the Kids' Inpatient Database (KID) and the National Trauma Data Bank (NTDB) registry for 2009. Patients ranged in age from birth up to 21 years. Data from the KID were used to estimate nationwide annual incidences. Data from the NTDB were used to describe patterns of injury in relation to age, race, and payor, with corroboration from the KID. Multiple logistic regression was used to model rates of mortality and spinal fusion. Results: In 2009, the estimated incidence of hospital admission for spinal injury in the US was 170 per 1 million in the population under 21 years of age. The incidence of SCI was 24 per 1 million. Incidences varied regionally. Adolescents predominated. Patterns of injury varied by age, race, and payor. Black patients were more severely injured than patients of other races as measured by Injury Severity Scale scores. Among black patients with spinal injury in the NTDB, 23.9% suffered firearm injuries; only 1% of white patients suffered firearm injuries. The overall mortality rate in the NTDB was 3.9%. In a multivariate analysis that included a large panel of clinical and nonclinical factors, black race retained significance as a predictor of mortality (p = 0.006; adjusted OR 1.571 [1.141-2.163]). Rates of spinal fusion were associated with race and payor in the NTDB data and with payor in the KID: patients with better insurance underwent spinal fusion at higher rates. Conclusions: The epidemiology of pediatric spinal injury in the US cannot be understood apart from considerations of race and economic status.
MeSH term(s)	Accidents, Traffic/economics ; Accidents, Traffic/statistics & numerical data ; Adolescent ; African Continental Ancestry Group/statistics & numerical data ; Athletic Injuries/economics ; Athletic Injuries/epidemiology ; Athletic Injuries/surgery ; Child ; Child, Preschool ; Databases, Factual ; European Continental Ancestry Group/statistics & numerical data ; Healthcare Disparities/statistics & numerical data ; Hispanic Americans/statistics & numerical data ; Humans ; Incidence ; Infant ; Infant, Newborn ; Insurance Coverage/statistics & numerical data ; Neurosurgical Procedures/utilization ; Socioeconomic Factors ; Spinal Cord Injuries/economics ; Spinal Cord Injuries/epidemiology ; Spinal Cord Injuries/surgery ; Spinal Fractures/economics ; Spinal Fractures/epidemiology ; Spinal Fractures/surgery ; Spinal Fusion/utilization ; Spinal Injuries/economics ; Spinal Injuries/epidemiology ; Spinal Injuries/surgery ; Survival Rate ; Trauma Severity Indices ; United States/epidemiology ; Violence/economics ; Violence/statistics & numerical data ; Young Adult
Language	English
Publishing date	2015-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2403985-8
ISSN	1933-0715 ; 1933-0707
ISSN (online)	1933-0715
ISSN	1933-0707
DOI	10.3171/2015.2.PEDS1515
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Article ; Online: Thirty-day outcomes of cerebrospinal fluid shunt surgery: data from the National Surgical Quality Improvement Program-Pediatrics.

Piatt, Joseph H

Journal of neurosurgery. Pediatrics

2014 Volume 14, Issue 2, Page(s) 179–183

Abstract: Object: Cerebrospinal fluid shunts are the mainstay of the treatment of hydrocephalus. In past studies, outcomes of shunt surgery have been analyzed based on follow-up of 1 year or longer. The goal of the current study is to characterize 30-day shunt ... ...

Abstract	Object: Cerebrospinal fluid shunts are the mainstay of the treatment of hydrocephalus. In past studies, outcomes of shunt surgery have been analyzed based on follow-up of 1 year or longer. The goal of the current study is to characterize 30-day shunt outcomes, to identify clinical risk factors for shunt infection and failure, and to develop statistical models that might be used for risk stratification. Methods: Data for 2012 were obtained from the National Surgical Quality Improvement Program-Pediatrics (NSQIP-P) of the American College of Surgeons. Files with index surgical procedures for insertion or revision of a CSF shunt composed the study set. Returns to the operating room within 30 days for shunt infection and for shunt failure without infection were the study end points. Associations with a large number of potential clinical risk factors were analyzed on a univariate basis. Logistic regression was used for multivariate analysis. Results: There were 1790 index surgical procedures analyzed. The overall rates of shunt infection and shunt failure without infection were 2.0% and 11.5%, respectively. Male sex, steroid use in the preceding 30 days, and nutritional support at the time of surgery were risk factors for shunt infection. Cardiac disease was a risk factor for shunt failure without infection, and initial shunt insertion, admission during the second quarter, and neuromuscular disease appeared to be protective. There was a weak association of increasing age with shunt failure without infection. Models based on these factors accounted for no more than 6% of observed variance. Construction of stable statistical models with internal validity for risk adjustment proved impossible. Conclusions: The precision of the NSQIP-P dataset has allowed identification of risk factors for shunt infection and for shunt failure without infection that have not been documented previously. Thirty-day shunt outcomes may be useful quality metrics, possibly even without risk adjustment. Whether important variation in 30-day outcomes exists among institutions or among neurosurgeons is yet unknown.
MeSH term(s)	Adrenal Cortex Hormones/administration & dosage ; Adrenal Cortex Hormones/adverse effects ; Aged ; Cerebrospinal Fluid Shunts/adverse effects ; Cerebrospinal Fluid Shunts/standards ; Child ; Equipment Failure ; Female ; Heart Diseases/complications ; Humans ; Hydrocephalus/surgery ; Logistic Models ; Male ; Multivariate Analysis ; Quality Improvement ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome ; United States
Chemical Substances	Adrenal Cortex Hormones
Language	English
Publishing date	2014-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2403985-8
ISSN	1933-0715 ; 1933-0707
ISSN (online)	1933-0715
ISSN	1933-0707
DOI	10.3171/2014.5.PEDS1421
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Article ; Online: Treatment of Sagittal Craniosynostosis Using Osteoplastic Parietal Craniotomy Flap With Distraction Osteogenesis: A Variation on Technique.

Habarth-Morales, Theodore E / Piatt, Joseph H / Caterson, Edward J

The Journal of craniofacial surgery

2021 Volume 33, Issue 5, Page(s) e491–e493

Abstract: Abstract: Late presentation sagittal craniosynostosis presents a unique challenge due to the decreased ability of the skull to repair the bony defects created by standard of care techniques. Distraction osteogenesis is a viable strategy to correct this ... ...

Abstract	Abstract: Late presentation sagittal craniosynostosis presents a unique challenge due to the decreased ability of the skull to repair the bony defects created by standard of care techniques. Distraction osteogenesis is a viable strategy to correct this defect in late presenting cases. The authors describe a variation in technique in which the temporalis muscle origin is retained, creating an osteoplastic bone flap with retained vascularity through the tem-poralis muscle. This may improve postoperative bony healing of bony defects in this compromised population. The authors present two patients who presented to them late with sagittal synostosis who were treated with distraction osteogenesis in which vascular continuity to the parietal bones is preserved through the temporalis muscle.
MeSH term(s)	Craniosynostoses/diagnostic imaging ; Craniosynostoses/surgery ; Craniotomy/methods ; Humans ; Jaw Abnormalities/surgery ; Osteogenesis, Distraction/methods ; Skull/surgery ; Surgical Flaps/surgery
Language	English
Publishing date	2021-12-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	1159501-2
ISSN	1536-3732 ; 1049-2275
ISSN (online)	1536-3732
ISSN	1049-2275
DOI	10.1097/SCS.0000000000008396
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Article ; Online: Conflict of interest.

Piatt, Joseph H

Journal of neurosurgery

2011 Volume 114, Issue 1, Page(s) 19–20; discussion 20

MeSH term(s)	Bias ; Biomedical Research/economics ; Biomedical Research/ethics ; Biomedical Research/trends ; Commerce/economics ; Commerce/ethics ; Commerce/trends ; Conflict of Interest/economics ; Device Approval ; Humans ; Neurosurgery/economics ; Neurosurgery/ethics ; Neurosurgery/trends ; Periodicals as Topic/economics ; Periodicals as Topic/ethics ; Periodicals as Topic/trends ; United States ; United States Food and Drug Administration
Language	English
Publishing date	2011-01
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	3089-2
ISSN	1933-0693 ; 0022-3085
ISSN (online)	1933-0693
ISSN	0022-3085
DOI	10.3171/2010.1.JNS10152
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Article ; Online: Cervical spine clearance.

Piatt, Joseph H

Journal of neurosurgery. Pediatrics

2010 Volume 6, Issue 6, Page(s) 604; author reply 604

MeSH term(s)	Algorithms ; Cervical Vertebrae/injuries ; Emergency Medical Services/standards ; Humans ; Infant ; Neck Injuries/diagnosis ; Spinal Cord Injuries/diagnosis
Language	English
Publishing date	2010-12
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	2403985-8
ISSN	1933-0715 ; 1933-0707
ISSN (online)	1933-0715
ISSN	1933-0707
DOI	10.3171/2010.5.PEDS10178
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Article ; Online: Intracranial suppuration complicating sinusitis among children: an epidemiological and clinical study.

Piatt, Joseph H

Journal of neurosurgery. Pediatrics

2011 Volume 7, Issue 6, Page(s) 567–574

Abstract: Object: Intracranial abscess is a very infrequent complication of sinusitis among children. Case series, mostly small and focusing on surgical treatment, have appeared in the literature, but there has been no study on the epidemiology of this condition, ...

Abstract	Object: Intracranial abscess is a very infrequent complication of sinusitis among children. Case series, mostly small and focusing on surgical treatment, have appeared in the literature, but there has been no study on the epidemiology of this condition, nor has there been any large-scale study on the intensity of therapy or outcomes. Methods: Data were drawn from the Kids' Inpatient Databases for 1997, 2000, 2003, and 2006 and the National Inpatient Sample for 2001. Cases were defined by the conjunction between the diagnostic codes for intracranial abscess and those for acute or chronic sinusitis or mastoiditis. Results: Eight hundred forty-seven hospital admissions were captured. Over the 10 years of the study, admission rates ranged between 2.74 and 4.38 per million children per year. Boys were affected much more commonly than girls. Black children were affected out of proportion to their presence in the population. The overall incidence seemed to peak in early adolescence. Sinogenic cases had a marked seasonal pattern peaking in winter, but no seasonal variation was seen for otogenic cases. Asthma comorbidity was more prevalent among sinogenic cases. The mortality rate was 2%, and death occurred only among sinogenic cases. Moreover, sinogenic cases tended to require more intensive therapy, as measured by the number of procedures, and there was a trend toward less favorable discharge dispositions. Older patients and black patients were less likely to be discharged directly to home. At least a quarter of the cases were managed without neurosurgical intervention. White patients were treated without neurosurgery more often than others. Conclusions: Analysis of administrative data sets has yielded a descriptive picture of intracranial abscess complicating sinusitis among children, but the very low incidence of this condition impedes prospective clinical research directed at practical management issues.
MeSH term(s)	Adolescent ; Brain Abscess/epidemiology ; Brain Abscess/etiology ; Brain Abscess/surgery ; Child ; Child, Preschool ; Ethnic Groups ; Female ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Neurosurgical Procedures ; Severity of Illness Index ; Sex Factors ; Sinusitis/complications ; Treatment Outcome ; United States/epidemiology ; Young Adult
Language	English
Publishing date	2011-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	2403985-8
ISSN	1933-0715 ; 1933-0707
ISSN (online)	1933-0715
ISSN	1933-0707
DOI	10.3171/2011.3.PEDS10504
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