Research

Research concentrations as the principal investigator or primary author have been dedicated to four main areas: neurotrauma outcomes after severe traumatic brain injury and acute spinal cord injury, spine outcomes, socioeconomic research, and patient education. Prior research support has been directed primarily at studies improving outcomes and at the development of neurotrauma biomarkers. These investigations have supported the unmet need to identify biomarkers to better predict prognosis after neurotrauma and tailor interventions to augment neurological recovery.

1.     Agarwal, N., Aabedi, A.A., Torres-Espin, A., Chou, A., Wozny, T., Mummaneni, P.V., Burke, J.F., Ferguson, A.R., Kyritsis, N., Dhall, S.S., Weinstein, P.R., Duong-Fernandez, X., Pan, J., Singh, V., Hemmerle, D.D., Talbott, J.F., Whetstone, W.D., Bresnahan, J.C., Manley, G.T., Beattie, M.S., DiGiorgio, A. Decision Tree-based Machine Learning Analysis of Intraoperative Vasopressor Use to Optimize Neurological Improvement in Acute Spinal Cord Injury. Neurosurgical Focus 52(4):E9, April 2022.

2.     Deng, H., Goldschmidt, E., Nwachuku, E., Yue, J.K., Angriman, F., Wei, Z., Agarwal, N., Puccio, A.M., Okonkwo, D.O. Hydrocephalus and Cerebrospinal Fluid Analysis Following Severe Traumatic Brain Injury: Evaluation of a Prospective Cohort. Neurology International 13(4):527-534, October 2021.

3.     Jorge, A., White, M.D. Agarwal, N. Outcomes in Socioeconomically Disadvantaged Patients with Spinal Cord Injury: A Systematic Review. Journal of Neurosurgery: Spine 29(6):680-686, December 2018.

4.     Agarwal, N., Hansberry, D.R., Singh, P.L., Heary, R.F., Goldstein, I.M. Quality Assessment of Spinal Cord Injury Patient Education Resources. Spine 39(11):E701–E704, May 2014.

Improving outcomes following spine surgery is another component of my efforts to blend my clinical practice and research endeavors. As the principial investigator for these studies, I have sought to critically analyze perioperative surgical and patient risk factors to improve outcomes. The importance of these discoveries has been recognized by my national academic specialty organizations with honors and awards as aforementioned.

1.     Agarwal, N., White, M.D., Zhang, X., Alan, N., Ozpinar, A., Salvetti, D.J., Tempel, Z.J., Okonkwo, D.O., Kanter, A.S., Hamilton, D.K. Impact of Endplate-Implant Area Mismatch on Rates and Grades of Subsidence Following Stand-alone Lateral Lumbar Interbody Fusion: An Analysis of 623 Levels. Journal of Neurosurgery: Spine 33(1):12-16, March 2020.

2.     Agarwal, N., Angriman, F., Goldschmidt, E., Zhou, J., Kanter, A.S., Okonkwo, D.O., Passias, P.G., Protopsaltis, T., Lafage, V., Lafage, R., Schwab, F., Bess, S., Ames, C., Smith, J.S., Shaffrey, C.I., Burton, D., Hamilton, D.K., International Spine Study Group. Relationship between Body Mass Index and Sagittal Vertical Axis Change as well as Health-Related Quality of Life in 564 Patients following Deformity Surgery. Journal of Neurosurgery: Spine. Published Online, doi: 10.3171/2019.4.SPINE18485, August 2019.

3.     Agarwal, N., Faramand, A.M., Alan, N., Tempel, Z.J., Hamilton, D.K., Okonkwo, D.O., Kanter, A.S. Lateral Lumbar Interbody Fusion in the Elderly: A 10 Year Experience. Journal of Neurosurgery: Spine 29(5): 525–529, November 2018.

4.     Agarwal, N., Agarwal, P., Querry, A., Mazurkiewicz, A., Tempel, Z.J., Friedlander, R.M., Gerszten, P.C., Hamilton, D.K., Okonkwo, D.O., Kanter, A.S. Implementation of an Infection Prevention Bundle and Increased Physician Awareness Improves Surgical Outcomes and Reduces Costs Associated with Spine Surgery. Journal of Neurosurgery: Spine 29(1):108-114, July 2018.

A subset of my research interests includes examining socioeconomic policies that impact neurosurgical practice and the delivery of quality care to patients. These investigations stem from my involvement in organized neurosurgery societies whose mission statements center around these issues.

1.     Agarwal, N., Agarwal, P., Taylor, T.M., Mortimer, A.R., Stacy, J.D., Spatola, M., Mazzola, C.A., Orrico, K.O., Heary, R.F. Contributions to the United States Neurosurgery Political Action Committee (NeurosurgeryPAC): A Historical Perspective. World Neurosurgery 135:273-279, March 2020.

2.     Agarwal, N., White, M.D., Pannullo, S.C., Chambless, L.B. Analysis of National Trends in Neurosurgical Resident Attrition. Journal of Neurosurgery 131(5):1668-1673, November 2019.

3.     Agarwal, N., Kashkoush, A., Baucom, E.T., Ratliff, J.K., Stroink, A.R., Council of State Neurosurgical Societies. Quality Reporting in Neurological Surgery: Practice Adherence to Quality Payment Program Guidelines. Neurosurgery 84(2):537-543, February 2019.

4.     Agarwal, N., Gupta, R., Agarwal, P., Matthew, P., Wolferz, R., Shah, A., Adeeb, N., Prabhu, A.V., Kanter, A.S., Okonkwo, D.O., Hamilton, D.K. Descriptive Analysis of State and Federal Spine Surgery Malpractice Litigation in the United States. Spine Journal 43(14):984-990, July 2018.

My early investigations addressed deficiencies of patient education materials for neurosurgical patients. For these studies, I served as the principal investigator or senior author. The culmination of this work resulted in a foundation award to further improve patient education and engagement through multimedia.

1.     Agarwal, N., Funahashi, R., Taylor, T., Jorge, A., Feroze, R., Zhou, J., Hansberry, D.R. Gross, B.A., Jankowitz, B.T., Friedlander, R.M. Patient Education and Engagement Through Multimedia: Prospective Pilot Study on Health Literacy in Patients with Cerebral Aneurysms. World Neurosurgery 138:e819-e826, June 2020.

2.     White, M.D., Latour, K., Giordano, M., Taylor, T., Agarwal, N. The Reliability and Quality of Online Patient Education Videos for Lateral Lumbar Interbody Fusion. Journal of Neurosurgery: Spine. Published Online, doi:10.3171/2020.4.SPINE191539, June 2020.

3.     Agarwal, N., Feghhi, D.P., Gupta, R., Hansberry, D.R., Quinn, J.C., Heary, R.F., Goldstein, I.M. A Comparative Analysis of Minimally Invasive and Open Spine Surgery Patient Education Resources. Journal of Neurosurgery: Spine 21(3):468-74, September 2014.

4.     Agarwal, N., Hansberry, D.R., Sabourin, V., Tomei, K.L., Prestigiacomo, C.J. A Comparative Analysis of the Quality of Patient Education Materials from Medical Specialties. JAMA: Internal Medicine 173(13):1257-1259, July 2013.