All Publications

  • Concussion: A Comprehensive Review of Current Evidence. Current reviews in musculoskeletal medicine Hornburg, K., Cassianni, C. E., Muhammad, S. M., Muñoz Eusse, J. E., Dixon, R. C. 2026; 19 (1)

    Abstract

    Concussion is a common form of mild traumatic brain injury affecting nearly two million people yearly, costing the US nearly 19 billion dollars annually. In light of such significant prevalence and disease burden, tools and interventions aimed at improving diagnosis, recovery, and management are constantly evolving. This narrative review synthesizes literature from PubMed, Scopus, and Google Scholar (2015-2025), prioritizing systematic reviews, randomized trials, and consensus guidelines with the goal of summarizing current best-practices based on up-to-date data and expert opinion.Concussion remains a clinical diagnosis supported by tools such as the SCAT6, though limitations persist. Biomarkers demonstrate high sensitivity for intracranial injury, but limited utility for diagnosing uncomplicated concussion. Recovery is heterogeneous, influenced by initial symptom burden, patient factors, and mechanism of injury. Management has shifted toward early, symptom-guided activity and targeted, multimodal rehabilitation. Persistent symptoms reflect multifactorial etiologies that require individualized care. Concussion care is transitioning toward more objective assessment and personalized management, though gaps remain in diagnostic precision and in predicting prolonged recovery.

    View details for DOI 10.1007/s12178-026-10051-w

    View details for PubMedID 42435097

    View details for PubMedCentralID PMC13355989

  • Venous Thromboembolism Outcomes Among Cancer and Non-cancer Patients Managed with Patient-centric Guideline-driven Protocol. Thrombosis and haemostasis Cassianni, C. E., McBane, R. D., Vlazny, D. T., Hodge, D. O., Casanegra, A. I., Houghton, D. E., Wysokinski, W. E. 2026; 126 (5): 518-525

    Abstract

    Patients with cancer and venous thromboembolism (VTE) have higher complication rates of anticoagulation. However, studies supporting this data are relatively old reflecting the era of vitamin K inhibitors.To assess VTE recurrence, major bleeding, and clinically relevant non-major bleeding (CRNMB) in patients (March 1, 2013 to April 30, 2023) with cancer-associated VTE and patients without cancer, the prospective Mayo Clinic Thrombophilia Clinic Registry was analyzed.Over the study period, 4,711 patients with acute VTE were enrolled including 2,064 patients with cancer (mean age 62.5 ± 12.4, 46% female) and 2,647 patients without cancer (mean age 59.4 ± 16.0, 45% female). The most common cancers were gastrointestinal (n = 423, 21%), pancreatic (n = 287, 14%), and genitourinary (n = 198, 10%). Direct oral anticoagulants were used in 1,339 (65%) cancer and in 1,952 (74%) non-cancer patients. Among cancer patients, 12-month Kaplan-Meier probability of VTE recurrence was 2.4-fold greater (7.1% vs. 2.9%, p < 0.001) compared with the non-cancer group, including higher recurrent leg deep vein thrombosis (3.0% vs. 1.4%; p = 0.002) and pulmonary embolism (3.5% vs. 1.0%, p < 0.001). Patients with cancer also had 2.1-fold greater risk of major bleeding (6.3% vs. 3.0%; p < 0.001) including bleeding from the gastrointestinal tract (3.0 vs. 1.4, p = 0.01) compared with patients without cancer. Clinically relevant non-major bleeding events were similar between the groups.In this large prospective registry of VTE management, patients with cancer had significantly higher rates of VTE recurrence and major bleeding compared with patients without cancer, yet the rate of complications are substantially smaller relative to historic values of a prior vitamin K antagonist era.

    View details for DOI 10.1055/a-2653-6161

    View details for PubMedID 40719144

  • Erratum: Design and Staged Implementation of a Multidisciplinary Preoperative Anemia Clinic at a Tertiary Care Medical Center. Anesthesia and analgesia Crispell, E. H., Cassianni, C. E., Burt, J. M., Gonzalez, J. A., Petsch, J. L., Hanson, A. C., Robbins, K. A., Go, R. S., Crestanello, J. A., Jacob, A. K., Kor, D. J., Warner, M. A. 2026; 142 (3): e56

    View details for DOI 10.1213/ANE.0000000000007926

    View details for PubMedID 41687683

  • Sensitivity of post-treatment surveillance in detecting recurrence and metastasis in surgically treated HPV-positive oropharyngeal squamous cell carcinoma patients. Oral oncology Zhu, A. Q., Cassianni, C. E., Haller, T., O'Byrne, T. J., Ochoa, P., Vallecillo, T., Pumford, A., Olawuni, F., Moore, E. J., Price, D. L., Tasche, K. K., Yin, L. X., Ma, D. J., Lester, S. C., Gamez, M., Neben Wittich, M. A., Price, K. A., Van Abel, K. M., Routman, D. M. 2025; 171: 107767

    Abstract

    There is a lack of data regarding the appropriate surveillance of HPV(+)OPSCC. Our study aims to determine the sensitivity of patient symptoms, physical exam findings, and imaging in identifying recurrence and disease progression.Mayo Clinic IRB (22-000684) approval was obtained, and the departmental REDCap database was queried to identify all HPV(+)OPSCC patients from 01/01/2006 to 12/31/2021 at our tertiary care center. Surgically treated patients with pathologic specimens positive for HPV (confirmed with in-situ hybridization (ISH) and/or p16 immuno-histochemistry) without evidence of distant metastatic disease at diagnosis were included.Sensitivity, specificity, PPV, and NPV of patient symptoms, physical exam findings, and imaging for disease progression were assessed both overall and at each time point.142/1142 patients experienced disease progression. 70% of patients with disease progression were detected within the first two years of surveillance. 79 patients with disease progression were detected via routine surveillance imaging, 34 via patient-reported symptoms, and 5 via physical exam. Routine surveillance imaging was the most sensitive method of detection for locoregional recurrence (sensitivity 92.3%, PPV 6.5%, NPV 42.9%) and distant metastasis (sensitivity 100%, PPV 6.7%, NPV 100.0%). Patient symptoms in aggregate had a 73.1% sensitivity for detecting locoregional recurrence (PPV 8.7%, NPV 95.4%); however no individual symptom had a sensitivity over 30%. Physical exam findings were the least sensitive method of detection.Our findings demonstrate that the majority of recurrences are detected within the first two years of surveillance. Routine surveillance imaging is the most sensitive modality for detecting disease progression as compared to patient symptoms or physical exam findings. Additional studies integrating newer technologies, such as ctHPVDNA. into surveillance are needed.

    View details for DOI 10.1016/j.oraloncology.2025.107767

    View details for PubMedID 41176926

  • Design and Staged Implementation of a Multidisciplinary Preoperative Anemia Clinic at a Tertiary Care Medical Center. Anesthesia and analgesia Crispell, E. H., Cassianni, C. E., Burt, J. M., Gonzalez, J. A., Petsch, J. L., Hanson, A. C., Robbins, K. A., Go, R. S., Crestanello, J. A., Jacob, A. K., Kor, D. J., Warner, M. A. 2025; 141 (5): 964-974

    Abstract

    Preoperative anemia is common and associated with adverse outcomes in surgical patients. There is limited information to guide the design and implementation of preoperative anemia clinics (PAC), which represents a critical barrier to entry for many practices.This is a descriptive observational study highlighting the design and implementation of a multidisciplinary PAC, including key steps in planning, stakeholder engagement, organizational structure, identification of target populations, establishing anemia treatments, information technology and electronic health record integration, provider training, and data infrastructure. Demographic and clinical characteristics, laboratory results, and anemia treatments for individuals evaluated in the PAC from November 4, 2019 through September 15, 2023 are enumerated. Patient-reported outcomes (PROs) assessing changes in anemia symptoms and well-being after surgery are evaluated for 2 subsets of patients (one before PAC implementation [pre-PAC], another after PAC implementation [post-PAC]), without formal statistical comparison given limited sample sizes.The PAC was initiated as a multidisciplinary effort under support from a Mayo Clinic Practice Transformation Award in 2019, including broad representation from anesthesiology, surgery, and medical practices, along with institutional project management support (eg, project manager, information technologists, systems engineers). While initially limited to cardiac surgery patients, the PAC underwent planned incremental expansion to include other surgical services. Over the study period, 1188 PAC consultations across 1159 unique patients met eligibility criteria, with a median age of 66 (57-73) years and 58.1% women. The most common etiology of anemia was iron deficiency (69.1%) followed by anemia related to cancer (17.3%). Anemia-directed therapies were recommended in 1038 (87.4%) encounters, with 730 (70.3%) of those receiving recommended treatment preoperatively. Seven hundred nine (97.1%) treatments included intravenous iron and 146 (20.0%) included erythropoiesis-stimulating agents. Fifteen pre-PAC and 38 post-PAC implementation patients completed PROs. PAC implementation was accompanied by earlier resolution of anemia symptoms and less pronounced declines in postoperative well-being scores.This report highlights the key steps for successful PAC implementation. Treatment is possible for most patients and may be accompanied by improvements in patient-important outcomes.

    View details for DOI 10.1213/ANE.0000000000007435

    View details for PubMedID 40014801

    View details for PubMedCentralID PMC12353018

  • Application of an Artificial Intelligence Model to Detect Heart Failure With Preserved Ejection Fraction to Handheld Ultrasound Imaging. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography James, J. K., Huntley, G., Arystan, A. Z., Cassianni, C., Scott, C. G., Davison, H., Akerman, A., Hawkes, W., Oliveria, J., Chartsias, A., Gomez, A., Upton, R., Pellikka, P. A. 2025; 38 (7): 633-635

    View details for DOI 10.1016/j.echo.2025.03.016

    View details for PubMedID 40204003