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Demographic predictors of treatment and complications for adult spinal deformity: An analysis of the national inpatient sample.
Brown, Nolan J; Jammal, Omar Al; Himstead, Alexander; Shahrestani, Shane; Yang, Chenyi; Patel, Neal A; Gendreau, Julian L; Sahyouni, Ronald; Diaz-Aguilar, Luis Daniel; Pham, Martin H.
Afiliación
  • Brown NJ; Department of Neurosurgery, University of California Irvine School of Medicine, Orange, CA, United States. Electronic address: nolanb@hs.uci.edu.
  • Jammal OA; Department of Neurosurgery, University of California San Diego School of Medicine, San Diego, CA, United States.
  • Himstead A; Department of Neurosurgery, University of California Irvine School of Medicine, Orange, CA, United States.
  • Shahrestani S; Department of Neurosurgery, USC Keck School of Medicine, Los Angeles, CA, United States; Medical Scientist Training Program, California Institute of Technology, Pasadena, CA, United States.
  • Yang C; Department of Neurosurgery, University of California Irvine School of Medicine, Orange, CA, United States.
  • Patel NA; Department of Neurosurgery, Mercer University School of Medicine, GA, United States.
  • Gendreau JL; Department of Biomedical Engineering, Johns Hopkins Whiting School of Engineering, MD, United States.
  • Sahyouni R; Department of Neurosurgery, University of California San Diego School of Medicine, San Diego, CA, United States.
  • Diaz-Aguilar LD; Department of Neurosurgery, University of California San Diego School of Medicine, San Diego, CA, United States.
  • Pham MH; Department of Neurosurgery, University of California San Diego School of Medicine, San Diego, CA, United States.
Clin Neurol Neurosurg ; 222: 107423, 2022 11.
Article en En | MEDLINE | ID: mdl-36063642
PURPOSE: To examine the role of demographics on surgical management and inpatient complications in patients with spinal deformity between 2010 and 2014 via retrospective analysis. METHODS: Data were obtained from the National Inpatient Sample (NIS). International Classification of Diseases 9th revision codes were used to identify patients with a primary diagnosis of adult spinal deformity (ASD). Multivariable Poisson regression analyses were used to determine whether any individual demographic variables were predictive of surgical management, surgical complexity, postoperative complications and revision operations. RESULTS: 17,433 patients were identified for analysis. Surgical intervention was performed for 94.5% of patients with a primary diagnosis of ASD. Patients at urban teaching hospitals were the most likely to receive surgery (OR= 2.13; 95% CI 1.51-2.95; p < 0.001) relative to rural patients. Female patients were the majority undergoing surgery and were more likely to receive a complication or require a revision when controlling for surgical complexity. Medicare patients were the least likely to undergo surgery and the most likely to receive complex fusion when undergoing an operation. Medicare patients were the least likely to experience complications (OR=0.89; 95% CI 0.80-0.98; p = 0.022) after adjusting for surgical complexity. With regards to race and ethnicity, Hispanics had a decreased likelihood of receiving a revision surgery. CONCLUSION: There were substantial differences in rates of surgical management, postoperative complications, and revisions among individuals of different demographics including sex, insurance status, ethnicity and hospital teaching status. Further research evaluating the effect of demographics in spine surgery is warranted to fully understand their influence on patient outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fusión Vertebral Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans País/Región como asunto: America do norte Idioma: En Revista: Clin Neurol Neurosurg Año: 2022 Tipo del documento: Article Pais de publicación: Países Bajos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fusión Vertebral Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans País/Región como asunto: America do norte Idioma: En Revista: Clin Neurol Neurosurg Año: 2022 Tipo del documento: Article Pais de publicación: Países Bajos