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Demographic predictors of treatments and surgical complications of lumbar degenerative diseases

Al Jammal, Omar M. and Shahrestani, Shane and Delavar, Arash and Brown, Nolan J. and Gendreau, Julian L. and Lien, Brian V. and Sahyouni, Ronald and Diaz-Aguilar, Luis Daniel and Shalakhti, Omar S. and Pham, Martin H. (2022) Demographic predictors of treatments and surgical complications of lumbar degenerative diseases. Medicine, 101 (11). Art. No. e29065. ISSN 0025-7974. doi:10.1097/md.0000000000029065. https://resolver.caltech.edu/CaltechAUTHORS:20220502-124702100

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Abstract

This was a national database study. To examine the role of comorbidities and demographics on inpatient complications in patients with lumbar degenerative conditions. Degenerative conditions of the lumbar spine account for the most common indication for spine surgery in the elderly population in the United States. Significant studies investigating demographic as predictors of surgical rates and health outcomes for degenerative lumbar conditions are lacking. Data were obtained from the National Inpatient Sample from 2010 to 2014 and International Classification of Diseases, 9th revision, Clinical Modification codes were used to identify patients with a primary diagnosis of degenerative lumbar condition. Patients were stratified based on demographic variables and comorbidity status. Multivariate regression analyses were used to determine whether any individual demographic variables, such as race, sex, insurance, and hospital status predicted postoperative complications. A total of 256,859 patients were identified for analysis. The rate of overall complications was found to be 16.1% with a mortality rate of 0.10%. Female, Black, Hispanic, and Asian/Pacific Islander patients had lower odds of receiving surgical treatment compared to White patients (P<.001). Medicare and Medicaid patients were less likely to be surgically managed than patients with private insurance (OR = 0.75, 0.37; P<.001, respectively). Urban hospitals were more likely to provide surgery when compared to rural hospitals (P < .001). Patients undergoing fusion had more complications than decompression alone (P < .001). Females, Medicare insurance status, Medicaid insurance status, urban hospital locations, and certain geographical locations were found to predict postoperative complications (P < .001). There were substantial differences in surgical management and postoperative complications among individuals of different sex, races, and insurance status. Further investigation evaluating the effect of demographics in spine surgery is warranted to fully understand their influence on patient complications.


Item Type:Article
Related URLs:
URLURL TypeDescription
https://doi.org/10.1097/md.0000000000029065DOIArticle
ORCID:
AuthorORCID
Shahrestani, Shane0000-0001-7561-4590
Delavar, Arash0000-0002-1095-7434
Brown, Nolan J.0000-0002-6025-346X
Lien, Brian V.0000-0003-3044-8626
Sahyouni, Ronald0000-0002-2124-0535
Pham, Martin H.0000-0002-7733-8902
Additional Information:© 2022 Lippincott, Williams & Wilkins. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Received: 30 November 2021; Received in final form: 23 February 2022; Accepted: 24 February 2022. Author contributions: Conceptualization: Omar M. Al Jammal, Shane Shahrestani, Martin H. Pham. Data curation: Arash Delavar, Nolan J. Brown. Formal analysis: Omar M. Al Jammal. Investigation: Brian V. Lien. Methodology: Shane Shahrestani. Project administration: Julian Gendreau, Martin H. Pham. Supervision: Martin H. Pham. Validation: Martin H. Pham. Writing – original draft: Omar M. Al Jammal. Writing – review & editing: Shane Shahrestani, Arash Delavar, Nolan J. Brown, Julian Gendreau, Brian V. Lien, Ronald Sahyouni, Luis Daniel Diaz-Aguilar, Omar S. Shalakhti, Martin H. Pham.
Subject Keywords:decompression, degenerative lumbar surgery, disparities, fusion, laminectomy, National Inpatient Sample, postoperative complications, spinal stenosis
Issue or Number:11
DOI:10.1097/md.0000000000029065
Record Number:CaltechAUTHORS:20220502-124702100
Persistent URL:https://resolver.caltech.edu/CaltechAUTHORS:20220502-124702100
Official Citation:Al Jammal, Omar M. BA; Shahrestani, Shane MS; Delavar, Arash MPH; Brown, Nolan J. BS; Gendreau, Julian L. MD; Lien, Brian V. BS; Sahyouni, Ronald MS, MD, PhD; Diaz-Aguilar, Luis Daniel MD; Shalakhti, Omar S. BS; Pham, Martin H. MD Demographic predictors of treatments and surgical complications of lumbar degenerative diseases, Medicine: March 18, 2022 - Volume 101 - Issue 11 - e29065 doi: 10.1097/MD.0000000000029065
Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:114542
Collection:CaltechAUTHORS
Deposited By: Tony Diaz
Deposited On:02 May 2022 17:06
Last Modified:03 May 2022 17:10

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