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Demographic predictors of treatment and complications for adult spinal deformity: An analysis of the national inpatient sample

Brown, Nolan J. and Al Jammal, Omar and Himstead, Alexander S. and Shahrestani, Shane and Yang, Chenyi and Patel, Neal A. and Gendreau, Julian L. and Sahyouni, Ronald and Diaz-Aguilar, Luis Daniel and Pham, Martin H. (2022) Demographic predictors of treatment and complications for adult spinal deformity: An analysis of the national inpatient sample. Clinical Neurology and Neurosurgery, 222 . Art. No. 107423. ISSN 0303-8467. doi:10.1016/j.clineuro.2022.107423.

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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.

Item Type:Article
Related URLs:
URLURL TypeDescription
Brown, Nolan J.0000-0002-6025-346X
Al Jammal, Omar0000-0001-6439-3526
Himstead, Alexander S.0000-0001-9244-700X
Shahrestani, Shane0000-0001-7561-4590
Patel, Neal A.0000-0003-4992-1356
Gendreau, Julian L.0000-0001-8412-0437
Sahyouni, Ronald0000-0002-2124-0535
Pham, Martin H.0000-0002-7733-8902
Additional Information:There were no conflicts of interest or sources of funding for this work.
Record Number:CaltechAUTHORS:20220909-232913000
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Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:116885
Deposited By: Olivia Warschaw
Deposited On:29 Oct 2022 22:17
Last Modified:01 Nov 2022 18:14

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