Walid M Sami, Zaytseva Nadezhda, Porubaiko Lyudmila, Abbara Moataz
Medical Center of Central Georgia, Macon, GA 31201, USA.
Ger Med Sci. 2012;10:Doc03. doi: 10.3205/000154. Epub 2012 Feb 1.
Hospital patient databases are typically used by administrative staff to estimate loss-profit ratios and to help with the allocation of hospital resources. These databases can also be very useful in following rehospitalization. This paper studies the recurrence of spine surgery patients in our hospital population based on administrative data analysis.
Hospital data on 4,958 spine surgery patients operated between 2002 and 2009 were retrospectively reviewed. After sorting the cohort per ascending discharge date, the patient official name, consisting of first, middle and last names, was used as the variable determining duplicate cases in the SPSS statistical program, designating the first case in each group as primary. Yearly recurrence rate and change in procedure distribution were studied. In addition, hospital charges and length of stay were compared using the Wilcoxon-Mann-Whitney test.
Of 4,958 spine surgery patients 364 (7.3%) were categorized as duplicate cases by SPSS. The number of primary cases from which duplicate cases emerged was 327 meaning that some patients had more than two spine surgeries.Among primary patients (N=327) the percentage of excision of intervertebral disk procedures was 33.3% and decreased to 15.1% in recurrent admissions of the same patients (N=364). This decrease was compensated by an increase in lumbar fusion procedures. On the other hand, the rate of cervical fusion remained the same.The difference in hospital charges between primary and duplicate patients was $2,234 for diskectomy, $6,319 for anterior cervical fusion, $8,942 for lumbar fusion--lateral technique, and $12,525 for lumbar fusion--posterior technique. Recurrent patients also stayed longer in hospital, up to 0.9 day in lumbar fusion - posterior technique patients.
Spine surgery is associated with an increasing possibility of additional spine surgery with rising invasiveness and cost.
医院患者数据库通常被行政人员用于估算损益比并协助医院资源的分配。这些数据库在跟踪再入院情况方面也非常有用。本文基于行政数据分析研究了我院脊柱手术患者的复发情况。
回顾性分析了2002年至2009年间接受脊柱手术的4958例患者的医院数据。按照出院日期升序对队列进行排序后，在SPSS统计程序中使用由名字、中间名和姓氏组成的患者正式姓名作为确定重复病例的变量，将每组中的第一个病例指定为原发病例。研究了年复发率和手术分布的变化。此外，使用Wilcoxon-Mann-Whitney检验比较了医院费用和住院时间。
在4958例脊柱手术患者中，SPSS将364例（7.3%）归类为重复病例。出现重复病例的原发病例数为327例，这意味着一些患者接受了两次以上的脊柱手术。在原发患者（N = 327）中，椎间盘切除术的比例为33.3%，在同一患者的再次入院（N = 364）中降至15.1%。这种下降由腰椎融合手术的增加得到补偿。另一方面，颈椎融合率保持不变。原发患者和重复患者之间的医院费用差异为：椎间盘切除术相差2234美元，颈椎前路融合术相差6319美元，腰椎融合术（外侧技术）相差8942美元，腰椎融合术（后路技术）相差12525美元。复发患者的住院时间也更长，后路腰椎融合术患者最长多住院0.9天。
脊柱手术与再次进行脊柱手术的可能性增加相关，且侵袭性和成本不断上升。
