Ambekar Sudheer, Sharma Mayur, Kukreja Sunil, Nanda Anil
Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, USA.
Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, USA.
Clin Neurol Neurosurg. 2014 Mar;118:65-8. doi: 10.1016/j.clineuro.2013.12.010. Epub 2014 Jan 3.
The aim of the present study was to analyze the practice patterns, complications and outcome following surgery for spinal meningioma in the United States.
We performed a retrospective cohort study using the Nationwide Inpatient Sample database from 2003 to 2010. In-patient mortality and discharge disposition were the outcome predictors.
A total of 13,792 admissions for surgically managed spinal meningioma were identified. The number of admissions increased from 12.6% in 2003 to 14.7% in 2010. 1.2% patients were ≤18 years and 28.4% ≥70 years. 8.3% patients had high co-morbidity score. The total in-hospital complication rate was 6.4%. 42% of the admissions were discharged to facilities other than home or self-care. Patients in the pediatric and adult age groups had a significantly higher rate of adverse outcome. There was no difference in complication rates and adverse discharge disposition between the hospitals with varying case volumes.
Caucasian patients with private insurance without co-morbidity had significantly lower complication rate and good outcome. Occurrence of spinal meningioma in the pediatric and adult age groups does not carry worse prognosis.
本研究旨在分析美国脊髓膜瘤手术后的实践模式、并发症及预后情况。
我们使用2003年至2010年的全国住院患者样本数据库进行了一项回顾性队列研究。住院死亡率和出院处置情况为预后预测指标。
共确定了13792例接受手术治疗的脊髓膜瘤住院病例。住院病例数从2003年的12.6%增至2010年的14.7%。1.2%的患者年龄≤18岁，28.4%的患者年龄≥70岁。8.3%的患者合并症评分较高。总的院内并发症发生率为6.4%。42%的住院患者出院后前往非家庭或自我护理机构。儿童和成人年龄组患者的不良预后发生率显著更高。不同病例数量的医院之间并发症发生率和不良出院处置情况无差异。
无合并症的白人参保患者并发症发生率显著更低，预后良好。儿童和成人年龄组发生脊髓膜瘤的预后并不更差。
