Steinberger Jeremy, Gilligan Jeffrey, Skovrlj Branko, Sarkiss Christopher A, Guzman Javier Z, Cho Samuel K, Caridi John M
Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Neurosurgery, North Jersey Spine Group, Wayne, NJ, USA.
Parkinsons Dis. 2018 Jun 27;2018:8428403. doi: 10.1155/2018/8428403. eCollection 2018.
Retrospective Database Analysis.
The purpose of this study was to assess characteristics and outcomes of patients with Parkinson's disease (PD) undergoing lumbar spine surgery for degenerative conditions.
The Nationwide Inpatient Sample was examined from 2002 to 2011. Patients were included for study based on ICD-9-CM procedural codes for lumbar spine surgery and substratified to degenerative diagnoses. Incidence and baseline patient characteristics were determined. Multivariable analysis was performed to determine independent risk factors increasing incidence of lumbar fusion revision in PD patients.
PD patients account for 0.9% of all degenerative lumbar procedures. At baseline, PD patients are older (70.7 versus 58.9, < 0.0001) and more likely to be male (58.6% male, < 160.0001). Mean length of stay (LOS) was increased in PD patients undergoing lumbar fusion (5.1 days versus 4.0 days, < 0.0001) and lumbar fusion revision (6.2 days versus 4.8 days, < 180.0001). Costs were 7.9% ( < 0.0001) higher for lumbar fusion and 25.2% ( < 0.0001) higher for lumbar fusion revision in PD patients. Multivariable analysis indicates that osteoporosis, fluid/electrolyte disorders, blood loss anemia, and insurance status are significant independent predictors of lumbar fusion revision in patients with PD.
PD patients undergoing lumbar surgery for degenerative conditions have increased LOS and costs when compared to patients without PD.
回顾性数据库分析。
本研究旨在评估因退行性疾病接受腰椎手术的帕金森病（PD）患者的特征和手术结果。
对2002年至2011年的全国住院患者样本进行检查。根据腰椎手术的ICD-9-CM程序编码纳入患者进行研究，并根据退行性诊断进行分层。确定发病率和患者基线特征。进行多变量分析以确定增加PD患者腰椎融合翻修率的独立危险因素。
PD患者占所有退行性腰椎手术患者的0.9%。在基线时，PD患者年龄更大（70.7岁对58.9岁，<0.0001），男性比例更高（男性占58.6%，<0.0001）。接受腰椎融合手术的PD患者平均住院时间（LOS）增加（5.1天对4.0天，<0.0001），接受腰椎融合翻修手术的患者平均住院时间增加（6.2天对4.8天，<0.0001）。PD患者腰椎融合手术费用高7.9%（<0.0001），腰椎融合翻修手术费用高25.2%（<0.0001）。多变量分析表明，骨质疏松症、液体/电解质紊乱、失血性贫血和保险状况是PD患者腰椎融合翻修的重要独立预测因素。
与非PD患者相比，因退行性疾病接受腰椎手术的PD患者住院时间和费用增加。
