Dietz Nicholas, Sharma Mayur, Kelly Michael, Ugiliweneza Beatrice, Wang Dengzhi, Osorio Joseph, Karikari Isaac, Drazin Doniel, Boakye Maxwell
5170University of Louisville, Louisville, KY, USA.
12230Georgetown University Hospital, Washington, DC, USA.
Global Spine J. 2022 Jan;12(1):92-101. doi: 10.1177/2192568220947377. Epub 2020 Aug 26.
Retrospective cohort study.
Recombinant human bone morphogenetic protein-2 (rhBMP-2) is used to achieve fusion in adult spinal deformity (ASD) surgery. Our aim was to investigate the long-term impact of rhBMP-2 use for clinical outcomes and health care utilization in this patient population.
We conducted an analysis using MarketScan to identify health resource utilization of rhBMP-2 use for ASD after surgical intervention compared to fusion without rhBMP-2 at 24 months' follow-up. Outcomes assessed included length of stay, complications, pseudoarthrosis, reoperation, outpatient services, and health care payments.
Of 7115 patients who underwent surgery for ASD, 854 received rhBMP-2 and 6261 were operated upon without use of rhBMP-2. One month after discharge, the rhBMP-2 cohort had a nonsignificant trend in fewer complications (15.38%) than those who did not receive rhBMP-2 (18.07%), = .0558. At 12 months, pseudoarthrosis was reported in 2.8% of cases with no BMP and 01.14% of cases with BMP, = .0048. Average payments at 12 months were $120 138 for the rhBMP-2 group and $118 373 for the no rhBMP-2 group, = .8228. At 24 months, payments were $141 664 for the rhBMP-2 group and $144 179 for the group that did not receive rhBMP-2, = .5946.
In ASD surgery, use of rhBMP-2 was not associated with increased complications or reoperations at index hospitalization and 1-month follow-up. Overall payments, including index hospitalization, readmissions, reoperations, and outpatient services were not different compared to those without the use of rhBMP-2 at 12 months and 24 months after discharge.
回顾性队列研究。
重组人骨形态发生蛋白-2（rhBMP-2）用于成人脊柱畸形（ASD）手术以实现融合。我们的目的是调查rhBMP-2的使用对该患者群体临床结局和医疗保健利用的长期影响。
我们使用MarketScan进行分析，以确定与未使用rhBMP-2进行融合相比，在24个月随访时rhBMP-2用于ASD手术干预后的医疗资源利用情况。评估的结局包括住院时间、并发症、假关节形成、再次手术、门诊服务和医疗费用支付。
在7115例行ASD手术的患者中，854例接受了rhBMP-2治疗，6261例手术未使用rhBMP-2。出院后1个月，rhBMP-2组并发症发生率（15.38%）低于未接受rhBMP-2组（18.07%），但差异无统计学意义（P = 0.0558）。12个月时，未使用BMP的病例中假关节形成报告率为2.8%，使用BMP的病例中为1.14%，差异有统计学意义（P = 0.0048）。rhBMP-2组12个月时的平均费用为120,138美元，未使用rhBMP-2组为118,373美元，差异无统计学意义（P = 0.8228）。24个月时，rhBMP-2组费用为141,664美元，未接受rhBMP-2组为144,179美元，差异无统计学意义（P = 0.5946）。
在ASD手术中，在初次住院和1个月随访时，使用rhBMP-2与并发症或再次手术增加无关。出院后12个月和24个月时，包括初次住院、再次入院、再次手术和门诊服务在内的总体费用与未使用rhBMP-2者相比无差异。
