Department of Anesthesiology, University of Minnesota, Minneapolis, MN, USA.
Department of Neurology, University of South Florida, Tampa, FL, USA.
Neuromodulation. 2021 Jan;24(1):126-134. doi: 10.1111/ner.13263. Epub 2020 Sep 14.
Chronic pain spinal implantable electronic devices (CPSIEDs) include devices that provide spinal cord stimulation and intrathecal drug therapy. In this study, we sought to evaluate the trends of CPSIED infections, related complications, and outcomes following the treatment of infection.
The Nationwide Inpatient Sample database contains data from 48 states, and the District of Columbia was used to identify patients with a primary diagnosis of CPSIED infection during the years 2005-2014. Patients with intrathecal pumps for the treatment of spasticity were excluded to limit the study population to patients with chronic pain disorders. Treatments were categorized as: 1) without device removal, 2) pulse generator or pump only removal, 3) intrathecal pump system removal, and 4) spinal cord stimulation system removal. Complications associated with CPSIED infections were identified using administrative billing codes.
During the study period 2005-2014, a total of 11,041 patients were admitted to the hospital with CPSIED infections. The majority of the patients were treated without surgical intervention (56%), and a smaller proportion underwent complete system explantation (22.7%). In-hospital mortality or permanent disability due to paralysis after CPSIED infection was around 1.83% and 2.77%, respectively. Infectious complications such as meningitis, abscess formation, and osteomyelitis occurred in 4.93%, 5.08%, and 1.5%, respectively. The median cost of hospitalization was around US $14,118.00, and the median length of stay was approximately six days (interquartile range = 4-13 days).
The complications of CPSIED infection were higher among patients that did not undergo device removal.
慢性疼痛脊髓植入式电子设备（CPSIED）包括提供脊髓刺激和鞘内药物治疗的设备。本研究旨在评估 CPSIED 感染的趋势，以及感染治疗后的相关并发症和结局。
全美住院患者样本数据库包含来自 48 个州的数据，哥伦比亚特区的数据用于识别 2005 年至 2014 年期间患有 CPSIED 感染的患者。排除了鞘内泵治疗痉挛的患者，以将研究人群限制为慢性疼痛障碍患者。治疗方法分为：1）不进行设备移除，2）仅移除脉冲发生器或泵，3）移除鞘内泵系统，以及 4）移除脊髓刺激系统。使用行政计费代码确定与 CPSIED 感染相关的并发症。
在研究期间（2005 年至 2014 年），共有 11041 名患者因 CPSIED 感染住院。大多数患者未经手术干预治疗（56%），较小比例的患者接受了完整系统切除（22.7%）。CPSIED 感染后，住院死亡率或永久性残疾导致瘫痪的比例分别约为 1.83%和 2.77%。感染性并发症如脑膜炎、脓肿形成和骨髓炎的发生率分别为 4.93%、5.08%和 1.5%。住院费用中位数约为 14118.00 美元，住院时间中位数约为六天（四分位距 = 4-13 天）。
未进行设备移除的患者 CPSIED 感染的并发症更高。
