Department of Orthopedic Surgery, Stanford University School of Medicine, Stanford, California, U.S.A.
Department of Orthopedic Surgery, Stanford University School of Medicine, Stanford, California, U.S.A..
Arthroscopy. 2021 Jan;37(1):282-289.e1. doi: 10.1016/j.arthro.2020.09.013. Epub 2020 Sep 20.
To discern differences between the PearlDiver and MarketScan databases with regards to patient demographics, costs, reoperations, and complication rates for isolated meniscectomy.
We queried the PearlDiver Humana Patient Records Database and the IBM MarketScan Commercial Claims and Encounters database for all patients who had record of meniscectomy denoted by Current Procedure Terminology 29880 or 29881 between January 1, 2007, and December 31, 2016. Those that had any other knee procedure at the same time as the meniscectomy were excluded, and the first instance of isolated meniscectomy was recorded. Patient demographics, Charlson Comorbidity Index, reoperations, 30- and 90-day complication rates, and costs were collected from both databases. Pearson's χ test with Yate's continuity correction and the Student t test were used to compare the 2 databases, and an alpha value of 0.05 was set as significant.
We identified 441,147 patients with isolated meniscectomy from the MarketScan database (0.36% of total database), approximately 10 times the number of patients (n = 49,924; 0.20% of total database) identified from PearlDiver. The PearlDiver population was significantly older (median age: 65-69) than the MarketScan cohort, where all patients were younger than 65 (median age: 52; P < .001). Average Charlson Comorbidity Index was significantly lower for MarketScan (0.172, standard deviation [SD]: 0.546) compared with PearlDiver (1.43, SD: 2.05; P < .001), even when we restricted the PearlDiver cohort to patients younger than 65 years (1.02, SD: 1.74; P < .001). The PearlDiver <65 years subcohort also had increased 30- (relative risk 1.53 [1.40-1.67]) and 90-day (relative risk 1.56 [1.47-1.66]) postoperative complications compared with MarketScan. Overall, laterality coding was more prevalent in the PearlDiver database.
For those undergoing isolated meniscectomy, the MarketScan database comprised an overall larger and younger cohort of patients with fewer comorbidities, even when examining only subjects younger than 65 years of age.
Level III, retrospective comparative study.
比较 PearlDiver 和 MarketScan 数据库在孤立性半月板切除术患者的人口统计学特征、成本、再次手术和并发症发生率方面的差异。
我们在 PearlDiver Humana 患者记录数据库和 IBM MarketScan 商业索赔和就诊数据库中查询了 2007 年 1 月 1 日至 2016 年 12 月 31 日期间所有记录有半月板切除术（当前操作术语 29880 或 29881）的患者。排除了同时进行任何其他膝关节手术的患者，并记录了第一次孤立性半月板切除术。从两个数据库中收集了患者人口统计学特征、Charlson 合并症指数、再次手术、30 天和 90 天并发症发生率和成本。使用 Pearson χ 检验（带有 Yate 连续性校正）和学生 t 检验比较了这两个数据库，将 α 值设定为 0.05 表示有统计学意义。
我们从 MarketScan 数据库中确定了 441,147 例孤立性半月板切除术患者（占总数据库的 0.36%），大约是从 PearlDiver 数据库中确定的患者数量（n=49,924；占总数据库的 0.20%）的 10 倍。PearlDiver 人群的年龄明显大于 MarketScan 队列（中位数年龄：65-69 岁），所有患者的年龄均小于 65 岁（中位数年龄：52 岁；P<0.001）。与 PearlDiver 相比，MarketScan 的平均 Charlson 合并症指数明显较低（0.172，标准差 [SD]：0.546），即使我们将 PearlDiver 队列限制在年龄小于 65 岁的患者中（1.02，SD：1.74；P<0.001）。PearlDiver <65 岁亚组的 30 天（相对风险 1.53 [1.40-1.67]）和 90 天（相对风险 1.56 [1.47-1.66]）术后并发症发生率也高于 MarketScan。总体而言，PearlDiver 数据库中更普遍存在侧别编码。
对于接受孤立性半月板切除术的患者，即使仅检查年龄小于 65 岁的患者，MarketScan 数据库也包括了一个更大、更年轻、合并症更少的患者队列。
三级，回顾性比较研究。
