Jammal Omar Al, Gendreau Julian, Alvandi Bejan, Patel Neal A, Brown Nolan J, Shahrestani Shane, Lien Brian V, Delavar Arash, Tran Katelynn, Sahyouni Ronald, Diaz-Aguilar Luis Daniel, Gilbert Kevin, Pham Martin H
Department of Neurosurgery, University of California San Diego School of Medicine, San Diego, CA, USA.
Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA.
Neurospine. 2021 Dec;18(4):725-732. doi: 10.14245/ns.2142614.307. Epub 2021 Dec 31.
To study the impact of demographic factors on management of traumatic injury to the lumbar spine and postoperative complication rates.
Data was obtained from the National Inpatient Sample (NIS) between 2010-2014. International Classification of Diseases, 9th revision, Clinical Modification codes identified patients diagnosed with lumbar fractures or dislocations due to trauma. A series of multivariate regression models determined whether demographic variables predicted rates of complication and revision surgery.
A total of 38,249 patients were identified. Female patients were less likely to receive surgery and to receive a fusion when undergoing surgery, had higher complication rates, and more likely to undergo revision surgery. Medicare and Medicaid patients were less likely to receive surgical management for lumbar spine trauma and less likely to receive a fusion when operated on. Additionally, we found significant differences in surgical management and postoperative complication rates based on race, insurance type, hospital teaching status, and geography.
Substantial differences in the surgical management of traumatic injury to the lumbar spine, including postoperative complications, among individuals of demographic factors such as age, sex, race, primary insurance, hospital teaching status, and geographic region suggest the need for further studies to understand how patient demographics influence management and complications for traumatic injury to the lumbar spine.
研究人口统计学因素对腰椎创伤管理及术后并发症发生率的影响。
数据来源于2010 - 2014年的全国住院患者样本（NIS）。国际疾病分类第九版临床修订本代码确定了因创伤导致腰椎骨折或脱位的患者。一系列多变量回归模型确定人口统计学变量是否可预测并发症发生率和翻修手术率。
共识别出38249例患者。女性患者接受手术的可能性较小，手术时接受融合手术的可能性较小，并发症发生率较高，且更有可能接受翻修手术。医疗保险和医疗补助患者接受腰椎创伤手术治疗的可能性较小，手术时接受融合手术的可能性也较小。此外，我们发现基于种族、保险类型、医院教学状况和地理位置，手术管理和术后并发症发生率存在显著差异。
年龄、性别、种族、主要保险、医院教学状况和地理区域等人口统计学因素个体之间，腰椎创伤的手术管理（包括术后并发症）存在实质性差异，这表明需要进一步研究以了解患者人口统计学如何影响腰椎创伤的管理和并发症。
