对需要进行二次腰椎手术的退变性腰椎疾病患者进行筛选：一项全国性样本队列研究。

Screening patients requiring secondary lumbar surgery for degenerative lumbar spine diseases: a nationwide sample cohort study.

机构信息

Department of Neurosurgery, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.

Division of Medical Statistics, Medical Research Collaborating Center, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.

出版信息

Sci Rep. 2024 Jan 14;14(1):1295. doi: 10.1038/s41598-024-51861-7.

DOI:10.1038/s41598-024-51861-7

PMID:38221532

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10788335/

Abstract

This study aims to identify healthcare costs indicators predicting secondary surgery for degenerative lumbar spine disease (DLSD), which significantly impacts healthcare budgets. Analyzing data from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) database of Republic of Korea (ROK), the study included 3881 patients who had surgery for lumbar disc herniation (LDH), lumbar spinal stenosis without spondylolisthesis (LSS without SPL), lumbar spinal stenosis with spondylolisthesis (LSS with SPL), and spondylolysis (SP) from 2006 to 2008. Patients were categorized into two groups: those undergoing secondary surgery (S-group) and those not (NS-group). Surgical and interim costs were compared, with S-group having higher secondary surgery costs ($1829.59 vs $1618.40 in NS-group, P = 0.002) and higher interim costs ($30.03; 1.86% of initial surgery costs vs $16.09; 0.99% of initial surgery costs in NS-group, P < 0.0001). The same trend was observed in LDH, LSS without SPL, and LSS with SPL (P < 0.0001). Monitoring interim costs trends post-initial surgery can effectively identify patients requiring secondary surgery.

摘要

本研究旨在确定预测退行性腰椎疾病（DLSD）二次手术的医疗保健成本指标，这对医疗保健预算有重大影响。本研究分析了来自韩国国民健康保险服务-国家样本队列（NHIS-NSC）数据库的 2006 年至 2008 年期间接受腰椎间盘突出症（LDH）、无脊椎滑脱的腰椎管狭窄症（LSS 无 SPL）、有脊椎滑脱的腰椎管狭窄症（LSS 有 SPL）和脊椎裂（SP）手术的 3881 名患者的数据。患者分为两组：进行二次手术（S 组）和未进行二次手术（NS 组）。比较了手术和中期成本，S 组的二次手术费用较高（$1829.59 比 NS 组的$1618.40，P=0.002），中期成本较高（$30.03；占初始手术成本的 1.86%，比 NS 组的$16.09；占初始手术成本的 0.99%，P<0.0001）。在 LDH、LSS 无 SPL 和 LSS 有 SPL 中也观察到了相同的趋势（P<0.0001）。监测初始手术后中期成本趋势可以有效地识别需要二次手术的患者。