Tanaka Tomoyuki, Sasaki Masanao, Katayanagi Junya, Hirakawa Akihiko, Fushimi Kiyohide, Yoshii Toshitaka, Jinno Tetsuya, Inose Hiroyuki
Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan.
Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan.
Bone Jt Open. 2024 Aug 9;5(8):662-670. doi: 10.1302/2633-1462.58.BJO-2024-0026.R1.
The escalating demand for medical resources to address spinal diseases as society ages is an issue that requires careful evaluation. However, few studies have examined trends in spinal surgery, especially unscheduled hospitalizations or surgeries performed after hours, through large databases. Our study aimed to determine national trends in the number of spine surgeries in Japan. We also aimed to identify trends in after-hours surgeries and unscheduled hospitalizations and their impact on complications and costs.
We retrospectively investigated data extracted from the Diagnosis Procedure Combination database, a representative inpatient database in Japan. The data from April 2010 to March 2020 were used for this study. We included all patients who had undergone any combination of laminectomy, laminoplasty, discectomy, and/or spinal arthrodesis.
This investigation included 739,474 spinal surgeries and 739,215 hospitalizations in Japan. There was an average annual increase of 4.6% in the number of spinal surgeries. Scheduled hospitalizations increased by 3.7% per year while unscheduled hospitalizations increased by 11.8% per year. In-hours surgeries increased by 4.5% per year while after-hours surgeries increased by 9.9% per year. Complication rates and costs increased for both after-hours surgery and unscheduled hospitalizations, in comparison to their respective counterparts of in-hours surgery and scheduled hospitalizations.
This study provides important insights for those interested in improving spine care in an ageing society. The swift surge in after-hours spinal surgeries and unscheduled hospitalizations highlights that the medical needs of an increasing number of patients due to an ageing society are outpacing the capacity of existing medical resources.
随着社会老龄化，用于治疗脊柱疾病的医疗资源需求不断增加，这是一个需要仔细评估的问题。然而，很少有研究通过大型数据库来研究脊柱手术的趋势，尤其是非计划住院或非工作时间进行的手术。我们的研究旨在确定日本脊柱手术数量的全国趋势。我们还旨在确定非工作时间手术和非计划住院的趋势及其对并发症和成本的影响。
我们回顾性调查了从日本具有代表性的住院患者数据库“诊断程序组合数据库”中提取的数据。本研究使用了2010年4月至2020年3月的数据。我们纳入了所有接受过椎板切除术、椎板成形术、椎间盘切除术和/或脊柱融合术任意组合手术的患者。
本次调查涵盖了日本的739,474例脊柱手术和739,215例住院病例。脊柱手术数量平均每年增长4.6%。计划住院每年增长3.7%，而非计划住院每年增长11.8%。工作时间内的手术每年增长4.5%，而非工作时间的手术每年增长9.9%。与工作时间内手术和计划住院相比，非工作时间手术和非计划住院的并发症发生率和成本均有所增加。
本研究为那些希望在老龄化社会中改善脊柱护理的人提供了重要见解。非工作时间脊柱手术和非计划住院的迅速增加凸显出，由于社会老龄化，越来越多患者的医疗需求超过了现有医疗资源的承载能力。
