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Pernik MN, Hicks WH, Akbik OS, Nguyen ML, Luu I, Traylor JI, Deme PR, Dosselman LJ, Hall K, Wingfield SA, Aoun SG, Bagley CA. Psoas Muscle Index as a Predictor of Perioperative Outcomes in Geriatric Patients Undergoing Spine Surgery. Global Spine J 2023; 13:2016-2024. [PMID: 35034500 PMCID: PMC10556882 DOI: 10.1177/21925682211072626] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
STUDY DESIGN Single-center retrospective study. OBJECTIVE The objective of this study was to evaluate the association of psoas muscle mass defined sarcopenia with perioperative outcomes in geriatric patients undergoing elective spine surgery. METHODS We included geriatric patients undergoing thoracolumbar spinal surgery. Total psoas surface area (TPA) was measured on preoperative axial computerized tomography or magnetic resonance imaging at the L3 vertebra and normalized to the L3 vertebral body area. Patients were divided into quartiles by normalized TPA, and the fourth quartile (Q4) was compared to quartiles 1-3 (Q1-3). Outcomes included perioperative transfusions, length of stay (LOS), delirium, pseudoarthrosis, readmission, discharge disposition, revision surgery, and mortality. RESULTS Of the patients who met inclusion criteria (n = 196), the average age was 73.4 y, with 48 patients in Q4 and 148 patients in Q1-3. Q4 normalized TPA cut-off was <1.05. Differences in Q4 preoperative characteristics included significantly lower body mass index, baseline creatinine, and a greater proportion of females (Table 1). Q4 patients received significantly more postoperative red blood cell and platelet transfusions and had longer ICU LOS (P < .05; Table 2). There was no difference in intraoperative transfusion volumes, delirium, initiation of walking, discharge disposition, readmission, pseudoarthrosis, or revision surgery (Tables 2 and 3). Mortality during follow-up was higher in Q4 but was not statistically significant (P = .075). CONCLUSION Preoperative TPA in geriatric patients undergoing elective spine surgery is associated with increased need for intensive care and postoperative blood transfusion. Preoperative normalized TPA is a convenient measurement and could be included in geriatric preoperative risk assessment algorithms.
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Affiliation(s)
- Mark N. Pernik
- Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA
| | - William H. Hicks
- Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA
| | - Omar S. Akbik
- Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA
| | - Madelina L. Nguyen
- Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA
| | - Ivan Luu
- Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA
| | - Jeffrey I. Traylor
- Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA
| | - Palvasha R. Deme
- Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA
| | - Luke J. Dosselman
- Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA
| | - Kristen Hall
- Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA
| | - Sarah A. Wingfield
- Department of Internal Medicine, Geriatrics Division, UT Southwestern Medical School, Dallas, TX, USA
| | - Salah G. Aoun
- Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA
| | - Carlos A. Bagley
- Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA
- Department of Orthopedic Surgery, UT Southwestern Medical School, Dallas, TX, USA
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Fudo T, Hashida R, Yokosuka K, Sato K, Hiraoka K. Changes of improvement in upper limb function predict surgical outcome after laminoplasty in 1 year in patients with cervical spondylotic myelopathy: a retrospective study. J Orthop Surg Res 2023; 18:323. [PMID: 37101171 PMCID: PMC10131369 DOI: 10.1186/s13018-023-03805-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/18/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Cervical spondylotic myelopathy preoperative prognostic factors include age, preoperative severity, and disease duration. However, there are no reports on the relationship between changes in physical function during hospitalization and postoperative course, and in recent years, the length of hospital stay has shortened. We aimed to investigate whether changes in physical function during hospitalization can predict the postoperative outcome. METHODS We recruited 104 patients who underwent laminoplasty for cervical spondylotic myelopathy by the same surgeon. Physical functions, including Simple Test for Evaluating Hand Function (STEF), grip strength, timed up and go test, 10-m walk, and time to stand on one leg, were assessed at admission and discharge. Patients with the Japanese Orthopaedic Association (JOA) score improvement rate of 50% or more were defined as the improved group. Decision tree analysis was investigated factor for identifying improvement in the JOA score. According to this analysis, we divided into two groups using age. Then, we conducted a logistic regression analysis to identify factors that improve the JOA score. RESULTS The improved and non-improved groups had 31 and 73 patients, respectively. The improved group was younger (p = 0.003) and had better improved Δgrip strength (p = 0.001) and ΔSTEF (p < .0007). Age was significantly positively correlated with disease duration (r = 0.4881, p = < .001). Disease duration exhibited a significant negative correlation with the JOA score improvement rate (r = - 0.2127, p = 0.031). Based on the decision tree analysis results, age was the first branching variable, with 15% of patients ≥ 67 years showing JOA score improvement. This was followed by ΔSTEF as the second branching factor. ΔSTEF was selected as the factor associated with JOA improvement in patients ≥ 67 years (odds ratio (OR) 0.95, 95% confidence interval (CI) 0.90-0.99, p = .047); in patients < 67 years, Δgrip strength was identified (OR 0.53, CI 0.33‒0.85, p = .0086). CONCLUSIONS In the improved group, upper limb function improved more than lower limb function from the early postoperative period. Upper limb function changes during hospitalization were associated with outcomes one year postoperatively. Improvement factors in upper extremity function differed by age, with changes in grip strength in patients < 67 years and STEF in patients ≥ 67 years, reflecting the outcome at one year postoperatively.
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Affiliation(s)
- Takuma Fudo
- Department of Orthopaedics, Kurume University, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Ryuki Hashida
- Department of Orthopaedics, Kurume University, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Kimiaki Yokosuka
- Department of Orthopaedics, Kurume University, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Kimiaki Sato
- Department of Orthopaedics, Kurume University, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Koji Hiraoka
- Department of Orthopaedics, Kurume University, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
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Shitrit P, Chowers MY, Muhsen K. The development and validation of screening tools for semi-automated surveillance of surgical site infection following various surgeries. Front Med (Lausanne) 2023; 10:1023385. [PMID: 36778736 PMCID: PMC9909272 DOI: 10.3389/fmed.2023.1023385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 01/10/2023] [Indexed: 01/27/2023] Open
Abstract
Background Surveillance of surgical site infections (SSIs) is essential for better prevention. We developed a screening method for SSIs in adults. Methods The training dataset included data from patients who underwent orthopedic surgeries (N = 1,090), colorectal surgeries (N = 817), and abdominal hysterectomies (N = 523) during 2015-2018. The gold standard for the validation of the screening tool was the presence of SSI as determined by a trained infection control practitioner, via manual full medical record review, using the US Center for Disease Control and Prevention criteria. Using multivariable regression models, we identified the correlates of SSI. Patients who had at least one of these correlates were classified as likely to having SSI and those who did not have any of the correlates were classified as unlikely to have SSI. We calculated the sensitivity and specificity of this tool compared to the gold standard and applied the tool to a validation dataset (N = 1,310, years 2019-2020). Results SSI was diagnosed by an infection control specialist in 8.2, 5.2, and 31.2% of the patients in the training dataset who underwent hysterectomies, orthopedic surgeries and colorectal surgeries, respectively, vs. 6.2, 6.6, and 25.5%, respectively, in the validation dataset. The correlates of SSI after abdominal hysterectomy were prolonged hospitalization, ordering wound or blood culture, emergency room visit and reoperation; in orthopedic surgery, emergency room visit, wound culture, reoperation, and documentation of SSI, and in colorectal surgeries prolonged hospitalization, readmission, and ordering wound or blood cultures. Area under the curve was >90%. The sensitivity and specificity (95% CI) of the screening tool were 98% (88-100) and 58% (53-62), for abdominal hysterectomy, 91% (81-96) and 82% (80-84) in orthopedic surgeries and 96% (90-98) and 62% (58-66) in colorectal surgeries. The corresponding values for the validation dataset were 89% (67-97) and 75% (69-80) in abdominal hysterectomy; 85% (72-93) and 83% (80-86) in orthopedic surgeries and 98% (93-99) and 59% (53-64) in colorectal surgeries. The number of files needed to be fully reviewed declined by 61-66. Conclusion The presented semi-automated simple screening tool for SSI surveillance had good sensitivity and specificity and it has great potential of reducing workload and improving SSI surveillance.
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Affiliation(s)
- Pnina Shitrit
- Infection Control Unit, Meir Medical Center, Kfar Saba, Israel,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,*Correspondence: Pnina Shitrit, ,
| | - Michal Y. Chowers
- Infectious Disease Unit, Meir Medical Center, Kfar Saba, Israel,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Charlotte D, Mathew NH, Tamir A, Michael B, Raphaële CM, Nicolas D, Marcel D, Charles F, Brian KK, Scott P, John S. Variations in LOS and its main determinants overtime at an academic spinal care center from 2006-2019. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:702-709. [PMID: 35013829 PMCID: PMC8747860 DOI: 10.1007/s00586-021-07086-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/16/2021] [Accepted: 12/03/2021] [Indexed: 01/14/2023]
Abstract
Objectives Efforts to safely reduce hospital LOS while maintaining quality outcomes and patient satisfaction are paramount. The primary goal of this study was to assess trends in LOS at a high-volume quaternary care spine center. Secondary goals were to assess trends in factors most associated with prolonged LOS. Methods This is a prospective study of all consecutive patients admitted from January 2006 to December 2019. Data included demographics, diagnostic category (degenerative, oncology, deformity, trauma, other), LOS (mean, median, interquartile range, standard deviation, defined as days from admission to discharge), and in-hospital adverse events. Results A total of 13,493 patients were included. Overall LOS has not changed over time with an overall median of 6.3 days (p = 0.451). Median LOS significantly increased for patients treated for degenerative pathology from 2.2 days in 2006 to 3.2 days in 2019 (p = 0.019). LOS has not changed for patients treated for deformity (overall median 6.8 days, p = 0.411), oncology (overall median 11.0 days, p = 0.051), or trauma (overall median 11.8 days, p = 0.582). Emergency admissions increased 3.2%/year for degenerative pathologies (p = < 0.001). Mean age has increased from 48.4 years in 2006 to 58.1 years in 2019 (p = < 0.001). This trend was observed in the deformity, degenerative and trauma group, not for patients treated for oncological disease. More adverse events were significantly associated with increasing age. Conclusion This is the first North American study to comprehensively analyze trends in LOS for spinal surgery overtime in an academic center. Overall, LOS has not changed from 2006–2019. Various factors that influence LOS appear to have balanced each other. It may also be explained by the changing epidemiology of both elective and emergency surgeries. These findings provide opportunities for intervention and improvement, targeted at the geriatric population, to reduce length of hospitalization.
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Affiliation(s)
- Dandurand Charlotte
- Combined Neurosurgical and Orthopedic Spine Program, Blusson Spinal Cord Center, University of British Columbia, 6th Floor, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada.
| | - N Hindi Mathew
- Combined Neurosurgical and Orthopedic Spine Program, Blusson Spinal Cord Center, University of British Columbia, 6th Floor, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada
| | - Ailon Tamir
- Combined Neurosurgical and Orthopedic Spine Program, Blusson Spinal Cord Center, University of British Columbia, 6th Floor, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada
| | - Boyd Michael
- Combined Neurosurgical and Orthopedic Spine Program, Blusson Spinal Cord Center, University of British Columbia, 6th Floor, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada
| | - Charest-Morin Raphaële
- Combined Neurosurgical and Orthopedic Spine Program, Blusson Spinal Cord Center, University of British Columbia, 6th Floor, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada
| | - Dea Nicolas
- Combined Neurosurgical and Orthopedic Spine Program, Blusson Spinal Cord Center, University of British Columbia, 6th Floor, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada
| | - Dvorak Marcel
- Combined Neurosurgical and Orthopedic Spine Program, Blusson Spinal Cord Center, University of British Columbia, 6th Floor, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada
| | - Fisher Charles
- Combined Neurosurgical and Orthopedic Spine Program, Blusson Spinal Cord Center, University of British Columbia, 6th Floor, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada
| | - K Kwon Brian
- Combined Neurosurgical and Orthopedic Spine Program, Blusson Spinal Cord Center, University of British Columbia, 6th Floor, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada
| | - Paquette Scott
- Combined Neurosurgical and Orthopedic Spine Program, Blusson Spinal Cord Center, University of British Columbia, 6th Floor, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada
| | - Street John
- Combined Neurosurgical and Orthopedic Spine Program, Blusson Spinal Cord Center, University of British Columbia, 6th Floor, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada.
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Boever J, Weber T, Krause EA, Mussa JA, Demissie YG, Gebremdihen AT, Mesfin FB. Neurosurgical Patients’ Experiences and Surgical Outcomes Among Single Tertiary Hospitals in Ethiopia and the United States. Cureus 2022; 14:e22035. [PMID: 35340506 PMCID: PMC8913517 DOI: 10.7759/cureus.22035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2022] [Indexed: 11/05/2022] Open
Abstract
Background In 2020, we published findings on reported outcomes of anterior cervical decompression and fusion surgery among neurosurgeons in Africa and North America. We found more similarities in outcomes than expected, however, differences still existed. Most notable was the length of stay of patients postoperatively in Africa compared to North America. We sought to examine the neurosurgical practices more closely at a single hospital in Ethiopia and compare it to our own institution, the University of Missouri in Columbia (UMC). Methods Two authors spent one week at Aabet Hospital (AH) in Ethiopia. Throughout the week, one author rotated in the clinic and OR gathering the information. Data collection for patients at UMC was collected through retrospective chart review over one week. Results A total of eight elective surgeries and four emergency procedures occurred at AH and 18 clinic patients were included in the study. The intraoperative data was collected during the elective procedures at AH. At UMC there were 99 clinic patients, and 29 elective surgeries and one emergency procedure were performed. Procedures at both institutions included cranial, spinal, vascular, and implantable/other cases. Distance travelled by patients to UMC was an average of 57 miles compared to 85 miles at AH. The median pre-op and post-op stays at AH were 2.5 and 6 days compared to 0.2 and 2.1 at UMC, respectively. Blood loss was greater at AH with a median blood loss of 175 mL. Median blood loss at UMC was 50 mL. Conclusion We found notable differences among neurosurgical practice and patient demographics at AH compared to UMC. This information will serve as the cornerstone for gathering more information about neurosurgical practice in Ethiopia where electronic medical records are unavailable.
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Alexandre M, Santos WZ, Mendonça RGMD, Gotfryd AO, Caffaro MFS, Meves R. PROFILE OF PATIENTS WITH SPINE TUMOR OPERATED IN A SOUTH AMERICAN REFERENCE SERVICE. EPIDEMIOLOGICAL STUDY. COLUNA/COLUMNA 2022. [DOI: 10.1590/s1808-185120222104262528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
ABSTRACT Objective: The objective was to conduct an analytical epidemiological study to understand the profile, treatment, and outcome of patients with spinal tumors in a Brazilian Quaternary Hospital of the SUS. Methods: A retrospective cohort analysis of data from the last five years was performed. It was described qualitative characteristics evaluated by absolute and relative frequencies and quantitative characteristics by sintetized measures. Associations between characteristics were verified using chi-square tests or exact tests. Results: 92 patients met the eligibility criteria. The mean age was 56.1 years (±14.7), with 48 men (52.2%) and 44 women (47.8%). The types of tumors organized in the three proposed groups had 19 multiple myelomas (20.7%), 62 metastases (67.3%), and 11 other tumors (12%). The neurological status measured through the ASIA score was A: 5.4%, B: 22.8%, C: 26.1%, D: 35.9%, E: 9.8%. Karnofsky was prevalent in the 50-70 range with 65.2%. The total hospitalization period had a mean of 22.8±18 days, preoperatively 11.9±9.2 days, and postoperatively 10.9±14 days. Karnofsky presented lower values according to the worst ASIA (p < 0.001). A total of 12 patients (13%) died during hospitalization. The total and postoperative length of stay was longer in patients who died (p = 0.002 and p < 0.001). Conclusions: This study provides epidemiological data that allow an understanding of the profile of patients with spinal tumors in the Brazilian Public Health System. The severity of the patients is higher when compared to most of the series cases in the literature. The patients with longer hospitalization stay died. Level of evidence IV; Case series.
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Affiliation(s)
| | | | | | | | | | - Robert Meves
- Irmandade da Santa Casa de Misericórdia de São Paulo, Brazil
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Riley J, Verma R. Spinal surgery during the COVID-19 pandemic: the experience in a tertiary referral centre. JOURNAL OF SPINE SURGERY 2021; 7:62-67. [PMID: 33834129 DOI: 10.21037/jss-20-643] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background The COVID-19 pandemic first came to prominence in December 2019, and since then has swept the globe, causing one of the largest public health problems seen. It has had a wide-ranging impact on healthcare provision, with a cessation of elective operating. We aimed to assess the impact of COVID-19 on a tertiary referral centre for spinal surgery in England. Methods An 82-day study period from 20th March 2020 to 10th June 2020 was used, and all spinal surgical patients were followed up prospectively, comparing patients from the same date range in 2019. We assessed rate of COVID transmission, 30-day mortality rates, complication rates and length of hospital stay in a large tertiary Teaching hospital in England. Results Seventy-eight patients were operated on during the COVID-19 pandemic period, with a 30-day mortality rate of 4.2%. Two of these deaths were attributable to COVID-19 (2.56%). The mean length of stay was 10.8 days. Neither the 30-day mortality rate or the length of stay was statistically significant compared to the 2019 control period. Five patients (6.4%) tested positive for COVID-19, all were negative at time of surgical intervention. Our complication rate was 10.3% during the COVID-19 pandemic period. Conclusions The number of operative cases performed during the COVID-19 pandemic fell by one-third compared to the same period in 2019. The COVID-19 pandemic did not cause a significant increase in 30-day mortality rate, length of stay, or complication rates. Further studies with larger patient numbers and longer-term outcomes will be needed to fully assess the impact of the COVID-19 pandemic on spinal surgery.
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Affiliation(s)
- James Riley
- Department of Spinal Surgery, Salford Royal NHS Foundation Trust, Salford, UK
| | - Rajat Verma
- Department of Spinal Surgery, Salford Royal NHS Foundation Trust, Salford, UK
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Zheng S, Wu YX, Wang JY, Li Y, Liu ZJ, Liu XG, Dang GT, Sun Y, Li J. Identifying the Characteristics of Patients With Cervical Degenerative Disease for Surgical Treatment From 17-Year Real-World Data: Retrospective Study. JMIR Med Inform 2020; 8:e16076. [PMID: 32242824 PMCID: PMC7165306 DOI: 10.2196/16076] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 11/15/2019] [Accepted: 01/26/2020] [Indexed: 01/23/2023] Open
Abstract
Background Real-world data (RWD) play important roles in evaluating treatment effectiveness in clinical research. In recent decades, with the development of more accurate diagnoses and better treatment options, inpatient surgery for cervical degenerative disease (CDD) has become increasingly more common, yet little is known about the variations in patient demographic characteristics associated with surgical treatment. Objective This study aimed to identify the characteristics of surgical patients with CDD using RWD collected from electronic medical records. Methods This study included 20,288 inpatient surgeries registered from January 1, 2000, to December 31, 2016, among patients aged 18 years or older, and demographic data (eg, age, sex, admission time, surgery type, treatment, discharge diagnosis, and discharge time) were collected at baseline. Regression modeling and time series analysis were conducted to analyze the trend in each variable (total number of inpatient surgeries, mean age at surgery, sex, and average length of stay). A P value <.01 was considered statistically significant. The RWD in this study were collected from the Orthopedic Department at Peking University Third Hospital, and the study was approved by the institutional review board. Results Over the last 17 years, the number of inpatient surgeries increased annually by an average of 11.13%, with some fluctuations. In total, 76.4% (15,496/20,288) of the surgeries were performed in patients with CDD aged 41 to 65 years, and there was no significant change in the mean age at surgery. More male patients were observed, and the proportions of male and female patients who underwent surgery were 64.7% (13,126/20,288) and 35.3% (7162/20,288), respectively. However, interestingly, the proportion of surgeries performed among female patients showed an increasing trend (P<.001), leading to a narrowing sex gap. The average length of stay for surgical treatment decreased from 21 days to 6 days and showed a steady decline from 2012 onward. Conclusions The RWD showed its capability in supporting clinical research. The mean age at surgery for CDD was consistent in the real-world population, the proportion of female patients increased, and the average length of stay decreased over time. These results may be valuable to guide resource allocation for the early prevention and diagnosis, as well as surgical treatment of CDD.
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Affiliation(s)
- Si Zheng
- Institute of Medical Information & Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yun Xia Wu
- Orthopaedic Department, Peking University Third Hospital, Beijing, China
| | - Jia Yang Wang
- Institute of Medical Information & Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yan Li
- Orthopaedic Department, Peking University Third Hospital, Beijing, China
| | - Zhong Jun Liu
- Orthopaedic Department, Peking University Third Hospital, Beijing, China
| | - Xiao Guang Liu
- Orthopaedic Department, Peking University Third Hospital, Beijing, China
| | - Geng Ting Dang
- Orthopaedic Department, Peking University Third Hospital, Beijing, China
| | - Yu Sun
- Orthopaedic Department, Peking University Third Hospital, Beijing, China
| | - Jiao Li
- Institute of Medical Information & Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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