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Hydrick TC, Zhang C, Ruch B, Wagler J, Kumm K, Harbell JW, Hewitt WR, Jadlowiec CC, Katariya NN, Moss AA, Nguyen MC, Reddy KS, Singer AL, Mathur AK. Declining Medicare reimbursement in abdominal transplantation from 2000 to 2021. Surgery 2023; 173:1484-1490. [PMID: 36894411 DOI: 10.1016/j.surg.2023.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND The Centers for Medicare and Medicaid Services is a major payer for abdominal transplant services. Reimbursement reductions could have a major impact on the transplant surgical workforce and hospitals. Yet government reimbursement trends in abdominal transplantation have not been fully characterized. METHODS We performed an economic analysis to characterize changes in inflation-adjusted trends in Medicare surgical reimbursement for abdominal transplant procedures. Using the Medicare Fee Schedule Look-Up Tool, we performed a procedure code-based surgical reimbursement rate analysis. Reimbursement rates were adjusted for inflation to calculate overall changes in reimbursement, overall year-over-year, 5-year year-over-year, and compound annual growth rate from 2000 to 2021. RESULTS We observed declines in adjusted reimbursement of common abdominal transplant procedures, including liver (-32.4%), kidney with and without nephrectomy (-24.2% and -24.1%, respectively), and pancreas transplant (-15.2%) (all, P < .05). Overall, the yearly average change for liver, kidney with and without nephrectomy, and pancreas transplant were -1.54%, -1.15%, -1.15%, and -0.72%. Five-year annual change averaged -2.69%, -2.35%, -2.64%, and -2.43%, respectively. The overall average compound annual growth rate was -1.27%. CONCLUSION This analysis depicts a worrisome reimbursement pattern for abdominal transplant procedures. Transplant surgeons, centers, and professional organizations should note these trends to advocate sustainable reimbursement policy and to preserve continued access to transplant services.
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Affiliation(s)
| | - Chi Zhang
- Division of Transplant Surgery, Mayo Clinic Arizona, Phoenix, AZ; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Mayo Clinic, Rochester, MN. https://twitter.com/ChiZhang_MD
| | - Brianna Ruch
- Division of Transplant Surgery, Mayo Clinic Arizona, Phoenix, AZ. https://twitter.com/BriannaCRuch
| | - Josiah Wagler
- Division of Transplant Surgery, Mayo Clinic Arizona, Phoenix, AZ
| | - Kayla Kumm
- Division of Transplant Surgery, Mayo Clinic Arizona, Phoenix, AZ
| | - Jack W Harbell
- Division of Transplant Surgery, Mayo Clinic Arizona, Phoenix, AZ
| | - Winston R Hewitt
- Division of Transplant Surgery, Mayo Clinic Arizona, Phoenix, AZ
| | - Caroline C Jadlowiec
- Division of Transplant Surgery, Mayo Clinic Arizona, Phoenix, AZ. https://twitter.com/CarrieJadlowiec
| | - Nitin N Katariya
- Division of Transplant Surgery, Mayo Clinic Arizona, Phoenix, AZ
| | - Adyr A Moss
- Division of Transplant Surgery, Mayo Clinic Arizona, Phoenix, AZ
| | | | - Kunam S Reddy
- Division of Transplant Surgery, Mayo Clinic Arizona, Phoenix, AZ
| | - Andrew L Singer
- Division of Transplant Surgery, Mayo Clinic Arizona, Phoenix, AZ
| | - Amit K Mathur
- Division of Transplant Surgery, Mayo Clinic Arizona, Phoenix, AZ; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Mayo Clinic, Rochester, MN.
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Hydrick TC, Haglin J, Wasif N. Trends in Reimbursement for Index Surgical Oncology Procedures in Contemporary Practice: Declining Reimbursement for Surgical Oncology Procedures-How Low Do We Go? Ann Surg Oncol 2022; 29:8099-8106. [PMID: 36175713 PMCID: PMC9521869 DOI: 10.1245/s10434-022-12561-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 08/15/2022] [Indexed: 12/04/2022]
Abstract
Background Comprehensive trends in Medicare reimbursement, increasingly relevant to current and future surgical oncology practice, have not been well studied. Objective The aim of this study was to analyze Medicare reimbursement for index surgical oncology procedures between 2007 and 2021. Methods Using the Physician Fee Schedule Look-Up Tool from the Centers for Medicare and Medicaid Services, reimbursement data from 2007 to 2021 were obtained for 23 index surgical oncology procedures. Total change in Medicare reimbursement, yearly rates of change, and compound annual growth rate were then calculated. All data were corrected for inflation using the consumer price index. Subset analysis was performed to assess the most recent 5-year trends. Results Overall reimbursement for the index surgical oncology procedures increased by an average of 21.6% from 2007 to 2021. After correcting for inflation, average reimbursement decreased to − 8.6%, with the greatest decline seen for thyroid surgery (− 16.9%). Breast surgery was the only category to experience an increase in adjusted reimbursement (9.0%). The average compound annual growth rate for all procedures was − 0.68% from 2007 to 2021. In the most recent 5-year subanalysis, the yearly decrease in inflation-adjusted Medicare reimbursement averaged − 2.47% per year, in comparison with the − 0.60% overall rate of yearly decline (p < 0.005). Conclusion Adjusted Medicare reimbursement for surgical oncology procedures decreased steadily from 2007 to 2021, with an accelerating trend over the last 5 years. As the Medicare population increases, surgical oncologists need to understand these trends so they may consider practice implications, advocate for proper reimbursement models, and preserve access to surgical oncology services.
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Affiliation(s)
| | - Jack Haglin
- Department of Orthopedic Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Nabil Wasif
- Division of Surgical Oncology, Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA.
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Hydrick TC, Rubel N, Renfree S, Lara N, Makovicka JL, Arvind V, Chang M, Chung A. Ninety-Day Readmission in Elective Revision Lumbar Fusion Surgery in the Inpatient Setting. Global Spine J 2020; 10:1027-1033. [PMID: 32875826 PMCID: PMC7645088 DOI: 10.1177/2192568219886535] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
STUDY DESIGN Retrospective review. OBJECTIVES (1) Identify the 90-day rate of readmission following revision lumbar fusion, (2) identify independent risk factors associated with increased rates of readmission within 90 days, (3) and identify the hospital costs associated with revision lumbar fusion and subsequent readmission within 90 days. METHODS Utilizing 2014 data from the Nationwide Readmissions Database, patients undergoing elective revision lumbar fusion were identified. With this sample, multivariate logistic regression was utilized to identify independent predictors of readmission within 90 days. An analysis of total hospital costs was also conducted. RESULTS In 2014, an estimated 14 378 patients underwent elective revision lumbar fusion. The readmission rate at 90 days was 3.1% (n = 446). Diabetes with chronic complications was the only comorbidity found to carry significantly increased odds of readmission. Surgical complications such as deep venous thrombosis, surgical wound disruption, hematoma, and pneumonia (experienced during the index admission) were also independent predictors of readmission. Anterior approaches were associated with increased odds of readmission. The most common related diagnoses on readmission were hardware issues, postoperative infection, and disc herniation. Readmissions were associated with an average of $96 152 in increased hospital costs per patient compared with those not readmitted. CONCLUSION Relevant patient comorbidities and surgical complications were associated with increased readmission within 90 days. Readmission within 90 days was associated with significant increases in hospital costs.
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Affiliation(s)
- Thomas C. Hydrick
- Mayo Clinic, Scottsdale, AZ, USA,Thomas C. Hydrick, Mayo Clinic Alix School of Medicine, 13400 East Shea Boulevard, Scottsdale, AZ 85253, Arizona.
| | | | | | - Nina Lara
- Mayo Clinic Arizona, Phoenix, AZ, USA
| | | | - Varun Arvind
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Naylor RM, Gilder HE, Gupta N, Hydrick TC, Labott JR, Mauler DJ, Trentadue TP, Ghislain B, Elder BD, Fogelson JL. Effects of Negative Pressure Wound Therapy on Wound Dehiscence and Surgical Site Infection Following Instrumented Spinal Fusion Surgery-A Single Surgeon's Experience. World Neurosurg 2020; 137:e257-e262. [PMID: 32004742 PMCID: PMC8063507 DOI: 10.1016/j.wneu.2020.01.152] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 01/18/2020] [Accepted: 01/20/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Incisional negative pressure wound therapy (NPWT) is used in many surgical specialties to prevent postoperative dehiscence and surgical site infections (SSIs). However, little is known about the role of incisional NPWT in spine fusion surgery. Therefore, we sought to report a single surgeon's experience using incisional NPWT and describe its effects on dehiscence and SSIs after instrumented spine surgery. METHODS We compared rates of hospital readmission and return to the operating room for dehiscence and SSIs in a consecutive series of patients who underwent spinal fusion surgery with or without NPWT from 2015 to 2018. RESULTS A total of 393 patients without and 76 patients with NPWT were included for analysis. Half way through the data collection period, all patients who underwent anterior lumbar fusion received NPWT. Three of 15 (20.0%) of non-NPWT patients who underwent anterior lumbar fusion had dehiscence or SSI compared with zero of 23 (0.0%) of NPWT patients (P = 0.01). NPWT for posterior surgeries was used on a case-by-case basis using risk factors that contribute to SSIs and dehiscence. NPWT patients had higher rates of spinal neoplasia (0.5% vs. 11.3%, P < 0.0001), osteomyelitis/diskitis (1.3% vs. 7.5%, P = 0.02), durotomy (14.9% vs. 28.6%, P = 0.007), revision surgery (32.2% vs. 59.6%, P = 0.0001), and longer fusion constructs (7 vs. 11 levels, P < 0.0001) but had similar rates of dehiscence and SSIs as non-NPWT patients (5.6% vs. 5.7%, P = 0.98). CONCLUSIONS NPWT decreases dehiscence and SSIs in patients undergoing lumbar fusion through an anterior approach. When preferentially used in patients at high risk for postoperative wound complications, NPWT prevents increased rates of dehiscence and SSI.
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Affiliation(s)
- Ryan M Naylor
- Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Hannah E Gilder
- Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Nikita Gupta
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona, USA
| | - Thomas C Hydrick
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona, USA
| | - Joshua R Labott
- Mayo Clinic Alix School of Medicine, Rochester, Minnesota, USA
| | - David J Mauler
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona, USA
| | - Taylor P Trentadue
- Mayo Clinic Alix School of Medicine, Rochester, Minnesota, USA; Mayo Clinic Medical Scientist Training Program, Rochester, Minnesota, USA
| | | | - Benjamin D Elder
- Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA; Department of Orthopedic Surgery, Rochester, Minnesota, USA; Department of Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
| | - Jeremy L Fogelson
- Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA; Department of Orthopedic Surgery, Rochester, Minnesota, USA.
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Makovicka JL, Deckey DG, Patel KA, Hassebrock JD, Chung AS, Tummala SV, Hydrick TC, Pena A, Chhabra A. Epidemiology of Lumbar Spine Injuries in Men's and Women's National Collegiate Athletic Association Basketball Athletes. Orthop J Sports Med 2019; 7:2325967119879104. [PMID: 31700939 PMCID: PMC6823986 DOI: 10.1177/2325967119879104] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background: Lumbar spine injuries (LSIs) are common in both men’s and women’s National Collegiate Athletic Association (NCAA) basketball players and can frequently lead to reinjuries and persistent pain. Purpose: To describe the epidemiology of an LSI in collegiate men’s and women’s basketball during the 2009-2010 through 2013-2014 academic years. Study Design: Descriptive epidemiology study. Methods: The incidence and characteristics of LSIs were identified utilizing the NCAA Injury Surveillance Program (ISP). Rates of injury were calculated as the number of injuries divided by the total number of athlete-exposures (AEs). AEs were defined as any student participation in 1 NCAA-sanctioned practice or competition. Incidence rate ratios (IRRs) were then calculated to compare the rates of injury between season, event type, mechanism, injury recurrence, and time lost from sport. Results: The NCAA ISP reported 124 LSIs from an average of 28 and 29 men’s and women’s teams, respectively. These were used via validated weighting methodology to estimate a total of 5197 LSIs nationally. The rate of LSIs in women was 2.16 per 10,000 AEs, while men suffered LSIs at a rate of 3.47 per 10,000 AEs. Men were 1.61 times more likely to suffer an LSI compared with women. In men, an LSI was 3.48 times more likely to occur in competition when compared with practice, while in women, an LSI was 1.36 times more likely to occur in competition than in practice. Women suffered the highest LSI rate during the postseason, while the highest rate in men was during the regular season. The majority of both female (58.9%; n = 1004) and male (73.1%; n = 2353) athletes returned to play within 24 hours of injury. Conclusion: To date, this is the largest study to characterize LSIs in NCAA basketball and provides needed information on the prevalence and timing of these injuries. The majority of injuries in both sexes were new, and most athletes returned to play in less than 24 hours. Injury rates were highest during competition in both sexes.
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Affiliation(s)
| | - David G Deckey
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - Karan A Patel
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | | | - Andrew S Chung
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - Sailesh V Tummala
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA
| | | | - Austin Pena
- Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, USA
| | - Anikar Chhabra
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
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Christopher ZK, Makovicka JL, Scott KL, Hassebrock JD, Patel KA, Chung AS, Tummala SV, Hydrick TC, Ginn J, Chhabra A. Elbow Injuries in National Collegiate Athletic Association Football Players: An Epidemiological Study Spanning 5 Academic Years. Orthop J Sports Med 2019; 7:2325967119867411. [PMID: 31523691 PMCID: PMC6732864 DOI: 10.1177/2325967119867411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background National Collegiate Athletic Association (NCAA) football players are at a high risk of injuries. Elbow injuries are uncommon, but there are insufficient data specifically on elbow injuries sustained in NCAA football players. Purpose To define the epidemiology of elbow injuries in NCAA football players during the 2009-2010 to 2013-2014 seasons using data from the NCAA Injury Surveillance Program (NCAA-ISP). Study Design Descriptive epidemiology study. Methods Using the NCAA-ISP database, a convenience sample of NCAA football athletes was reviewed to determine the types, rates, and trends in elbow injuries. Several factors were examined, including the diagnosis, injury setting, time lost from sport, surgical necessity, and injury recurrence. Raw injury data were obtained as well as weighted totals from the NCAA-ISP to generate national estimates and adjust for underreporting. Injury rates were calculated by dividing the number of injuries by the total number of athlete-exposures (AEs). The rate ratios of injuries during competition versus practice were compared, as were the rate ratios of preseason, regular-season, and postseason injuries by type. Results We identified 4874 total elbow injuries from the 2009-2010 to 2013-2014 seasons. The rate of injuries overall was 1.892 per 10,000 AEs. The rate for competition was 9.053 per 10,000 AEs and 1.121 per 10,000 AEs for practice. The rate ratio between competition and practice was 8.08 (95% CI, 6.04-10.80). Injury rates for the preseason, regular season, and postseason were 1.851, 1.936, and 1.406 per 10,000 AEs, respectively. Acute elbow instability was the most common injury type (65.43%). The most common mechanism was a contact injury (86.77%); 96.82% of injuries did not require surgery, and most elbow injuries required less than 24 hours of participation restriction (67.33%). Conclusion Although elbow injuries in NCAA football players are uncommon, it is important to recognize and treat these injuries appropriately. Dislocations and ulnar collateral ligament injuries caused athletes to miss extended periods of play. Fortunately, a majority of injuries resulted in less than 24 hours of participation restriction. Particular attention should be given to preventing elbow injuries, especially ulnar collateral ligament strains, hyperextension injuries, and acute instability.
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Affiliation(s)
| | | | - Kelly L Scott
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | | | - Karan A Patel
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - Andrew S Chung
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - Sailesh V Tummala
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA
| | | | | | - Anikar Chhabra
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
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Hassebrock JD, Patel KA, Makovicka JL, Chung AS, Tummala SV, Hydrick TC, Ginn JE, Hartigan DE, Chhabra A. Elbow Injuries in National Collegiate Athletic Association Athletes: A 5-Season Epidemiological Study. Orthop J Sports Med 2019; 7:2325967119861959. [PMID: 31448298 PMCID: PMC6688148 DOI: 10.1177/2325967119861959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Little research has focused on the rates and patterns of elbow injuries in
National Collegiate Athletic Association (NCAA) student-athletes. Purpose: To describe the epidemiological patterns of elbow injuries in NCAA athletes
during 5 seasons over the academic years 2009 through 2014 using the NCAA
Injury Surveillance Program (NCAA-ISP) database. Study Design: Descriptive epidemiology study. Methods: A voluntary convenience sample of NCAA varsity teams from 11 sports was
examined to determine the rates and patterns of elbow injuries. Rates and
distributions of elbow injuries were identified within the context of sport,
event type, time in season, mechanism, time lost from sport, surgical
treatment, and injury type. Rates of injury were calculated as the number of
injuries divided by the total number of athlete-exposures (AEs). An AE was
defined as any student participation in 1 NCAA-sanctioned practice or
competition with an inherent risk of exposure to potential injury. Injury
rate ratios (IRRs) and injury proportion ratios (IPRs) were then calculated
to compare the rates within and between sports by event type, season, sex,
mechanism, surgical treatment, and time lost from sport. Comparisons between
sexes were made using only sports data that had both male and female
samples. Results: Overall, 373 elbow injuries were reported in the NCAA-ISP data set during the
2009-2010 through 2013-2014 academic years among 11 varsity sports. The
overall rate of injury was 1.76 per 10,000 AEs. The rate of elbow injuries
in men was 0.74 per 10,000 AEs, while women experienced injuries at a rate
of 0.63 per 10,000 AEs. In sex-comparable sports, men were 1.17 times more
likely to experience an elbow injury compared with women. Men’s wrestling
(6.00/10,000 AEs) and women’s tennis (1.86/10,000 AEs) were the sports with
the highest rates of elbow injuries by sex, respectively. The top 3 highest
injury rates overall occurred in men’s wrestling, baseball, and tennis.
Elbow injuries were 3.5 times more likely to occur during competition
compared with practice. Athletes were 0.76 times less likely to sustain an
elbow injury during the preseason compared with in-season. Contact events
were the most common mechanism of injury (67%). For sex-comparable sports,
men were 2.41 times more likely than women to have contact as their injury
mechanism (95% CI, 0.78-7.38). The majority of athletes missed less than 24
hours of participation time (67%), and only a minority (3%) of patients with
elbow injuries went on to have surgical intervention. Elbow ulnar collateral
ligament injuries were most common (26% of total injuries). Conclusion: Analysis of the study data demonstrated a significant rate of elbow injuries,
1.76 injuries per 10,000 AEs in NCAA collegiate athletes. Higher injury
rates can be expected in males within sex-comparable sports. Elbow injuries
are most common in the setting of competitions and most commonly occur
secondary to contact-type mechanisms. Injuries were more likely to occur
during in-season play. The majority of injuries required less than 24 hours
of time away from sport and did not require surgical intervention.
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Affiliation(s)
| | - Karan A Patel
- Department of Orthopedics, Mayo Clinic, Phoenix, Arizona, USA
| | | | - Andrew S Chung
- Department of Orthopedics, Mayo Clinic, Phoenix, Arizona, USA
| | | | | | | | | | - Anikar Chhabra
- Department of Orthopedics, Mayo Clinic, Phoenix, Arizona, USA
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8
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Makovicka JL, Patel KA, Deckey DG, Hassebrock JD, Chung AS, Tummala SV, Hydrick TC, Gulbrandsen M, Hartigan DE, Chhabra A. Lower Back Injuries in National Collegiate Athletic Association Football Players: A 5-Season Epidemiological Study. Orthop J Sports Med 2019; 7:2325967119852625. [PMID: 31245431 PMCID: PMC6582304 DOI: 10.1177/2325967119852625] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Low back injuries are common in collegiate football players and can frequently lead to persistent pain, reinjuries, and time lost from participation. Purpose: To describe the epidemiology of back injuries in National Collegiate Athletic Association (NCAA) football players during the 2009/2010 through 2013/2014 academic years utilizing the NCAA Injury Surveillance Program (ISP) database. Study Design: Descriptive epidemiology study. Methods: A convenience sample of NCAA varsity football teams was utilized to determine the rates and patterns of back injuries as well as to generate national injury estimates. The rates and distribution of back injuries were identified within the context of mechanism of injury, injury chronicity, and time lost from sport. Injury rates were calculated as the number of injuries divided by the total number of athlete-exposures (AEs). Incidence rate ratios were calculated to compare the rates of injury between season, event type, mechanism of injury, injury chronicity, and time lost from sport. Results: Nationally, there were 267 low back injuries reported in the database. These were used to estimate 7076 back injuries over the 5-year period, approximately 82% of which were new injuries. The injuries occurred at a rate of 2.70 per 10,000 AEs. Overall, injuries were 3.12 times more likely to occur in competitions than in practices. Athletes were 4.67 times more likely to sustain a back injury during the preseason compared with the postseason but were 1.41 times more likely to sustain a low back injury during the preseason compared with the regular season. Both contact and noncontact were reported equally as the mechanism of injury (37.8% and 38.3%, respectively), and unspecified low back pain was the most common injury (64.2%). Only 1.6% of patients required surgery for their injury, and the majority of athletes (59.6%) returned to play within 24 hours. Conclusion: There was a relatively high rate of lumbar back injuries at the collegiate level (2.70/10,000 AEs), the majority of which were new injuries. About 18% of reported injuries were reinjuries. Although very few required surgery, a careful examination and work-up should be conducted to evaluate each injury. Regimented physical therapy and reconditioning programs are recommended to avert reinjuries.
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Affiliation(s)
| | - Karan A Patel
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - David G Deckey
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | | | - Andrew S Chung
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - Sailesh V Tummala
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA
| | | | | | - David E Hartigan
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - Anikar Chhabra
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
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