Surgical treatment of adolescent idiopathic scoliosis in the United States from 1997 to 2012: an analysis of 20,346 patients
Surgical treatment of adolescent idiopathic scoliosis in the United States from 1997 to 2012: an analysis of 20,346 patients
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DOI：
10.3171/2015.3.peds14649
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发表时间：
2015-09-01
影响因子：
1.9
通讯作者：
Daniels, Alan H.
中科院分区：
文献类型：
--
作者：
Vigneswaran, Hari T.;Grabel, Zachary J.;Daniels, Alan H.
青少年特发性脊柱侧凸（AIS）可导致严重的发病率，可能需要手术干预。在本研究中，作者旨在评估美国手术AIS的趋势以及患者合并症、手术方法、住院并发症、住院时间（LOS），1997 - 2012年美国AIS患者的住院费用从儿童住院患者数据库中识别出1997年至2012年接受脊柱融合术（ICD-9-CM手术代码81.xx）的患者（ICD-9-CM诊断代码737.30）。感兴趣的参数包括患者的合并症，手术方法（后，前，或前后联合），在医院并发症，医院LOS，和hospital charge.Results的作者确定了20,346例患者的年龄范围为0-21岁，已被承认为AIS手术在规定的研究期间。1997年后路融合占手术的63.4%，2012年占94.1%（r = 0.95，p < 0.01）。所有融合组的平均合并症数量从1997年的3.0例增加至2012年的4.2例（r = 0.92，p = 0.01）。发生并发症的患者百分比从1997年的15.6%增加到2012年的22.3%（r = 0.78，p = 0.07）。平均住院时间从1997年的6.5天下降到2012年的5.6天（r = 0.86，p = 0.03）。从1997年到2012年，AIS手术治疗的平均住院费用（调整为2012年美元）从1997年的55，495美元增加到2012年的177，176美元（r = 0.99，p
OBJECT Adolescent idiopathic scoliosis (AIS) can cause substantial morbidity and may require surgical intervention. In this study, the authors aimed to evaluate US trends in operative AIS as well as patient comorbidities, operative approach, in-hospital complications, hospital length of stay (LOS), and hospital charges in the US for the period from 1997 to 2012.METHODS Patients with AIS (ICD-9-CM diagnosis codes 737.30) who had undergone spinal fusion (ICD-9-CM procedure codes 81.xx) from 1997 to 2012 were identified from the Kids' Inpatient Database. Parameters of interest included patient comorbidities, operative approach (posterior, anterior, or combined anteroposterior), in-hospital complications, hospital LOS, and hospital charges.RESULTS The authors identified 20,346 patients in the age range of 0-21 years who had been admitted for AIS surgery in the defined study period. Posterior fusions composed 63.4% of procedures in 1997 and 94.1% in 2012 (r = 0.95, p < 0.01). The mean number of comorbidities among all fusion groups increased from 3.0 in 1997 to 4.2 in 2012 (r = 0.92, p = 0.01). The percentage of patients with complications increased from 15.6% in 1997 to 22.3% in 2012 (r = 0.78, p = 0.07). The average hospital LOS decreased from 6.5 days in 1997 to 5.6 days in 2012 (r = 0.86, p = 0.03). From 1997 to 2012, the mean hospital charges (adjusted to 2012 US dollars) for surgical treatment of AIS more than tripled from $55,495 in 1997 to $177,176 in 2012 (r = 0.99, p