Outcomes Associated With Infection of Chronic Pain Spinal Implantable Electronic Devices: Insights From a Nationwide Inpatient Sample Study.
Outcomes Associated With Infection of Chronic Pain Spinal Implantable Electronic Devices: Insights From a Nationwide Inpatient Sample Study.
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DOI：
10.1111/ner.13263
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发表时间：
2021-01
期刊：
影响因子：
2.8
通讯作者：
Shankar, Hariharan
中科院分区：
文献类型：
--
作者：
Goel, Vasudha;Kumar, Varun;Agrawal, Shivani N.;Patwardhan, Amol M.;Ibrahim, Mohab;DeSimone, Daniel C.;Sivanesan, Eellan;Banik, Ratan K.;Shankar, Hariharan
慢性疼痛脊柱植入式电子设备（CPSIEDs）包括提供脊髓刺激和鞘内药物治疗的设备。在本研究中，我们试图评估CPSIED感染的趋势、相关并发症以及感染治疗后的结果。
全国住院患者样本数据库包含来自48个州和哥伦比亚特区的数据，用于确定2005 - 2014年间主要诊断为CPSIED感染的患者。为将研究人群限制在慢性疼痛疾病患者，排除了使用鞘内泵治疗痉挛的患者。治疗分为以下几类：1）未移除设备，2）仅移除脉冲发生器或泵，3）移除鞘内泵系统，4）移除脊髓刺激系统。使用行政收费代码确定与CPSIED感染相关的并发症。
在2005 - 2014年研究期间，共有11041名CPSIED感染患者入院。大多数患者未接受手术干预治疗（56%），较小比例的患者接受了完整系统移除（22.7%）。CPSIED感染后院内死亡率和因瘫痪导致的永久性残疾率分别约为1.83%和2.77%。脑膜炎、脓肿形成和骨髓炎等感染性并发症的发生率分别为4.93%、5.08%和1.5%。住院费用中位数约为14118.00美元，住院时间中位数约为6天（四分位间距 = 4 - 13天）。
未移除设备的患者中CPSIED感染的并发症更高。
Chronic pain spinal implantable electronic devices (CPSIEDs) include devices that provide spinal cord stimulation and intrathecal drug therapy. In this study, we sought to evaluate the trends of CPSIED infections, related complications, and outcomes following the treatment of infection. The Nationwide Inpatient Sample database contains data from 48 states, and the District of Columbia was used to identify patients with a primary diagnosis of CPSIED infection during the years 2005–2014. Patients with intrathecal pumps for the treatment of spasticity were excluded to limit the study population to patients with chronic pain disorders. Treatments were categorized as: 1) without device removal, 2) pulse generator or pump only removal, 3) intrathecal pump system removal, and 4) spinal cord stimulation system removal. Complications associated with CPSIED infections were identified using administrative billing codes. During the study period 2005–2014, a total of 11,041 patients were admitted to the hospital with CPSIED infections. The majority of the patients were treated without surgical intervention (56%), and a smaller proportion underwent complete system explantation (22.7%). In-hospital mortality or permanent disability due to paralysis after CPSIED infection was around 1.83% and 2.77%, respectively. Infectious complications such as meningitis, abscess formation, and osteomyelitis occurred in 4.93%, 5.08%, and 1.5%, respectively. The median cost of hospitalization was around US $14,118.00, and the median length of stay was approximately six days (interquartile range = 4–13 days). The complications of CPSIED infection were higher among patients that did not undergo device removal.
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