National Trends in the Usage and Success of Sacral Nerve Test Stimulation
National Trends in the Usage and Success of Sacral Nerve Test Stimulation
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DOI：
10.1016/j.juro.2010.10.060
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发表时间：
2011-03-01
影响因子：
6.6
通讯作者：
Clemens, J. Quentin
中科院分区：
文献类型：
--
作者：
Cameron, Anne P.;Anger, Jennifer T.;Clemens, J. Quentin
目的：一般社区对骶神经调节的结局知之甚少，迄今为止发表的报告仅限于病例系列或随机对照试验。本分析的目的是确定国家骶神经调节试验阶段的成功率和患者因素，有助于success.Materials和方法：医疗索赔数据从5%的样本医疗保险受益人（1997年至2007年）和雇员的25个大（财富500强）公司（Ingenix（R），2002年至2007年）。使用骶神经调节手术的计费代码，成功被定义为从测试阶段（经皮或分期）进展到电池植入。成功率进行了比较的基础上，年龄，种族，性别和diagnosis.Results：在医疗保险样本358例接受经皮测试刺激和1,132进行2阶段的铅放置，其中45.8%和35.4%，分别进行了后续的电池植入。在私人保险样本中，有266例经皮手术和794例2期手术。24.1%的病例在经皮手术后植入电池，而50.9%的分期手术导致电池植入。性别是唯一一致的预测成功，女性患者表现出较高的成功率在每个dataset.Conclusions：骶神经调节成功率在这些数据集中发表的病例系列和小型随机对照试验。女性的结果明显好于男性，私人保险的个人比医疗保险的个人的结果更好，这表明了潜在的年龄效应。
Purpose: Little is known about outcomes of sacral neuromodulation in the general community, with published reports to date limited to case series or randomized, controlled trials. The goal of this analysis was to identify the national sacral neuromodulation test phase success rate and patient factors that contribute to success.Materials and Methods: Medical claims data were obtained from a 5% sample of Medicare beneficiaries (1997 to 2007) and from employees of 25 large (Fortune 500) companies (Ingenix (R), 2002 to 2007). Using billing codes for the sacral neuromodulation procedure, success was defined as progressing from test phase (percutaneous or staged) to battery implantation. The rate of success was compared based on age, race, gender and diagnosis.Results: In the Medicare sample 358 patients received percutaneous test stimulation and 1,132 underwent 2-stage lead placement, of whom 45.8% and 35.4%, respectively, underwent subsequent battery implantation. In the privately insured sample there were 266 percutaneous procedures and 794, 2-stage procedures. Percutaneous procedures were followed by battery placement in 24.1% of cases, whereas 50.9% of staged procedures resulted in battery implantation. Gender was the only consistent predictor of success, with female patients demonstrating higher success rates in each data set.Conclusions: The sacral neuromodulation success rates in these data sets are inferior to those published in case series and small randomized, controlled trials. Women had significantly better results than men and privately insured individuals had better results than those with Medicare, indicating a potential age effect.