Objective

Identify the impact of preoperative treatment of Osteoporosis (OP) on reoperation rates, complications and healthcare utilization following thoraco-lumbar (TL) spine fusions.

Materials and Methods

We used ICD9/10 and CPT codes to extract data from MarketScan (2000–2018). Patients were divided into two groups based on preoperative treatment of OP within one year prior to the index spinal fusion: medication (m-OP) cohort and non-medication (nm-OP) cohort. Outcomes (re-operation rates, re-admission, complications, healthcare utilization) were analyzed at 1-, 12-, 24- and 60-months.

Results

Of 3606 patients, 65% (n = 2330) of patients did not receive OP medications (nm-OP). At index hospitalization, there were no difference in LOS (median nm-OP: 3 days vs. m-OP:4 days), discharge to home (nm-OP 80% vs. m-OP 75%) and complications (nm-OP 13% vs. m-OP 12%). Reoperation rates were not different among the cohorts at 1- (nm-OP 5.7% vs. m-OP 4.2%), 2- (nm-OP 9.4% vs. m-OP 7.8) and 5 years (nm-OP 16.9% vs. m-OP 14.8%). Patients in m-OP cohort incurred higher overall median payments at 1 year ($17,866 vs. $ 16,010), 2 years ($38,634 vs. $34,454) and 5 years ($94,797 vs. $91,072) compared to nm-OP cohort.

Conclusion

Preoperative treatment of OP had no impact on complications, LOS, discharge disposition following TL fusions at index hospitalization. Similarly, no impact of preoperative treatment was noted in terms of reoperation rates at 12-, 24- and 60 months following the index spine fusion. Patients who received preoperative treatment for OP incurred higher health care utilization at 12-, 24- and 60 months following surgery.

中文翻译：

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骨质疏松症术前治疗对胸腰椎融合术患者再次手术、并发症和医疗保健利用的影响。5年国家数据库分析

客观的

确定术前骨质疏松症 (OP) 治疗对胸腰椎 (TL) 脊柱融合术后再手术率、并发症和医疗保健利用率的影响。

材料和方法

我们使用 ICD9/10 和 CPT 代码从 MarketScan (2000-2018) 中提取数据。根据脊柱融合术前一年内 OP 的术前治疗将患者分为两组：药物 (m-OP) 队列和非药物 (nm-OP) 队列。在 1、12、24 和 60 个月时分析结果（再次手术率、再次入院、并发症、医疗保健利用率）。

结果

在 3606 名患者中，65% (n = 2330) 的患者未接受 OP 药物治疗 (nm-OP)。在首次住院时，LOS（中位 nm-OP：3 天 vs. m-OP：4 天）、出院回家（nm-OP 80% vs. m-OP 75%）和并发症（nm- OP 13% 与 m-OP 12%）。1- (nm-OP 5.7% vs. m-OP 4.2%)、2- (nm-OP 9.4% vs. m-OP 7.8) 和 5 年 (nm-OP 16.9%) 的队列中再手术率没有差异与 m-OP 14.8%）。与 nm-OP 队列相比，m-OP 队列中的患者在 1 年（17,866 美元与 16,010 美元）、2 年（38,634 美元与 34,454 美元）和 5 年（94,797 美元与 91,072 美元）时的总支付中位数更高。

结论

OP 的术前治疗对住院时 TL 融合后的并发症、LOS、出院处置没有影响。同样，在索引脊柱融合后 12、24 和 60 个月的再手术率方面没有注意到术前治疗的影响。接受手术前 OP 治疗的患者在手术后 12、24 和 60 个月的医疗保健利用率更高。