In-Hospital Complications and Resource Utilization Following Lumbar Spine Surgery in Patients with Parkinson Disease: Evaluation of the National Inpatient Sample Database

Joseph F. Baker, Shearwood McClelland, Breton G. Line, Justin S. Smith, Robert Hart, Christopher P. Ames, Chris Shaffrey, Shay Bess

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background Previous reports suggest that patients with Parkinson disease (PD) have elevated rates of complications following spine surgery; however, these reports are limited by small patient series. In this study, we used the National Inpatient Sample (NIS) database to compare in-hospital complications following elective lumbar spine surgery in patients with a diagnosis of PD and patients without PD. Methods The NIS database was accessed to identify patients with PD and those without PD who underwent lumbar spine surgery. All patients identified had a diagnosis code consistent with degenerative lumbar spine pathology. The patients were evaluated for the presence or absence of PD and divided into 4 lumbar spine procedure groups: decompression alone, lateral fusion, posterior fusion, and anterior fusion technique. Propensity score matching (PSM) was performed for the PD versus non-PD patients in each procedure group to control for confounding demographic variables, and in-hospital complications were compared between the 2 groups. Results Between 2001 and 2012, a total of 613,522 lumbar spine surgery patient episodes were identified, of which 4492 (0.7%) involved a diagnosis of PD. Following PSM for patient age, sex, and race, the patients with PD were at increased risk for acute postoperative hemorrhagic anemia, increased blood transfusion requirements, and increased genitourinary, neurologic, and cardiac complications compared with the patients without PD. Conclusions PSM analysis of the NIS database demonstrated that patients with PD are at increased risk for acute in-hospital complications and greater blood transfusion requirements than those without PD. Surgeons should be aware of the increased risks and differing requirements when treating spinal pathology in patients with PD.

Original languageEnglish (US)
Pages (from-to)470-476
Number of pages7
JournalWorld Neurosurgery
Volume106
DOIs
StatePublished - Oct 1 2017

Fingerprint

Parkinson Disease
Inpatients
Spine
Databases
Propensity Score
Blood Transfusion
Pathology
Confounding Factors (Epidemiology)
Decompression
Nervous System
Anemia
Demography

Keywords

  • Degenerative
  • Lumbar spine
  • National inpatient sample
  • Parkinson disease

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

In-Hospital Complications and Resource Utilization Following Lumbar Spine Surgery in Patients with Parkinson Disease : Evaluation of the National Inpatient Sample Database. / Baker, Joseph F.; McClelland, Shearwood; Line, Breton G.; Smith, Justin S.; Hart, Robert; Ames, Christopher P.; Shaffrey, Chris; Bess, Shay.

In: World Neurosurgery, Vol. 106, 01.10.2017, p. 470-476.

Research output: Contribution to journalArticle

Baker, Joseph F. ; McClelland, Shearwood ; Line, Breton G. ; Smith, Justin S. ; Hart, Robert ; Ames, Christopher P. ; Shaffrey, Chris ; Bess, Shay. / In-Hospital Complications and Resource Utilization Following Lumbar Spine Surgery in Patients with Parkinson Disease : Evaluation of the National Inpatient Sample Database. In: World Neurosurgery. 2017 ; Vol. 106. pp. 470-476.
@article{6d361508ddda47089420d6ce4780341a,
title = "In-Hospital Complications and Resource Utilization Following Lumbar Spine Surgery in Patients with Parkinson Disease: Evaluation of the National Inpatient Sample Database",
abstract = "Background Previous reports suggest that patients with Parkinson disease (PD) have elevated rates of complications following spine surgery; however, these reports are limited by small patient series. In this study, we used the National Inpatient Sample (NIS) database to compare in-hospital complications following elective lumbar spine surgery in patients with a diagnosis of PD and patients without PD. Methods The NIS database was accessed to identify patients with PD and those without PD who underwent lumbar spine surgery. All patients identified had a diagnosis code consistent with degenerative lumbar spine pathology. The patients were evaluated for the presence or absence of PD and divided into 4 lumbar spine procedure groups: decompression alone, lateral fusion, posterior fusion, and anterior fusion technique. Propensity score matching (PSM) was performed for the PD versus non-PD patients in each procedure group to control for confounding demographic variables, and in-hospital complications were compared between the 2 groups. Results Between 2001 and 2012, a total of 613,522 lumbar spine surgery patient episodes were identified, of which 4492 (0.7{\%}) involved a diagnosis of PD. Following PSM for patient age, sex, and race, the patients with PD were at increased risk for acute postoperative hemorrhagic anemia, increased blood transfusion requirements, and increased genitourinary, neurologic, and cardiac complications compared with the patients without PD. Conclusions PSM analysis of the NIS database demonstrated that patients with PD are at increased risk for acute in-hospital complications and greater blood transfusion requirements than those without PD. Surgeons should be aware of the increased risks and differing requirements when treating spinal pathology in patients with PD.",
keywords = "Degenerative, Lumbar spine, National inpatient sample, Parkinson disease",
author = "Baker, {Joseph F.} and Shearwood McClelland and Line, {Breton G.} and Smith, {Justin S.} and Robert Hart and Ames, {Christopher P.} and Chris Shaffrey and Shay Bess",
year = "2017",
month = "10",
day = "1",
doi = "10.1016/j.wneu.2017.07.006",
language = "English (US)",
volume = "106",
pages = "470--476",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - In-Hospital Complications and Resource Utilization Following Lumbar Spine Surgery in Patients with Parkinson Disease

T2 - Evaluation of the National Inpatient Sample Database

AU - Baker, Joseph F.

AU - McClelland, Shearwood

AU - Line, Breton G.

AU - Smith, Justin S.

AU - Hart, Robert

AU - Ames, Christopher P.

AU - Shaffrey, Chris

AU - Bess, Shay

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Background Previous reports suggest that patients with Parkinson disease (PD) have elevated rates of complications following spine surgery; however, these reports are limited by small patient series. In this study, we used the National Inpatient Sample (NIS) database to compare in-hospital complications following elective lumbar spine surgery in patients with a diagnosis of PD and patients without PD. Methods The NIS database was accessed to identify patients with PD and those without PD who underwent lumbar spine surgery. All patients identified had a diagnosis code consistent with degenerative lumbar spine pathology. The patients were evaluated for the presence or absence of PD and divided into 4 lumbar spine procedure groups: decompression alone, lateral fusion, posterior fusion, and anterior fusion technique. Propensity score matching (PSM) was performed for the PD versus non-PD patients in each procedure group to control for confounding demographic variables, and in-hospital complications were compared between the 2 groups. Results Between 2001 and 2012, a total of 613,522 lumbar spine surgery patient episodes were identified, of which 4492 (0.7%) involved a diagnosis of PD. Following PSM for patient age, sex, and race, the patients with PD were at increased risk for acute postoperative hemorrhagic anemia, increased blood transfusion requirements, and increased genitourinary, neurologic, and cardiac complications compared with the patients without PD. Conclusions PSM analysis of the NIS database demonstrated that patients with PD are at increased risk for acute in-hospital complications and greater blood transfusion requirements than those without PD. Surgeons should be aware of the increased risks and differing requirements when treating spinal pathology in patients with PD.

AB - Background Previous reports suggest that patients with Parkinson disease (PD) have elevated rates of complications following spine surgery; however, these reports are limited by small patient series. In this study, we used the National Inpatient Sample (NIS) database to compare in-hospital complications following elective lumbar spine surgery in patients with a diagnosis of PD and patients without PD. Methods The NIS database was accessed to identify patients with PD and those without PD who underwent lumbar spine surgery. All patients identified had a diagnosis code consistent with degenerative lumbar spine pathology. The patients were evaluated for the presence or absence of PD and divided into 4 lumbar spine procedure groups: decompression alone, lateral fusion, posterior fusion, and anterior fusion technique. Propensity score matching (PSM) was performed for the PD versus non-PD patients in each procedure group to control for confounding demographic variables, and in-hospital complications were compared between the 2 groups. Results Between 2001 and 2012, a total of 613,522 lumbar spine surgery patient episodes were identified, of which 4492 (0.7%) involved a diagnosis of PD. Following PSM for patient age, sex, and race, the patients with PD were at increased risk for acute postoperative hemorrhagic anemia, increased blood transfusion requirements, and increased genitourinary, neurologic, and cardiac complications compared with the patients without PD. Conclusions PSM analysis of the NIS database demonstrated that patients with PD are at increased risk for acute in-hospital complications and greater blood transfusion requirements than those without PD. Surgeons should be aware of the increased risks and differing requirements when treating spinal pathology in patients with PD.

KW - Degenerative

KW - Lumbar spine

KW - National inpatient sample

KW - Parkinson disease

UR - http://www.scopus.com/inward/record.url?scp=85026753074&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85026753074&partnerID=8YFLogxK

U2 - 10.1016/j.wneu.2017.07.006

DO - 10.1016/j.wneu.2017.07.006

M3 - Article

C2 - 28711540

AN - SCOPUS:85026753074

VL - 106

SP - 470

EP - 476

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -