Neurospine.  2021 Dec;18(4):725-732. 10.14245/ns.2142614.307.

Demographic Predictors of Treatment and Complications for Spinal Disorders: Part 2, Lumbar Spine Trauma

Affiliations
  • 1Department of Neurosurgery, University of California San Diego School of Medicine, San Diego, CA, USA
  • 2Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
  • 3Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
  • 4Department of Neurosurgery, Mercer University School of Medicine, Savannah, GA, USA
  • 5Department of Neurosurgery, University of California Irvine, Orange, CA, USA
  • 6Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
  • 7Department of Medical Engineering, California Institute of Technology, Pasadena, CA, USA

Abstract


Objective
To study the impact of demographic factors on management of traumatic injury to the lumbar spine and postoperative complication rates.
Methods
Data was obtained from the National Inpatient Sample (NIS) between 2010–2014. International Classification of Diseases, 9th revision, Clinical Modification codes identified patients diagnosed with lumbar fractures or dislocations due to trauma. A series of multivariate regression models determined whether demographic variables predicted rates of complication and revision surgery.
Results
A total of 38,249 patients were identified. Female patients were less likely to receive surgery and to receive a fusion when undergoing surgery, had higher complication rates, and more likely to undergo revision surgery. Medicare and Medicaid patients were less likely to receive surgical management for lumbar spine trauma and less likely to receive a fusion when operated on. Additionally, we found significant differences in surgical management and postoperative complication rates based on race, insurance type, hospital teaching status, and geography.
Conclusion
Substantial differences in the surgical management of traumatic injury to the lumbar spine, including postoperative complications, among individuals of demographic factors such as age, sex, race, primary insurance, hospital teaching status, and geographic region suggest the need for further studies to understand how patient demographics influence management and complications for traumatic injury to the lumbar spine.

Keyword

Lumbar spine trauma; Fusion; Decompression; Trauma; National Inpatient Sample
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