Muhammad Umar Jawad, Haroon M Kisana, Victoria N Greenstein, Donnell B McDonald, Norman B Chutkan
{"title":"颈椎前路手术资源利用的差异：NSQIP® 和 PearlDiver® 数据库分析。","authors":"Muhammad Umar Jawad, Haroon M Kisana, Victoria N Greenstein, Donnell B McDonald, Norman B Chutkan","doi":"10.1016/j.spinee.2025.01.017","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Widespread racial, gender-related, socioeconomic and insurance-related disparities have been widely implicated in the utilization of new and improved surgical techniques including various aspects spinal surgery. A comprehensive analysis of such disparities is lacking for motion-preserving techniques in cervical spine surgery.</p><p><strong>Purpose: </strong>To explore the disparities in resource utilization of motion-sparing technology in cervical spine surgery.</p><p><strong>Study design/ setting: </strong>Retrospective review of large database PATIENT SAMPLE: NSQIP® database from 2010 to 2021 and PearlDiver® database from 2010 to 2022 were queried. CPT codes for cervical disc arthroplasty (CDA), and anterior cervical discectomy and fusion (ACDF) were utilized to isolate the case records (Table 1 and 3).</p><p><strong>Outcome measures: </strong>Preoperative clinical, racial, and gender data were investigated utilizing NSQIP®. PearlDiver® was used for area-level family income, education, insurance status and unemployment.</p><p><strong>Methods: </strong>Chi-square, Kruskal-Wallis and logistic regression were used for univariable categorical, continuous and multivariable analyses, respectively.</p><p><strong>Results: </strong>A total of 5,912 and 32,625 CDA cases and 69,701 and 526,851 ACDF cases were isolated from NSQIP® and PearlDiver®, respectively. 'Younger' age, 'Asian Pacific Islander' race and elective surgery (p<.001), were associated with undergoing CDA in NSQIP® database. Presence of Type 1 diabetes, smoking and hypertension (HTN) (p<.001) were associated with undergoing ACDF in NSQIP®. PearlDiver® database showed 'Younger' age, higher area-level 'Family Income', and a higher mean percent of patients with 'private health insurance' (p<.001) were associated with undergoing CDA. Higher area level unemployment was associated with ACDF.</p><p><strong>Conclusion: </strong>Wide spread racial, gender-related, and socioeconomic disparities have been observed. Identification of these disparities is sentinel for implication of change in health-care policy mitigating issues such as underinsurance leading to establishment of health equity.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Disparity in resource utilization of motion-sparing anterior cervical spine surgery: an analysis of NSQIP® and PearlDiver® database.\",\"authors\":\"Muhammad Umar Jawad, Haroon M Kisana, Victoria N Greenstein, Donnell B McDonald, Norman B Chutkan\",\"doi\":\"10.1016/j.spinee.2025.01.017\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Widespread racial, gender-related, socioeconomic and insurance-related disparities have been widely implicated in the utilization of new and improved surgical techniques including various aspects spinal surgery. A comprehensive analysis of such disparities is lacking for motion-preserving techniques in cervical spine surgery.</p><p><strong>Purpose: </strong>To explore the disparities in resource utilization of motion-sparing technology in cervical spine surgery.</p><p><strong>Study design/ setting: </strong>Retrospective review of large database PATIENT SAMPLE: NSQIP® database from 2010 to 2021 and PearlDiver® database from 2010 to 2022 were queried. CPT codes for cervical disc arthroplasty (CDA), and anterior cervical discectomy and fusion (ACDF) were utilized to isolate the case records (Table 1 and 3).</p><p><strong>Outcome measures: </strong>Preoperative clinical, racial, and gender data were investigated utilizing NSQIP®. PearlDiver® was used for area-level family income, education, insurance status and unemployment.</p><p><strong>Methods: </strong>Chi-square, Kruskal-Wallis and logistic regression were used for univariable categorical, continuous and multivariable analyses, respectively.</p><p><strong>Results: </strong>A total of 5,912 and 32,625 CDA cases and 69,701 and 526,851 ACDF cases were isolated from NSQIP® and PearlDiver®, respectively. 'Younger' age, 'Asian Pacific Islander' race and elective surgery (p<.001), were associated with undergoing CDA in NSQIP® database. Presence of Type 1 diabetes, smoking and hypertension (HTN) (p<.001) were associated with undergoing ACDF in NSQIP®. PearlDiver® database showed 'Younger' age, higher area-level 'Family Income', and a higher mean percent of patients with 'private health insurance' (p<.001) were associated with undergoing CDA. Higher area level unemployment was associated with ACDF.</p><p><strong>Conclusion: </strong>Wide spread racial, gender-related, and socioeconomic disparities have been observed. Identification of these disparities is sentinel for implication of change in health-care policy mitigating issues such as underinsurance leading to establishment of health equity.</p>\",\"PeriodicalId\":49484,\"journal\":{\"name\":\"Spine Journal\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.9000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Spine Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.spinee.2025.01.017\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.spinee.2025.01.017","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Disparity in resource utilization of motion-sparing anterior cervical spine surgery: an analysis of NSQIP® and PearlDiver® database.
Background: Widespread racial, gender-related, socioeconomic and insurance-related disparities have been widely implicated in the utilization of new and improved surgical techniques including various aspects spinal surgery. A comprehensive analysis of such disparities is lacking for motion-preserving techniques in cervical spine surgery.
Purpose: To explore the disparities in resource utilization of motion-sparing technology in cervical spine surgery.
Study design/ setting: Retrospective review of large database PATIENT SAMPLE: NSQIP® database from 2010 to 2021 and PearlDiver® database from 2010 to 2022 were queried. CPT codes for cervical disc arthroplasty (CDA), and anterior cervical discectomy and fusion (ACDF) were utilized to isolate the case records (Table 1 and 3).
Outcome measures: Preoperative clinical, racial, and gender data were investigated utilizing NSQIP®. PearlDiver® was used for area-level family income, education, insurance status and unemployment.
Methods: Chi-square, Kruskal-Wallis and logistic regression were used for univariable categorical, continuous and multivariable analyses, respectively.
Results: A total of 5,912 and 32,625 CDA cases and 69,701 and 526,851 ACDF cases were isolated from NSQIP® and PearlDiver®, respectively. 'Younger' age, 'Asian Pacific Islander' race and elective surgery (p<.001), were associated with undergoing CDA in NSQIP® database. Presence of Type 1 diabetes, smoking and hypertension (HTN) (p<.001) were associated with undergoing ACDF in NSQIP®. PearlDiver® database showed 'Younger' age, higher area-level 'Family Income', and a higher mean percent of patients with 'private health insurance' (p<.001) were associated with undergoing CDA. Higher area level unemployment was associated with ACDF.
Conclusion: Wide spread racial, gender-related, and socioeconomic disparities have been observed. Identification of these disparities is sentinel for implication of change in health-care policy mitigating issues such as underinsurance leading to establishment of health equity.
期刊介绍：
The Spine Journal, the official journal of the North American Spine Society, is an international and multidisciplinary journal that publishes original, peer-reviewed articles on research and treatment related to the spine and spine care, including basic science and clinical investigations. It is a condition of publication that manuscripts submitted to The Spine Journal have not been published, and will not be simultaneously submitted or published elsewhere. The Spine Journal also publishes major reviews of specific topics by acknowledged authorities, technical notes, teaching editorials, and other special features, Letters to the Editor-in-Chief are encouraged.
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