Trends in the treatment of lumbar spine fractures in the United States: A socioeconomics perspective - Clinical article

Ali A. Baaj, Katheryne Downes, Alexander R. Vaccaro, Juan S. Uribe, Fernando Vale Diaz

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Object. The objective of this study was to investigate a national health care database and analyze demographics, hospital charges, and treatment trends of patients diagnosed with lumbar spine fractures in the US over a 5-year period. Methods. Clinical data were derived from the Nationwide Inpatient Sample (NIS) for the years 2003 through 2007. The NIS is maintained by the Agency for Healthcare Research and Quality and represents a 20% random stratified sample of all discharges from nonfederal hospitals within the US. Patients with lumbar spine fractures were identified using the appropriate ICD-9-CM code. Data on the number of vertebral body augmentation procedures were also retrieved. National estimates of discharges, hospital charges, discharge patterns, and treatment with spinal fusion trends were retrieved and analyzed. Results. More than 190,000 records of patients with lumbar spine fractures were abstracted from the database. During the 5-year period, there was a 17% increase in hospitalizations for lumbar spine fractures. This was associated with a 27% increase in hospital charges and a 55% increase in total national charges (both adjusted for inflation). The total health care bill associated with lumbar spine fractures in 2007 exceeded 1 billion US dollars. During this same time period, there was a 24% increase in spinal fusions for lumbar fractures, which was associated with a 15% increase in hospital charges. The ratio of spinal fusions to hospitalizations (surgical rate) during this period, however, was stable with an average of 7.4% over the 5-year period. There were an estimated 13,000 vertebral body augmentation procedures for nonpathological fractures performed in 2007 with a total national bill of 450 million US dollars. Conclusions. An increasing trend of hospitalizations, surgical treatment, and charges associated with lumbar spine fractures was observed between 2003 and 2007 on a national level. This trend, however, does not appear to be as steep as that of surgical utilization in degenerative spine disease. Furthermore, the ratio of spinal fusions to hospitalizations for lumbar fractures appears to be stable, possibly indicating no significant changes in indications for surgical intervention over the time period studied.

Original languageEnglish (US)
Pages (from-to)367-370
Number of pages4
JournalJournal of Neurosurgery: Spine
Volume15
Issue number4
DOIs
StatePublished - Oct 1 2011

Fingerprint

Spine
Hospital Charges
Spinal Fusion
Hospitalization
Therapeutics
Inpatients
Databases
Delivery of Health Care
Health Services Research
Economic Inflation
International Classification of Diseases
Demography

Keywords

  • Fracture
  • Lumbar spine
  • Nationwide inpatient sample
  • Outcome
  • Spinal fusion
  • Trauma

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology

Cite this

Trends in the treatment of lumbar spine fractures in the United States : A socioeconomics perspective - Clinical article. / Baaj, Ali A.; Downes, Katheryne; Vaccaro, Alexander R.; Uribe, Juan S.; Vale Diaz, Fernando.

In: Journal of Neurosurgery: Spine, Vol. 15, No. 4, 01.10.2011, p. 367-370.

Research output: Contribution to journalArticle

Baaj, Ali A. ; Downes, Katheryne ; Vaccaro, Alexander R. ; Uribe, Juan S. ; Vale Diaz, Fernando. / Trends in the treatment of lumbar spine fractures in the United States : A socioeconomics perspective - Clinical article. In: Journal of Neurosurgery: Spine. 2011 ; Vol. 15, No. 4. pp. 367-370.
@article{6e7fa17611f149bd9b13f952402cd9da,
title = "Trends in the treatment of lumbar spine fractures in the United States: A socioeconomics perspective - Clinical article",
abstract = "Object. The objective of this study was to investigate a national health care database and analyze demographics, hospital charges, and treatment trends of patients diagnosed with lumbar spine fractures in the US over a 5-year period. Methods. Clinical data were derived from the Nationwide Inpatient Sample (NIS) for the years 2003 through 2007. The NIS is maintained by the Agency for Healthcare Research and Quality and represents a 20{\%} random stratified sample of all discharges from nonfederal hospitals within the US. Patients with lumbar spine fractures were identified using the appropriate ICD-9-CM code. Data on the number of vertebral body augmentation procedures were also retrieved. National estimates of discharges, hospital charges, discharge patterns, and treatment with spinal fusion trends were retrieved and analyzed. Results. More than 190,000 records of patients with lumbar spine fractures were abstracted from the database. During the 5-year period, there was a 17{\%} increase in hospitalizations for lumbar spine fractures. This was associated with a 27{\%} increase in hospital charges and a 55{\%} increase in total national charges (both adjusted for inflation). The total health care bill associated with lumbar spine fractures in 2007 exceeded 1 billion US dollars. During this same time period, there was a 24{\%} increase in spinal fusions for lumbar fractures, which was associated with a 15{\%} increase in hospital charges. The ratio of spinal fusions to hospitalizations (surgical rate) during this period, however, was stable with an average of 7.4{\%} over the 5-year period. There were an estimated 13,000 vertebral body augmentation procedures for nonpathological fractures performed in 2007 with a total national bill of 450 million US dollars. Conclusions. An increasing trend of hospitalizations, surgical treatment, and charges associated with lumbar spine fractures was observed between 2003 and 2007 on a national level. This trend, however, does not appear to be as steep as that of surgical utilization in degenerative spine disease. Furthermore, the ratio of spinal fusions to hospitalizations for lumbar fractures appears to be stable, possibly indicating no significant changes in indications for surgical intervention over the time period studied.",
keywords = "Fracture, Lumbar spine, Nationwide inpatient sample, Outcome, Spinal fusion, Trauma",
author = "Baaj, {Ali A.} and Katheryne Downes and Vaccaro, {Alexander R.} and Uribe, {Juan S.} and {Vale Diaz}, Fernando",
year = "2011",
month = "10",
day = "1",
doi = "10.3171/2011.5.SPINE10934",
language = "English (US)",
volume = "15",
pages = "367--370",
journal = "Journal of Neurosurgery: Spine",
issn = "1547-5654",
publisher = "American Association of Neurological Surgeons",
number = "4",

}

TY - JOUR

T1 - Trends in the treatment of lumbar spine fractures in the United States

T2 - A socioeconomics perspective - Clinical article

AU - Baaj, Ali A.

AU - Downes, Katheryne

AU - Vaccaro, Alexander R.

AU - Uribe, Juan S.

AU - Vale Diaz, Fernando

PY - 2011/10/1

Y1 - 2011/10/1

N2 - Object. The objective of this study was to investigate a national health care database and analyze demographics, hospital charges, and treatment trends of patients diagnosed with lumbar spine fractures in the US over a 5-year period. Methods. Clinical data were derived from the Nationwide Inpatient Sample (NIS) for the years 2003 through 2007. The NIS is maintained by the Agency for Healthcare Research and Quality and represents a 20% random stratified sample of all discharges from nonfederal hospitals within the US. Patients with lumbar spine fractures were identified using the appropriate ICD-9-CM code. Data on the number of vertebral body augmentation procedures were also retrieved. National estimates of discharges, hospital charges, discharge patterns, and treatment with spinal fusion trends were retrieved and analyzed. Results. More than 190,000 records of patients with lumbar spine fractures were abstracted from the database. During the 5-year period, there was a 17% increase in hospitalizations for lumbar spine fractures. This was associated with a 27% increase in hospital charges and a 55% increase in total national charges (both adjusted for inflation). The total health care bill associated with lumbar spine fractures in 2007 exceeded 1 billion US dollars. During this same time period, there was a 24% increase in spinal fusions for lumbar fractures, which was associated with a 15% increase in hospital charges. The ratio of spinal fusions to hospitalizations (surgical rate) during this period, however, was stable with an average of 7.4% over the 5-year period. There were an estimated 13,000 vertebral body augmentation procedures for nonpathological fractures performed in 2007 with a total national bill of 450 million US dollars. Conclusions. An increasing trend of hospitalizations, surgical treatment, and charges associated with lumbar spine fractures was observed between 2003 and 2007 on a national level. This trend, however, does not appear to be as steep as that of surgical utilization in degenerative spine disease. Furthermore, the ratio of spinal fusions to hospitalizations for lumbar fractures appears to be stable, possibly indicating no significant changes in indications for surgical intervention over the time period studied.

AB - Object. The objective of this study was to investigate a national health care database and analyze demographics, hospital charges, and treatment trends of patients diagnosed with lumbar spine fractures in the US over a 5-year period. Methods. Clinical data were derived from the Nationwide Inpatient Sample (NIS) for the years 2003 through 2007. The NIS is maintained by the Agency for Healthcare Research and Quality and represents a 20% random stratified sample of all discharges from nonfederal hospitals within the US. Patients with lumbar spine fractures were identified using the appropriate ICD-9-CM code. Data on the number of vertebral body augmentation procedures were also retrieved. National estimates of discharges, hospital charges, discharge patterns, and treatment with spinal fusion trends were retrieved and analyzed. Results. More than 190,000 records of patients with lumbar spine fractures were abstracted from the database. During the 5-year period, there was a 17% increase in hospitalizations for lumbar spine fractures. This was associated with a 27% increase in hospital charges and a 55% increase in total national charges (both adjusted for inflation). The total health care bill associated with lumbar spine fractures in 2007 exceeded 1 billion US dollars. During this same time period, there was a 24% increase in spinal fusions for lumbar fractures, which was associated with a 15% increase in hospital charges. The ratio of spinal fusions to hospitalizations (surgical rate) during this period, however, was stable with an average of 7.4% over the 5-year period. There were an estimated 13,000 vertebral body augmentation procedures for nonpathological fractures performed in 2007 with a total national bill of 450 million US dollars. Conclusions. An increasing trend of hospitalizations, surgical treatment, and charges associated with lumbar spine fractures was observed between 2003 and 2007 on a national level. This trend, however, does not appear to be as steep as that of surgical utilization in degenerative spine disease. Furthermore, the ratio of spinal fusions to hospitalizations for lumbar fractures appears to be stable, possibly indicating no significant changes in indications for surgical intervention over the time period studied.

KW - Fracture

KW - Lumbar spine

KW - Nationwide inpatient sample

KW - Outcome

KW - Spinal fusion

KW - Trauma

UR - http://www.scopus.com/inward/record.url?scp=80053450476&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80053450476&partnerID=8YFLogxK

U2 - 10.3171/2011.5.SPINE10934

DO - 10.3171/2011.5.SPINE10934

M3 - Article

C2 - 21740124

AN - SCOPUS:80053450476

VL - 15

SP - 367

EP - 370

JO - Journal of Neurosurgery: Spine

JF - Journal of Neurosurgery: Spine

SN - 1547-5654

IS - 4

ER -