Representativeness of the American Spine Registry: a comparison of patient characteristics with the National Inpatient Sample.

Autor:	Bydon M; 1Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester, Minnesota.; 2Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota., Sardar ZM; Departments of3Orthopedic Surgery and., Michalopoulos GD; 1Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester, Minnesota.; 2Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota., El Sammak S; 1Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester, Minnesota.; 2Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota., Chan AK; 4Neurological Surgery, Columbia University, The Och Spine Hospital at NewYork-Presbyterian, New York, New York., Carreon LY; 5Norton Leatherman Spine Center, Louisville, Kentucky., Norheim E; 6Southern California Permanente Medical Group, Downey, California., Park P; 7Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan., Ratliff JK; 8Department of Neurosurgery, Stanford University School of Medicine, Stanford, California., Tumialán L; 9Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona., Pugely AJ; 10Department of Orthopedic Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa., Steinmetz MP; 11Department of Neurological Surgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio., Hsu W; 12Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Knightly JJ; 13Atlantic Neurosurgical Specialists, Morristown, New Jersey., Ziegenhorn DM; 14American Academy of Orthopaedic Surgeons, Rosemont, Illinois., Donnelly PC; 14American Academy of Orthopaedic Surgeons, Rosemont, Illinois., Mullen KJ; 14American Academy of Orthopaedic Surgeons, Rosemont, Illinois., Rykowsky S; 15NeuroPoint Alliance, Chicago, Illinois., De A; 14American Academy of Orthopaedic Surgeons, Rosemont, Illinois., Potts EA; 16Goodman Campbell Brain and Spine, St. Vincent Health, Indianapolis, Indiana., Coric D; 17Neuroscience Institute, Carolina Neurosurgery & Spine Associates, Carolinas Healthcare System, Charlotte, North Carolina., Wang MY; 18Department of Neurosurgery, University of Miami, Florida., Qureshi S; 19Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York., Sethi RK; 20Neuroscience Institute, Virginia Mason Hospital, Seattle, Washington., Fu KM; 21Department of Neurological Surgery, Weill Cornell Medical Center, New York, New York., Patel AA; 22Department of Orthopaedics, University of Utah, Salt Lake City, Utah., Yoon ST; 23Department of Orthopaedic Surgery, Emory University, Atlanta, Georgia., Brodke D; 22Department of Orthopaedics, University of Utah, Salt Lake City, Utah., Stroink AR; 24Central Illinois Neuro Health Science, Bloomington, Illinois., Bisson EF; 25Department of Neurological Surgery, University of Utah, Salt Lake City, Utah., Haid RW; 26Atlanta Brain and Spine Care, Atlanta, Georgia., Asher AL; 17Neuroscience Institute, Carolina Neurosurgery & Spine Associates, Carolinas Healthcare System, Charlotte, North Carolina., Burton D; 27Department of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, Kansas; and., Mummaneni PV; 28Department of Neurological Surgery, University of California, San Francisco, California., Glassman SD; 5Norton Leatherman Spine Center, Louisville, Kentucky.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Spine [J Neurosurg Spine] 2023 May 05; Vol. 39 (2), pp. 228-237. Date of Electronic Publication: 2023 May 05 (Print Publication: 2023).
DOI:	10.3171/2023.3.SPINE221264
Abstrakt:	Objective: The American Spine Registry (ASR) is a collaborative effort between the American Academy of Orthopaedic Surgeons and the American Association of Neurological Surgeons. The goal of this study was to evaluate how representative the ASR is of the national practice with spinal procedures, as recorded in the National Inpatient Sample (NIS). Methods: The authors queried the NIS and the ASR for cervical and lumbar arthrodesis cases performed during 2017-2019. International Classification of Diseases, 10th Revision and Current Procedural Terminology codes were used to identify patients undergoing cervical and lumbar procedures. The two groups were compared for the overall proportion of cervical and lumbar procedures, age distribution, sex, surgical approach features, race, and hospital volume. Outcomes available in the ASR, such as patient-reported outcomes and reoperations, were not analyzed due to nonavailability in the NIS. The representativeness of the ASR compared to the NIS was assessed via Cohen's d effect sizes, and absolute standardized mean differences (SMDs) of < 0.2 were considered trivial, whereas > 0.5 were considered moderately large. Results: A total of 24,800 arthrodesis procedures were identified in the ASR for the period between January 1, 2017, and December 31, 2019. During the same time period, 1,305,360 cases were recorded in the NIS. Cervical fusions comprised 35.9% of the ASR cohort (8911 cases) and 36.0% of the NIS cohort (469,287 cases). The two databases presented trivial differences in terms of patient age and sex for all years of interest across both cervical and lumbar arthrodeses (SMD < 0.2). Trivial differences were also noted in the distribution of open versus percutaneous procedures of the cervical and lumbar spine (SMD < 0.2). Among lumbar cases, anterior approaches were more common in the ASR than in the NIS (32.1% vs 22.3%, SMD = 0.22), but the discrepancy among cervical cases in the two databases was trivial (SMD = 0.03). Small differences were illustrated in terms of race, with SMDs < 0.5, and a more significant discrepancy was identified in the geographic distribution of participating sites (SMDs of 0.7 and 0.74 for cervical and lumbar cases, respectively). For both of these measures, SMDs in 2019 were smaller than those in 2018 and 2017. Conclusions: The ASR and NIS databases presented a very high similarity in proportions of cervical and lumbar spine surgeries, as well as similar distributions of age and sex, and distribution of open versus endoscopic approach. Slight discrepancies in anterior versus posterior approach among lumbar cases and patient race, and more significant discrepancies in geographic representation were also identified, yet decreasing trends in differences suggested the improving representativeness of the ASR over the course of time and its progressive growth. These conclusions are important to underline the external validity of quality investigations and research conclusions to be drawn from analyses in which the ASR is used.
Databáze:	MEDLINE
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