A large database study of hospitalization charges and follow-up re-admissions in US lumbar fusion surgeries using a cellular bone allograft (CBA) versus recombinant human bone morphogenetic protein-2 (rhBMP-2)

Autor: Kimberly Dorsch, Bradley Wetzell, Mark A. Moore, Venkateswarlu Kondragunta, Julie B. McLean
Rok vydání: 2020
Předmět:
Male
lcsh:Diseases of the musculoskeletal system
Time Factors
Databases
Factual
Economics
ViviGen
Bone Morphogenetic Protein 2
Infuse
0302 clinical medicine
lcsh:Orthopedic surgery
Transforming Growth Factor beta
Bone cell
Orthopedics and Sports Medicine
030212 general & internal medicine
Bone allograft
Bone Transplantation
Lumbar Vertebrae
Confounding
Database study
Health Care Costs
Allografts
Hospital Charges
Recombinant Proteins
Hospitalization
Recombinant human bone morphogenetic protein-2
Health Resources
Female
CBA
Research Article
medicine.medical_specialty
Human bone
Bone morphogenetic protein
Patient Readmission
03 medical and health sciences
Lumbar
medicine
Humans
Retrospective Studies
Cellular bone allograft
business.industry
Patient Acceptance of Health Care
United States
Lumbar fusion
Surgery
lcsh:RD701-811
Spinal Fusion
Orthopedic surgery
lcsh:RC925-935
business
Delivery of Health Care
rhBMP-2
030217 neurology & neurosurgery
Follow-Up Studies
Zdroj: Journal of Orthopaedic Surgery and Research
Journal of Orthopaedic Surgery and Research, Vol 15, Iss 1, Pp 1-13 (2020)
ISSN: 1749-799X
Popis: Background The objective of this study was to retrospectively compare initial procedure and 12-month follow-up hospitalization charges and resource utilization (lengths of stay; LOS) for lumbar fusion surgeries using either recombinant human bone morphogenetic protein-2 (rhBMP-2) or a cellular bone allograft comprised of viable lineage-committed bone cells (V-CBA) via a large US healthcare system database. Potentially relevant re-admissions during the follow-up period were also assessed. Methods A total of 16,172 patients underwent lumbar fusion surgery using V-CBA or rhBMP-2, of whom 3503 (21.66%) patients had follow-up re-admission data. Initial patient, procedure, and hospital characteristics were assessed to determine confounding factors. Multivariate regression modeling compared differences in hospitalization charges (in 2018 US dollars) and LOS (in days) between the groups, as well as incidences of potentially relevant re-admissions during the 12-month follow-up period. Results The adjusted mean initial procedure and 12-month follow-up hospital charges were significantly lower in the V-CBA group versus the rhBMP-2 group ($109,061 and $108,315 versus $160,191 and $130,406, respectively; P < 0.0001 for both comparisons). This disparity remained in an ad hoc comparison of charges for initial single-level treatments only (V-CBA = $103,064, rhBMP-2 = $149,620; P < 0.0001). The adjusted mean initial LOS were significantly lower in the V-CBA group (3.77 days) versus the rhBMP-2 group (3.88 days; P < 0.0001), but significantly higher for the cumulative follow-up hospitalizations in the 12-month follow-up period (7.87 versus 7.46 days, respectively; P < 0.0001). Differences in rates of follow-up re-admissions aligned with comorbidities at the initial procedure. Subsequent lumbar fusion rates were comparable, but significantly lower for V-CBA patients who had undergone single-level treatments only, in spite of V-CBA patients having significantly higher rates of initial comorbidities that could negatively impact clinical outcomes. Conclusions The results of this study indicate that use of V-CBA for lumbar fusion surgeries performed in the US may result in substantially lower overall hospitalization charges versus rhBMP-2, with both exhibiting similar rates of 12-month re-admissions and subsequent lumbar fusion procedures.
Databáze: OpenAIRE
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