Burden of Sciatica on US Medicare Recipients
| Autor: | Joseph P. Maslak, Daneel M. Patoli, Michael H. McCarthy, Alpesh A. Patel, Tyler J. Jenkins, Wellington K. Hsu, Abhishek Kannan, Joseph A. Weiner |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Medicare Advantage Medicare Cohort Studies Sciatica 03 medical and health sciences symbols.namesake 0302 clinical medicine Cost of Illness Quality of life Prevalence Humans Medicine Orthopedics and Sports Medicine Patient Reported Outcome Measures Fisher's exact test Disease burden Aged Aged 80 and over 030222 orthopedics business.industry Incidence (epidemiology) 030229 sport sciences Evidence-based medicine United States Cohort Quality of Life symbols Physical therapy Female Surgery medicine.symptom business Follow-Up Studies |
| Zdroj: | Journal of the American Academy of Orthopaedic Surgeons. 28:e433-e439 |
| ISSN: | 1067-151X |
| DOI: | 10.5435/jaaos-d-19-00174 |
| Popis: | OBJECTIVE This study evaluates the disease burden of sciatica on the US Medicare cohort. BACKGROUND DATA Sciatica is a common disability that has important physical, mental, and economic effects. The Medicare Health Outcomes Survey (HOS) is a demographic and outcomes survey used to monitor the performance of Medicare Advantage health plans in the United States. The HOS includes data on demographics, chronic medical conditions, and patient-reported outcomes. METHODS Medicare HOS data for cohorts from 2007 to 2013 were obtained. Patients were placed into two categories based on the survey results: with or without a history of sciatica. Baseline demographics, chronic medical conditions, and physical health symptoms were aggregated. In addition, average VR-12 physical component summary and mental component summary scores were calculated for each group at baseline and at 2-year follow-up. A Fisher exact test was used to assess significance for categorical variables, and a t-test was used for continuous variables. VR-12 changes as small as 1 to 2 units have been found to be clinically and socially relevant. RESULTS The baseline cohort data of 1,000,952 patients yielded 250,869 patients (25%) who reported the diagnosis of sciatica, compared with 750,083 patients (75%) without sciatica. Patients with a history of sciatica tended to be younger, less educated, and notably with more medical comorbidities. Physical component summary outcomes were approximately 8 units lower in the sciatica group at baseline and 7 units lower at 2-year follow-up. Mental component summary outcomes were 6 units lower in the sciatica group at baseline and 5 units lower at 2-year follow-up. CONCLUSION A large percentage of the US Medicare cohort suffers from symptomatic sciatica. Our study identified a 25% prevalence in the Medicare cohort. In addition, sciatica is associated with an increased incidence of comorbid medical conditions and poor health-related quality of life. LEVEL OF EVIDENCE Level III STUDY DESIGN:: Observational-Cohort Study. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|