Data from Stanford University Provide New Insights into Reoperation (Predictors of 2-year Reoperation In Medicare Patients Undergoing Primary Thoracolumbar Deformity Surgery)

2020 DEC 23 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- Research findings on Surgery - Reoperation are discussed in a new report. According to news reporting out of Stanford, California, by NewsRx editors, research stated, “This was a retrospective cohort study in which the authors used a nationally representative administrative database. Their goal was to identify the risk factors for reoperation in Medicare patients undergoing primary thoracolumbar adult spinal deformity (ASD) surgery.”

Our news journalists obtained a quote from the research from Stanford University, “Previous literature reports estimate that 20% of patients undergoing thoracolumbar ASD correction undergo revision surgery within 2 years. Most published data discuss risk factors for revision surgery in the general population, but these have not been explored specifically in the Medicare population. Using the MarketScan Medicare Supplemental database, the authors identified patients who were diagnosed with a spinal deformity and underwent ASD surgery between 2007 and 2015. The interactions of patient demographics, surgical factors, and medical factors with revision surgery were investigated during the 2 years following primary ASD surgery. The authors excluded patients without Medicare insurance and those with any prior history of trauma or tumor. Included in the data set were 2564 patients enrolled in Medicare who underwent ASD surgery between 2007 and 2015. The mean age at diagnosis with spinal deformity was 71.5 years. A majority of patients (68.5%) were female. Within 2 years of follow-up, 661 (25.8%) patients underwent reoperation. Preoperative osteoporosis (OR 1.58, p< 0.0001), congestive heart failure (OR 1.35, p = 0.0161), and paraplegia (OR 2.41, p< 0.0001) independently increased odds of revision surgery. The use of intraoperative bone morphogenetic protein was protective against reoperation (OR 0.71, p = 0.0371). Among 90-day postoperative complications, a wound complication was the strongest predictor of undergoing repeat surgery (OR 2.85, p = 0.0061). The development of a pulmonary embolism also increased the odds of repeat surgery (OR 1.84, p = 0.0435). Approximately one-quarter of Medicare patients with ASD who underwent surgery required an additional spinal surgery within 2 years.”

According to the news editors, the research concluded: “Baseline comorbidities such as osteoporosis, congestive heart failure, and paraplegia, as well as short-term complications such as pulmonary embolism and wound complications significantly increased the odds of repeat surgery.”

This research has been peer-reviewed.

For more information on this research see: Predictors of 2-year Reoperation In Medicare Patients Undergoing Primary Thoracolumbar Deformity Surgery. Journal of Neurosurgery: Spine, 2020;33(5):1-5. Journal of Neurosurgery: Spine can be contacted at: Amer Assoc Neurological Surgeons, 5550 Meadowbrook Drive, Rolling Meadows, IL 60008, USA.

Our news journalists report that additional information may be obtained by contacting Kunal Varshneya, Stanford University, School of Medicine, Neurosurg Ai Lab, Stanford, CA 94305, United States. Additional authors for this research include Rayyan T. Jokhai, Parastou Fatemi, Martin N. Stienen, Zachary A. Medress, Allen L. Ho, John K. Ratliff and Anand Veeravagu.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.3171/2020.5.spine191425. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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