TY - JOUR
T1 - Differences in Health Care Resource Utilization After Surgery for Metastatic Spinal Column Tumors in Patients with a Concurrent Affective Disorder in the United States
AU - Elsamadicy, Aladine A.
AU - Koo, Andrew B.
AU - Sarkozy, Margot
AU - Reeves, Benjamin C.
AU - Pennington, Zach
AU - Havlik, John
AU - Sandhu, Mani R.
AU - Hersh, Andrew
AU - Patel, Saarang
AU - Kolb, Luis
AU - Larry Lo, Sheng Fu
AU - Shin, John H.
AU - Mendel, Ehud
AU - Sciubba, Daniel M.
N1 - Funding Information:
Conflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/5
Y1 - 2022/5
N2 - Background: Affective disorders, such as depression and anxiety, are exceedingly common among patients with metastatic cancer. The aim of this study was to investigate the relationship between affective disorders and health care resource utilization in patients undergoing surgery for a spinal column metastasis. Methods: A retrospective cohort study was performed using the 2016–2018 National Inpatient Sample database. All adult patients (≥18 years) undergoing surgery for a metastatic spinal tumor were identified using the International Classification of Diseases, Tenth Revision, Clinical Modification coding systems. Patients were categorized into 2 cohorts: no affective disorder (No-AD) and affective disorder (AD). Patient demographics, comorbidities, hospital characteristics, intraoperative variables, postoperative adverse events (AEs), length of stay (LOS), discharge disposition, and total cost of hospital admission were assessed. A multivariate logistic regression analysis was used to identify independent predictors of increased cost, nonroutine discharge, and prolonged LOS. Results: Of the 8360 patients identified, 1710 (20.5%) had a diagnosis of AD. Although no difference was observed in the rates of postoperative AEs between the cohorts (P = 0.912), the AD cohort had a significantly longer mean LOS (No-AD, 10.1 ± 8.3 days vs. AD, 11.6 ± 9.8 days; P = 0.012) and greater total cost (No-AD, $53,165 ± 35,512 vs. AD, $59,282 ± 36,917; P = 0.011). No significant differences in nonroutine discharge were observed between the cohorts (P = 0.265). On multivariate regression analysis, having an affective disorder was a significant predictor of increased costs (odds ratio, 1.45; confidence interval, 1.03–2.05; P = 0.034) and nonroutine discharge (odds ratio, 1.40; confidence interval, 1.06–1.85; P = 0.017), but not prolonged LOS (P = 0.067). Conclusions: Our study found that affective disorders were significantly associated with greater hospital expenditures and nonroutine discharge, but not prolonged LOS, for patients undergoing surgery for spinal metastases.
AB - Background: Affective disorders, such as depression and anxiety, are exceedingly common among patients with metastatic cancer. The aim of this study was to investigate the relationship between affective disorders and health care resource utilization in patients undergoing surgery for a spinal column metastasis. Methods: A retrospective cohort study was performed using the 2016–2018 National Inpatient Sample database. All adult patients (≥18 years) undergoing surgery for a metastatic spinal tumor were identified using the International Classification of Diseases, Tenth Revision, Clinical Modification coding systems. Patients were categorized into 2 cohorts: no affective disorder (No-AD) and affective disorder (AD). Patient demographics, comorbidities, hospital characteristics, intraoperative variables, postoperative adverse events (AEs), length of stay (LOS), discharge disposition, and total cost of hospital admission were assessed. A multivariate logistic regression analysis was used to identify independent predictors of increased cost, nonroutine discharge, and prolonged LOS. Results: Of the 8360 patients identified, 1710 (20.5%) had a diagnosis of AD. Although no difference was observed in the rates of postoperative AEs between the cohorts (P = 0.912), the AD cohort had a significantly longer mean LOS (No-AD, 10.1 ± 8.3 days vs. AD, 11.6 ± 9.8 days; P = 0.012) and greater total cost (No-AD, $53,165 ± 35,512 vs. AD, $59,282 ± 36,917; P = 0.011). No significant differences in nonroutine discharge were observed between the cohorts (P = 0.265). On multivariate regression analysis, having an affective disorder was a significant predictor of increased costs (odds ratio, 1.45; confidence interval, 1.03–2.05; P = 0.034) and nonroutine discharge (odds ratio, 1.40; confidence interval, 1.06–1.85; P = 0.017), but not prolonged LOS (P = 0.067). Conclusions: Our study found that affective disorders were significantly associated with greater hospital expenditures and nonroutine discharge, but not prolonged LOS, for patients undergoing surgery for spinal metastases.
KW - Affective disorders
KW - Health care resource utilization
KW - Spinal column metastases
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U2 - 10.1016/j.wneu.2022.01.112
DO - 10.1016/j.wneu.2022.01.112
M3 - Article
C2 - 35123021
AN - SCOPUS:85125659313
SN - 1878-8750
VL - 161
SP - e252-e267
JO - World Neurosurgery
JF - World Neurosurgery
ER -