Evidence map›Paper›PMID 30320933›Full record

ArticleNeuromodulation : journal of the International Neuromodulation Society2019

Prevalence and Cost Analysis of Chronic Pain After Hernia Repair: A Potential Alternative Approach With Neurostimulation.

Aladine A Elsamadicy, Bilal Ashraf, Xinru Ren, Amanda R Sergesketter, Lefko Charalambous, Hanna Kemeny, Tiffany Ejikeme, Siyun Yang, Promila Pagadala, Beth Parente and 3 more

Open access · greenAbstract read
In one paragraph

Article in Neuromodulation : journal of the International Neuromodulation Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.2field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 3 institutions in 1 country.

Aladine A ElsamadicyDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Bilal AshrafDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Xinru RenDepartment of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA.
Amanda R SergesketterDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Lefko CharalambousDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Hanna KemenyDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Tiffany EjikemeDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Siyun YangDepartment of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA.
Promila PagadalaDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Beth ParenteDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Jichun XieDepartment of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA.
Theodore N PappasDepartment of Surgery, Duke University Medical Center, Durham, NC, USA.
Shivanand P LadDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Duke Medical Center · USDuke University Hospital · USDuke University · US

Funding

Duke CTSA (Composite)KL2TR001115 · NCATS · DUKE UNIVERSITY · PI BOULWARE, LEIGH E, KRAFT, MONICA · 2013 to 2017
$5.1M
Inter-disciplinary Program for Training and Mentoring in CER Methods and PracticeKM1CA156687 · NCI · DUKE UNIVERSITY · PI ABERNETHY, AMY P., DELONG, ELIZABETH R. · 2010 to 2010
$2.4M
NCATS NIH HHS KL2 TR001115NCI NIH HHS KM1 CA156687NIH HHS 156687
6 · The paper itself

Abstract

objectivesChronic pain (CP) affects a significant number of patients following hernia repair, ranging from 11 to 54% in the literature. The aim of this study was to assess the prevalence, overall costs, and health care utilization associated with CP after hernia repair. MATERIALS AND

methodsA retrospective longitudinal study was performed using the Truven MarketScan® data base to identify patients who develop chronic neuropathic posthernia repair pain from 2001 to 2012. Patients were grouped into CP and No Chronic Pain (No CP) cohorts. Patients were excluded if they 1) were under 18 years of age; 2) had a previous pain diagnosis; 3) had CP diagnosed <90 days after the index hernia repair; 4) had less than one year of follow-up; or 5) had less than one-year baseline record before hernia repair. Patients were grouped into the CP cohort if their CP diagnosis was made within the two years following index hernia repair. Total, outpatient, and pain prescription costs were collected in the period of five years prehernia to nine years posthernia repair. A longitudinal multivariate analysis was used to model the effects of chronic neuropathic posthernia repair pain on total inpatient/outpatient and pain prescription costs.

resultsWe identified 76,173 patients who underwent hernia repair and met inclusion criteria (CP: n = 14,919, No CP: n = 61,254). There was a trend for increased total inpatient/outpatient and pain prescription costs one-year posthernia repair, when compared to baseline costs for both cohorts. In both cohorts, total inpatient/outpatient costs remained elevated from baseline through nine years posthernia repair, with the CP cohort experiencing significantly higher cumulative median costs (CP: $51,334, No CP: $37,388). The CP diagnosis year was associated with a 1.75-fold increase (p < 0.001) in total inpatient/outpatient costs and a 2.26-fold increase (p < 0.001) in pain prescription costs versus all other years. In the longitudinal analysis, the CP cohort had a 1.14-fold increase (p < 0.001) in total inpatient/outpatient costs and 2.00-fold increase (p < 0.001) in pain prescription costs.

conclusionsOur study demonstrates the prevalence of CP after hernia surgery to be nearly 20%, with significantly increased costs and healthcare resource utilization. While current treatment paradigms are effective for many, there remains a large number of patients that could benefit from an overall approach that includes nonopioid treatments, such as potentially incorporating neurostimulation, for CP that presents posthernia repair.

Indexed as

AdultAgedChronic PainCohort StudiesCosts and Cost AnalysisDrug CostsElectric Stimulation TherapyFemaleHerniaHerniorrhaphyHumansLongitudinal StudiesMaleMiddle AgedPatient Acceptance of Health CarePostoperative PainChronic painDRG stimulationhernia repairneuromodulationperipheral nerve stimulationspinal cord stimulation

Identifiers

PMID30320933
PMCPMC6465156
OpenAlexW2896278279

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.