Evidence map›Paper›PMID 35141663›Full record

ArticleNorth American Spine Society journal2022

Geographic variations in health care resource utilization following elective ACDF for cervical spondylotic myelopathy: A national trend analysis.

Andrew B Koo, Aladine A Elsamadicy, Margot Sarkozy, Neil Pathak, Wyatt B David, Isaac G Freedman, Benjamin C Reeves, Daniel M Sciubba, Maxwell Laurans, Luis Kolb

Abstract read
In one paragraph

Article in North American Spine Society journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Andrew B KooDepartment of Neurosurgery, Yale University School of Medicine, New Haven, CT, United States.
Aladine A ElsamadicyDepartment of Neurosurgery, Yale University School of Medicine, New Haven, CT, United States.
Margot SarkozyDepartment of Neurosurgery, Yale University School of Medicine, New Haven, CT, United States.
Neil PathakDepartment of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, United States.
Wyatt B DavidDepartment of Neurosurgery, Yale University School of Medicine, New Haven, CT, United States.
Isaac G FreedmanDepartment of Neurosurgery, Yale University School of Medicine, New Haven, CT, United States.
Benjamin C ReevesDepartment of Neurosurgery, Yale University School of Medicine, New Haven, CT, United States.
Daniel M SciubbaDepartment of Neurosurgery, John Hopkins School of Medicine, Baltimore, MD, United States.
Maxwell LauransDepartment of Neurosurgery, Yale University School of Medicine, New Haven, CT, United States.
Luis KolbDepartment of Neurosurgery, Yale University School of Medicine, New Haven, CT, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAs health care expenditures continue to increase, standardizing health care delivery across geographic regions has been identified as a method to reduce costs. However, few studies have demonstrated how the practice of elective spine surgery varies by geographic location. The aim of this study was to assess the geographic variations in management, complications, and total cost of elective anterior cervical discectomy and fusion (ACDF) for cervical spondylotic myelopathy (CSM).

methodsThe National Inpatient Sample database (2016-2017) was queried using the ICD-10-CM procedural and diagnostic coding systems to identify all adult (≥18 years) patients with a primary diagnosis of CSM undergoing an elective ACDF. Patients were divided into regional cohorts as defined by the U.S. Census Bureau: Northeast, Midwest, South, and West. Weighted patient demographics, Elixhauser comorbidities, perioperative complications, length of stay (LOS), discharge disposition, and total cost of admission were assessed.

resultsA total of 17,385 adult patients were identified. While the age (p=0.116) and proportion of female patients (p=0.447) were similar among the cohorts, race (p<0.001) and healthcare coverage (p<0.001) varied significantly. The Northeast had the largest proportion of patients in the 76-100th household income quartile (Northeast: 32.1%; Midwest: 16.9%; South: 15.7%; West: 27.5%, p<0.001). Complication rates were similar between regional cohorts (Northeast: 10.1%; Midwest: 12.2%; South: 10.3%; West: 11.9%, p=0.503), as was LOS (Northeast: 2.2±2.4 days; Midwest: 2.1±2.4 days; South: 2.0±2.5 days; West: 2.1±2.4 days, p=0.678). The West incurred the greatest mean total cost of admission (Northeast: $19,167±10,267; Midwest: $18,903±9,114; South: $18,566±10,152; West: $24,322±15,126, p<0.001). The Northeast had the lowest proportion of patients with a routine discharge (Northeast: 72.0%; Midwest: 84.8%; South: 82.3%; West: 83.3%, p<0.001). The odds ratio for Western hospital region was 3.46 [

conclusionOur study suggests that regional variations exist in elective ACDF for CSM, including patient demographics, hospital costs, and nonroutine discharges, while complication rates and LOS were similar between regions.

Indexed as

Anterior cervical discectomy and fusionCervical spondylotic myelopathyComplicationsGeographic variationsHealthcare expendituresStandardized healthcare delivery

Identifiers

PMID35141663
PMCPMC8819911

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.