Time trends in spine surgery in Italy: a nationwide, population-based study of 1,560,969 records of administrative health data from 2001 to 2019.

IF 2.5 2区 医学 Q1 ORTHOPEDICS
Marina Torre, Andrea Piazzolla, Enrico Ciminello, Tiziana Falcone, Eugenio Carrani, Simona Pascucci, Michela Franzò, Giuseppe Barbagallo, Vincenzo Vitiello, Gustavo Zanoli, Alessia Biondi, Letizia Sampaolo, Veronica Mari, Francesco Langella, Pedro Berjano
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引用次数: 0

Abstract

Background and purpose:  The use of spinal implants has increased substantially. Their widespread use raises public health concerns. We aimed to study spinal surgery trends in Italy from 2001 to 2019 and present a mapping for ICD9-CM codes potentially related to spinal diagnoses and procedures.

Methods:  ICD9-CM codes of interest were selected and mapped to clinically meaningful spinal diagnostic categories and procedure classes. The Italian National Hospital Discharge Records database was then browsed according to these codes. Surgical volumes and trends were described. Population incidence rates (IR) were estimated and provided with 95% confidence intervals (CI). Variations in IRs were reported in terms of incidence rate ratio. The statistical significance of counts and IR time series trends was assessed by using the Cox-Stuart test.

Results:  1,560,969 spinal procedures were extracted from 209,818,966 admissions registered nationally. The annual number of spinal procedures increased significantly by 67%, from 58,369 in 2001 to 97,636 in 2019 (P < 0.002). 1,040,326 (67%) procedures did not include implants, while 590,643 (33%) used implants, 395,450 (25%) associated with fusions and 125,193 (8%) with non-fusions. Population IRs increased from 100.9 (CI 100.1-101.7) to 163.2 (CI 162.2-164.3) episodes per 100,000 inhabitants. Surgical volumes for non-implant-related procedures remained stable, while implant-related procedures increased significantly, by 420% over the 19 observed years (P = 0.002).

Conclusion: Spinal surgical procedures and their population incidence rates increased significantly. Fusions and other implant-related procedures increased substantially for most diagnostic categories. An ICD9-CM mapping for spinal diagnoses and procedures as a reproducible tool for further explorations was presented.

意大利脊柱手术的时间趋势:一项基于人口的全国性研究,对2001年至2019年的1,560,969份行政卫生数据记录进行了研究。
背景和目的:脊柱植入物的使用已大大增加。它们的广泛使用引起了公众对健康的担忧。我们旨在研究2001年至2019年意大利脊柱手术的趋势,并绘制可能与脊柱诊断和手术相关的ICD9-CM代码的图谱。方法:选择感兴趣的ICD9-CM代码并将其映射到临床有意义的脊柱诊断类别和手术类别。然后根据这些代码浏览意大利国家医院出院记录数据库。描述了手术量和趋势。估计人群发病率(IR)并提供95%置信区间(CI)。根据发病率比报告了ir的变化。采用Cox-Stuart检验评估计数和IR时间序列趋势的统计学意义。结果:从全国登记的209,818,966例住院患者中提取了1,560,969例脊柱手术。脊柱手术的年数量显著增加了67%,从2001年的58,369例增加到2019年的97,636例(P < 0.002)。1,040,326例(67%)手术不包括种植体,590,643例(33%)使用种植体,395,450例(25%)与融合相关,125,193例(8%)与非融合相关。人口ir从每10万居民100.9例(CI 100.1-101.7)增加到163.2例(CI 162.2-164.3)。非种植体相关手术的手术量保持稳定,而种植体相关手术的数量显著增加,在19年的观察中增加了420% (P = 0.002)。结论:脊柱外科手术及其人群发病率明显增高。在大多数诊断类别中,融合和其他与植入物相关的手术大幅增加。提出了一种用于脊柱诊断和程序的ICD9-CM映射,作为进一步探索的可重复工具。
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来源期刊
Acta Orthopaedica
Acta Orthopaedica 医学-整形外科
CiteScore
6.40
自引率
8.10%
发文量
105
审稿时长
4-8 weeks
期刊介绍: Acta Orthopaedica (previously Acta Orthopaedica Scandinavica) presents original articles of basic research interest, as well as clinical studies in the field of orthopedics and related sub disciplines. Ever since the journal was founded in 1930, by a group of Scandinavian orthopedic surgeons, the journal has been published for an international audience. Acta Orthopaedica is owned by the Nordic Orthopaedic Federation and is the official publication of this federation.
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