Do Postoperative Outcomes of Surgical Treatment for Spinal Metastasis Differ by Institutional Function?: Analysis of a Nationwide Administrative Database in Japan.

IF 1.7 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2025-09-15 DOI:10.1097/BSD.0000000000001885

Kentaro Yamada, Mikayo Toba, Hiroyuki Sato, Satoru Egawa, Shingo Morishita, Yu Matsukura, Takashi Hirai, Akihiro Hirakawa, Atsushi Kudo, Kiyohide Fushimi, Toshitaka Yoshii

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引用次数: 0

Abstract

Study design: Retrospective comparative study.

Objective: To investigate the impact of institutional function (cancer center and surgical volume for spine surgery) on in-hospital outcomes after surgical treatment for spinal metastasis using a nationwide administrative database.

Summary of background data: Multidisciplinary approaches to bone metastasis have become common in Japan, especially in cancer centers. However, whether treatment outcomes for spinal metastasis surgery differ by institutional function remains controversial.

Methods: Data of patients who underwent surgical procedures for spinal metastasis between 2012 and 2020 were extracted from the Diagnosis Procedure Combination database. In-hospital outcomes included in-hospital mortality, 30-day mortality, length of stay until discharge home, postoperative complications, and unfavorable ambulatory status. Univariate and multivariate analyses were performed to investigate the association between cancer center/surgical volume and each outcome while adjusting for potential confounders.

Results: A total of 10,320 patients were included in this study. Among them, 5261 patients were treated at cancer centers. The median annual surgical volume for spine surgery was 166 cases. The 30-day mortality was lower in cancer centers than in noncancer centers [odds ratio (OR): 0.841, 95% CI: 0.709-0.999, P=0.0483] and in high-volume hospitals for spine surgery than in low-volume hospitals (OR per 50 cases: 0.958, 95% CI: 0.928-0.990, P=0.0101). The length of stay until discharge home, postoperative complications, and postoperative unfavorable ambulatory status did not differ by cancer center or surgical volume.

Conclusion: The short-term mortality was lower in cancer centers or high-volume hospitals, whereas postoperative complications and ambulatory outcomes did not differ by institutional function. A deeper understanding of the multidisciplinary approaches or processes of care adopted at these institutions might be important to deliver similar outcomes in other hospitals to patients with spinal metastasis.

Level of evidence: Level III.

查看原文本刊更多论文

脊柱转移手术治疗的术后效果因机构功能而异吗？：日本全国行政数据库分析。

研究设计：回顾性比较研究。目的：利用一个全国性的行政数据库，探讨机构功能（肿瘤中心和脊柱外科手术量）对脊柱转移手术治疗后住院结果的影响。背景资料总结：多学科方法治疗骨转移在日本已经变得普遍，尤其是在癌症中心。然而，脊柱转移手术的治疗结果是否因机构功能而异仍存在争议。方法：从诊断程序组合数据库中提取2012年至2020年接受脊柱转移手术的患者数据。住院结果包括住院死亡率、30天死亡率、出院前住院时间、术后并发症和不利的门诊状况。在调整潜在混杂因素的同时，进行单因素和多因素分析，以调查癌症中心/手术量与每个结果之间的关系。结果：本研究共纳入10320例患者。其中，5261名患者在癌症中心接受了治疗。脊柱外科的年手术量中位数为166例。癌症中心的30天死亡率低于非癌症中心[比值比（OR）： 0.841, 95% CI: 0.709-0.999， P=0.0483]，脊柱外科大医院的30天死亡率低于小医院（OR / 50例：0.958,95% CI: 0.928-0.990， P=0.0101）。出院前的住院时间、术后并发症和术后不利的活动状态没有因癌症中心或手术量而异。结论：癌症中心或大容量医院的短期死亡率较低，而术后并发症和门诊结果没有因机构功能而差异。更深入地了解这些机构采用的多学科方法或护理过程，对于在其他医院为脊柱转移患者提供类似的结果可能很重要。证据等级：三级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.