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Outcome Measures of Medicare Patients With Diabetes Mellitus Undergoing Thoracolumbar Deformity Surgery

Kunal Varshneya, Anika Bhattacharjya, Jigyasa Sharma, Martin N. Stienen, Zachary A Medress, John K Ratliff & Anand Veeravagu

abstract

STUDY DESIGN
This was a retrospective study.

OBJECTIVE
The objective of this study was to identify the impact of diabetes on postoperative outcomes in Medicare patients undergoing adult spinal deformity (ASD) surgery.

METHODS
We queried the MarketScan Medicare database to identify patients who underwent ASD surgery from 2007 to 2016. Patients were then stratified based on diabetes status at the time of the index operation. Patients not enrolled in the Medicare dataset and those with any prior history of trauma or tumor were excluded from this study.

RESULTS
A total of 2564 patients met the inclusion criteria of this study, of which n=746 (29.1.%) were diabetic. Patients with diabetes had a higher rate of postoperative infection than nondiabetic patients (3.1% vs. 1.7%, P<0.05) within 90 days. Renal complications were also more elevated in the diabetic cohort (3.2% vs. 1.3%, P<0.05). Readmission rates were significantly higher in the diabetes cohort through of 60 days (15.2% vs. 11.8%, P<0.05) and 90 days (17.0% vs. 13.4%, P<0.05). When looking specifically at the outpatient payments, patients with diabetes did have a higher financial burden at 60 days ($8147 vs. $6956, P<0.05) and 90 days ($10,126 vs. $8376, P<0.05).

CONCLUSIONS
In this study, diabetic patients who underwent ASD surgery had elevated rates of postoperative infection, outpatient costs, and rates of readmissions within 90 days. Further research should investigate the role of poor glycemic control on spine surgery outcomes.
   
citation Varshneya K, Bhattacharjya A, Sharma J, Stienen M N, Medress Z A, Ratliff J K, Veeravagu A. Outcome Measures of Medicare Patients With Diabetes Mellitus Undergoing Thoracolumbar Deformity Surgery. Clin Spine Surg 2021;.
   
type journal paper/review (English)
date of publishing 29-06-2021
journal title Clin Spine Surg
ISSN electronic 2380-0194
PubMed 34183547
DOI 10.1097/BSD.0000000000001229