Surgical Treatment of Metastatic Spine Disease: An Update on National Trends and Clinical Outcomes from 2010-2014

ABSTRACT Background Context Metastatic spine disease (MSD) is becoming more prevalent as medical treatment for cancers advance and extend survival. More MSD patients are treated surgically to maintain neurological function, ambulation, and quality of life. Purpose The purpose of this study was to use a large, nationally representative database to examine the trends, patient outcomes, and healthcare resource utilization associated with surgical treatment of MSD. Design This was an epidemiologic study using national administrative data from the Nationwide Readmissions Database (NRD). Patient Sample All patients in the NRD from 2010 to 2014 who underwent spinal surgery were included in the study. Outcome Measures Mortality, blood transfusion, complications, length of stay (LOS), cost, and discharge location during index hospitalization as well as hospital readmission and revision surgery within 90-days of surgery were analyzed. Methods International Classification of Diseases, Ninth Revision, (ICD-9) codes were used to identify patients of interest within the NRD from 2010 to 2014. Patients were separated into two cohorts: those with MSD and those without. Trends for surgical treatment of MSD was assessed and outcomes measures for both cohorts were analyzed and compared. Results The number of surgical treatments for MSD increased from 6,007 in 2010 to 7,032 in 2014 (p-trend Conclusions The number of MSD patients who undergo surgical treatments is increasing. Not only do these patients have worse outcomes during index hospitalization, but they are also at an increased risk of hospital readmission for SSI and neurologic complications. These findings stress the need for multidisciplinary perioperative treatment plans that mitigate risks and facilitate quick, effective recovery in these unique, at-risk patients.