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    Outcomes Associated With Infection of Chronic Pain Spinal Implantable Electronic Devices: Insights From a Nationwide Inpatient Sample Study

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    Author
    Goel, Vasudha
    Kumar, Varun
    Agrawal, Shivani N
    Patwardhan, Amol M
    Ibrahim, Mohab
    DeSimone, Daniel C
    Sivanesan, Eellan
    Banik, Ratan K
    Shankar, Hariharan
    Affiliation
    Univ Arizona, Dept Anesthesiol
    Issue Date
    2020-09-14
    Keywords
    Intrathecal pump infections
    Outcomes
    spinal cord stimulator infections
    
    Metadata
    Show full item record
    Publisher
    WILEY
    Citation
    Goel, V., Kumar, V., Agrawal, S. N., Patwardhan, A. M., Ibrahim, M., DeSimone, D. C., ... & Shankar, H. (2020). Outcomes Associated With Infection of Chronic Pain Spinal Implantable Electronic Devices: Insights From a Nationwide Inpatient Sample Study. Neuromodulation: Technology at the Neural Interface.
    Journal
    Neuromodulation: journal of the International Neuromodulation Society
    Rights
    Copyright © 2020 International Neuromodulation Society.
    Collection Information
    This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.
    Abstract
    Objectives Chronic pain spinal implantable electronic devices (CPSIEDs) include devices that provide spinal cord stimulation and intrathecal drug therapy. In this study, we sought to evaluate the trends of CPSIED infections, related complications, and outcomes following the treatment of infection. Materials and Methods The Nationwide Inpatient Sample database contains data from 48 states, and the District of Columbia was used to identify patients with a primary diagnosis of CPSIED infection during the years 2005-2014. Patients with intrathecal pumps for the treatment of spasticity were excluded to limit the study population to patients with chronic pain disorders. Treatments were categorized as: 1) without device removal, 2) pulse generator or pump only removal, 3) intrathecal pump system removal, and 4) spinal cord stimulation system removal. Complications associated with CPSIED infections were identified using administrative billing codes. Results During the study period 2005-2014, a total of 11,041 patients were admitted to the hospital with CPSIED infections. The majority of the patients were treated without surgical intervention (56%), and a smaller proportion underwent complete system explantation (22.7%). In-hospital mortality or permanent disability due to paralysis after CPSIED infection was around 1.83% and 2.77%, respectively. Infectious complications such as meningitis, abscess formation, and osteomyelitis occurred in 4.93%, 5.08%, and 1.5%, respectively. The median cost of hospitalization was around US $14,118.00, and the median length of stay was approximately six days (interquartile range = 4-13 days). Conclusions The complications of CPSIED infection were higher among patients that did not undergo device removal.
    Note
    12 month embargo; first published: 14 September 2020
    ISSN
    1094-7159
    EISSN
    1525-1403
    PubMed ID
    32929856
    DOI
    10.1111/ner.13263
    Version
    Final accepted manuscript
    ae974a485f413a2113503eed53cd6c53
    10.1111/ner.13263
    Scopus Count
    Collections
    UA Faculty Publications

    entitlement

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