Introduction: Randomized controlled studies have shown Deep Brain Stimulation (DBS) to be an effective treatment for Parkinson’s Disease (PD). Outside of large center studies, little is known about trends in DBS use in the US. This study examines utilization patterns, patient characteristics, and in hospital complications from 2000 to 2007 using the Nationwide Inpatient Sample (NIS).
Methods: We identified all individuals in NIS with PD (332.0) and Essential Tremor (333.1) who underwent DBS (02.93) from 2000 to 2007. We examined age, gender, region of country, teaching status of the hospital, and Elixhauser index for comorbidities. In hospital systemic and technical complications were examined. DBS patients from 2000 and 2007 were compared using Chi Square Analysis.
Results: Patients undergoing DBS for PD were significantly older in 2007 (p=0.01). Both ET and PD patients in 2007 also had significantly more comorbidities (p<0.001). In-hospital complications decreased from 3.8 to 2.8%. DBS was performed in medium or high volume centers in 71% of cases in 2000 and 51% of cases in 2007. 89% of cases were performed in teaching hospitals in 2000 v. 75% in 2007. In both samples, 73% of cases were performed in the western and the southern regions of the US.
Conclusions: From 2000 to 2007, patients undergoing DBS were older and had more comorbidities; technical and systemic complications related directly to surgery remained low. As capabilities of administrative databases improve in the future, we will hopefully be able to ascertain how well these patients fare in the long-term.
Patient Care: These data provide insight into which patients are being offered DBS throughout the US and demonstrate a low complication rate as the procedure is being offered in older patients with co-morbidities.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) describe the trends in DBS utilization, 2) discuss patients who are currently being offered DBS surgery, and 3) understand how and where DBS is being implemented.