Introduction: Metastatic spine tumors constitute a significant source of morbidity and mortality in the US. We created a database of patients who underwent surgery for metastatic spine tumors at our institution from 2004 to 2011. The aim of this database is to elucidate the healthcare burden of this disease entity in our population and to analyze patient outcomes.
Methods: Data were abstracted using the Datamart Casemix database maintained by our institution, and operative cases with the appropriate ICD-9 code were cross-referenced with electronic patient records (EPR). Patient demographics, complications and co-morbidities were also compiled.
Results: Between 2004 and 2011, a total of 236 patients (133 male, 103 female) presented with spinal metastases, and underwent 327 surgeries performed by 18 surgeons. The cohort consists of 166 white, 51 black, 4 Hispanic, 7 Asian, and 8 other races. The average age of a patient at surgery was 56.17 years (range-16-89 years), and the average hospital stay was 11.5 days. At the present time, 52 patients have been reported as deceased on EPR (22%). The most common primary in our cohort was Lung (36) followed by Breast (31), Head and Neck (25), Renal Cell (22), Multiple Myeloma (22), Prostate (18), Colorectal (14), other GI/abdominal (20), Sarcoma (15), Hemato-oncological (10), Melanoma (7), Pheochromocytoma (4), Male reproductive organ (4), Unknown primary (4), and Gynecological (4). Lung cancer patients had the shortest life span after surgery (12 weeks) and pheochromocytoma the longest (182 weeks), with an overall lifespan of 40.5 weeks for the whole cohort.
Conclusions: Analyzing trends in disease entities in the local population using hospital based databases might help define disease epidemiology better. Understanding the factors that predict patient outcomes would help healthcare providers to tailor management plans that optimize patient survival and comfort while at the same time making judicious use of healthcare resources.
Patient Care: Measurement of trends in clinical practice using local hospital databases helps define what works, what doesn't, and what can be done to fix issues that are unearthed in the process.
Learning Objectives: By the conclusion of this session, participants should be able to:
1) Understand how hospital databases can help physicians improve their practice.
2) Describe the importance of analyzing data retrospectively in order to make plans prospectively.