Abstract:
BACKGROUND:Vertebral augmentation (VA) performed on inpatients with painful osteoporotic vertebral compression fractures (VCFs) has been shown to facilitate discharge, decrease analgesic requirements, and improve pain. OBJECTIVE:The purpose of our study was to compare the overall cost, length of stay, and readmission data for patients hospitalized with painful osteoporotic VCFs, treated either medically or with inpatient VA. SETTING:A single academic medical center. STUDY DESIGN:Economic analysis METHODS:Patients admitted with VCF over a 30-month period were identified using ICD-9 codes. The total length of stay, hospitalization costs, average daily cost, and 30-day readmission rates were compared between those who underwent VA and those managed nonoperatively. A subgroup analysis was performed with an age matched group of controls as well. Two-tailed t-tests were used for statistical significance. RESULTS:Thirty-nine inpatients underwent VA; 61 levels were augmented. Their average age was 81.7 years. There were 209 patients who were treated nonoperatively for VCF. Their average age was 72.7 years, a significant age difference from the VA group (P < 0.01). The VA patients' average length of stay was 13.8 days, compared to 8.1 days in the medically managed group (P < 0.01). Average total costs were $26,074 in the VA group and $15,507 in the medically managed group (P < 0.01). The daily costs of admission were $2,040 in the VA group and $2,069 in the medically managed group (P = 0.85). The readmission rates related to VCF were 0% in the VA group; 5.2% in the medically managed group; and 7.7% in the age-matched control group. Of those who underwent VA, 43% experienced delays in care related to anticoagulation or medical comorbidities. LIMITATIONS:The study is retrospective and uses billing data as a marker for total cost of care, The study does not account for cost differences between vertebroplasty and kyphoplasty. CONCLUSION:Inpatient VA can be cost effective as demonstrated by the same daily cost between the VA and medically managed groups. Early identification and consultation can facilitate VA and rapid discharge. Anticoagulation issues and medical comorbidities can delay VA and lengthen hospital stays. Hospital admitted patients with painful osteoporotic VCF who are managed conservatively and discharged are at risk for readmission.
journal_name
Pain Physicianjournal_title
Pain physicianauthors
Flug J,Hanford A,Ortiz Osubject
Has Abstractpub_date
2013-09-01 00:00:00pages
441-5issue
5eissn
1533-3159issn
2150-1149journal_volume
16pub_type
杂志文章相关文献
Pain Physician文献大全abstract::Postlumbar laminectomy syndrome, or pain following operative procedures of the lumbar spine, is increasingly a common entity in modern medicine. Multiple causes proposed for recurrence of pain after lumbar laminectomy are: epidural fibrosis, recurrent disc herniation, instability, and facet joints. Even though the pre...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2001-04-01 00:00:00
abstract::Over the past 2 decades, the issue of fetal pain and stress has attracted considerable attention and has become the focus of ongoing debate in light of advances in medical diagnostics and technology that allow invasive prenatal medical intervention(s), and an enhanced understanding of fetal neurophysiology, together w...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:Patients suffering from osteoarthritis of the knee and patients post total knee arthroplasty often develop refractory, disabling chronic knee pain. Radiofrequency ablation, including conventional, pulsed, and cooled, has recently become more accepted as an interventional technique to manage chronic knee pain...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2017-03-01 00:00:00
abstract::Vertebroplasty and kyphoplasty are relatively new techniques used to treat painful vertebral compression fractures (VCFs). Vertebroplasty is the injection of a vertebral body with bone cement, generally polymethylmethacrylate (PMMA). Kyphoplasty is the placement of balloons (called "tamps") into the vertebral body wit...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Abuse of prescribed controlled substance has become a serious social as well as health care issue over the past decade. A particularly alarming trend exists among patients aged 12 to 17. Common abuse behaviors include doctor shopping, drug theft, feigned pain symptoms to gain health care access, drug sharing...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2009-05-01 00:00:00
abstract::Chronic low back pain secondary to involvement of the facet joints is a common problem. Facet joints have been recognized as potential sources of back pain since 1911. Multiple authors have described distributions of pain patterns of facet joint pain. The facet joints are paired diarthrodial articulations between the ...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Chronic low back pain (CLBP) incurs huge costs owing to increased healthcare expenditure, disability, insurance, and work absenteeism. Opioid analgesics are commonly used for the management of CLBP. OBJECTIVE:To compare and rank the opioids used in the management of CLBP, in terms of efficacy and safety. S...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2021-01-01 00:00:00
abstract::We introduce a new way to engage the patient with chronic pain, Goal-Directed Health Care (G-DHC). Identifying the patient's major life goals during the medical interview is the key element of this approach along with connecting these life goals to specific health-related goals. The implementation of G-DHC is a shift ...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:Evidence of a paradigm shift towards epicranial neurostimulation treatment techniques aimed at the site of headache pain is beginning to populate the literature. This is most apparent by 2 recently published reports describing alternative approaches to peripheral nerve stimulation techniques for refractory m...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Throughout the COVID-19 pandemic, clinicians have had to think quickly, adapt to changing recommendations sometimes on a daily basis, and have often had to rely on trial-and-error-based treatment protocols under various conditions. As we move on past the apex of the COVID-19 curve, new treatment protocols fo...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Varicella-zoster virus, a member of the herpes virus family, is a neurotrophic virus that primarily affects afferent sensory neurons. Reactivation of latent virus within the dorsal root ganglion and axoplasmic transport to epithelial nerve terminals causes the segmental cutaneous rash and neuralgic pain char...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:Interactions between the sympathetic and somatic nervous system play an essential role in the pathophysiologic mechanisms of neuropathic pain. The α2-adrenoceptor agonists produce effective antinociception, but sedation is an important adverse effect. Multidrug therapy is potentially valuable to decrease sid...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2014-03-01 00:00:00
abstract::Calcineurin may be involved in affecting nociceptive processes in multiple circumstances. It is conceivable that interfering with calcineurin's normal role in contributing to glial resting membrane potential, via its effects on the ion channel (TRESK) [tandem-pore-domain weakly inward rectifying potassium channels (TW...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:The symptom severity of back pain/leg pain is not correlated with the severity of degenerative changes and canal stenosis in lumbar stenosis. Considering the individual pain sensitivity might play an important role in pain perception, this discordance between the radiologic findings and clinical symptoms in ...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2013-03-01 00:00:00
abstract::Appropriate diagnosis is essential in providing proper and effective therapy. The field of diagnostic accuracy tests is dynamic with new tests being developed at a fast pace along with improvement in technology of existing tests on a continuous basis. Well-designed diagnostic test accuracy studies can help in making a...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2009-11-01 00:00:00
abstract::Propofol is a common induction agent that is utilized worldwide in the field of anesthesiology. In recent years, its potential therapeutic role in a variety of patient states has been demonstrated. Controversy exists regarding Propofol mediated analgesic and antihyperalgesic properties. Recent studies have suggested a...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:The facet joints contribute to chronic cervical spine pain in an estimated 55% of chronic neck pain cases and can be treated with percutaneous radiofrequency neurotomy (PRN). Damage to surrounding structures during treatment or successful treatment of the primary pain source leading to unmasking could lead t...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2019-03-01 00:00:00
abstract::Management of pain from skeletal metastases is notoriously difficult. Case reports and case series have described radiofrequency ablation of the obturator nerve branches to the femoral head for treatment of intractable hip pain. Ablation of the obturator branches to the femoral head is technically difficult because of...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:The growth of interventional pain medicine in recent years has resulted in more procedures being carried out under fluoroscopic guidance. The proximity of the pain physician (PP) to ionization radiation (IR) potentially increases the risk of radiation exposure to the ocular region. A European directive has r...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Several meta-analyses have been performed to compare unilateral percutaneous kyphoplasty (PKP) and bilateral PKP in the treatment of osteoporotic vertebral compression fractures (OVCFs), but inconsistencies in the results have led to questions as to which technique is preferable. OBJECTIVE:This study was de...
journal_title:Pain physician
pub_type: 杂志文章,meta分析
doi:
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Suprascapular nerve block is performed in the management of chronic shoulder pain and frozen shoulder. OBJECTIVE:To investigate the effects of ultrasound-guided suprascapular nerve block in restoration of shoulder motion in breast cancer survivors. STUDY DESIGN:A cohort study. SETTING:A training and resea...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2017-02-01 00:00:00
abstract::This a unique case of severe scapular pain following unintentional epidural space air injection during epidural steroid injection.A 70-year-old woman presented for a fluoroscopically guided C7-T1 interlaminar epidural steroid injection. Three injection attempts were made using the loss of resistance with air technique...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:The spine, pelvis, skull, and femur are the most common sites of bone metastases, and pain is the main symptom of metastatic tumors. Percutaneous femoroplasty (PFP) is becoming increasingly popular for treating proximal femoral metastases. OBJECTIVES:To assess the clinical value and feasibility of PFP perfo...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2016-07-01 00:00:00
abstract::The increasing use of opioids to manage pain in the United States over the last decade has resulted in a subset of our population developing opioid tolerance. While the management of opioid tolerant patients during acute episodes of care is well known to be a challenge amongst health care providers, there is little in...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Pulsed radiofrequency (PRF) therapy is a clinical treatment utilizing electromagnetic energy aimed to relieve neuropathic pain. This is the first study examining the modulated expression of pain regulatory genes following the induction of the spared nerve injury (SNI) pain model and subsequently treated with...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:While most trials of thoracic paravertebral nerve blocks (TPVB) for breast surgery show benefit, their effect on postoperative pain intensity, opioid consumption, and prevention of chronic postsurgical pain varies substantially across studies. Variability may result from use of different drugs and techniques...
journal_title:Pain physician
pub_type: 杂志文章,meta分析,评审
doi:
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Symptomatic Tarlov cysts are a common cause of chronic pain. Many methods have been reported to treat this disease, with variable results. Most previous reports concerning the treatment methods of symptomatic Tarlov cysts were either sporadic case reports or series of limited cases. OBJECTIVE:This study aim...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Diversity of treatments used for headache, and varied quality of research conduct and reporting make it difficult to accurately assess the literature and to determine the best treatment(s) for patients. OBJECTIVES:To compare the quality of available research evidence describing the effects and outcomes of c...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Lumbar disc prolapse, protrusion, and extrusion are the most common causes of nerve root pain and surgical interventions, and yet they account for less than 5% of all low back problems. The typical rationale for traditional surgery is that it is an effort to provide more rapid relief of pain and disability. ...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Extensive decompression with laminectomy, where appropriate, is often still described as the method of choice when operating on degenerative lumbar spinal stenosis. Nonetheless, tissue-sparing procedures are becoming more common. Endoscopic techniques have become the standard in many areas because of the sur...
journal_title:Pain physician
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2015-01-01 00:00:00