223 Surgical Management of Degenerative Cervical Myelopathy: Comparing Outcomes Between Patients Admitted Through Clinic Versus Emergency Department
OBJECTIVES/GOALS: Degenerative cervical myelopathy (DCM) can lead to pain, disability, and permanent spinal cord impairment. Timely diagnosis and surgical intervention is essential to optimize functional outcomes for patients with CSM. Here, we compared patients who were admitted through clinic vers...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2023-04-01
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| Series: | Journal of Clinical and Translational Science |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2059866123002947/type/journal_article |
| _version_ | 1797840446151458816 |
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| author | Dagoberto Pina Jared Watson Alex Villegas Zachary Booz Joseph Holland Micaela White Gabriel Santamaria Joseph Wick Wyatt Vander Voort Brandon Ortega Keegan Conry Yashar Javidan Rolando Roberto Eric Klineberg Shaina Lipa Hai Le |
| author_facet | Dagoberto Pina Jared Watson Alex Villegas Zachary Booz Joseph Holland Micaela White Gabriel Santamaria Joseph Wick Wyatt Vander Voort Brandon Ortega Keegan Conry Yashar Javidan Rolando Roberto Eric Klineberg Shaina Lipa Hai Le |
| author_sort | Dagoberto Pina |
| collection | DOAJ |
| description | OBJECTIVES/GOALS: Degenerative cervical myelopathy (DCM) can lead to pain, disability, and permanent spinal cord impairment. Timely diagnosis and surgical intervention is essential to optimize functional outcomes for patients with CSM. Here, we compared patients who were admitted through clinic versus the emergency department (ED) for surgical management of DCM. METHODS/STUDY POPULATION: Patients aged ≥18 years admitted for surgery for DCM through clinic (elective cohort) were compared to a surgical cohort who were evaluated through the ED (call cohort). Basic demographics included age, gender, race, ethnicity, and insurance payor. Sociodemographic characteristics were estimated using the Social Deprivation Index (SDI) and the Area Deprivation Index (ADI) for the state of California, which were obtained through aggregated Zip Code Tabulation Area (ZCTA). Cervical MRI was reviewed to assess severity of spinal cord compression. Other outcomes included number of motion segments operated on, functional outcome using the Nurick classification, length of stay (LOS), disposition, and 30-day reoperation and readmission rates. RESULTS/ANTICIPATED RESULTS: From 2015 to 2021, 327 DCM patients received surgery (227 Elective Cohort, 100 Call Cohort). Elective cohort was mainly female (48.0 vs 30.0%, p=0.002) and white (72.7 vs 51.0%, p=0.0001). Call cohort was mainly uninsured/covered by Medicare/Medicaid (78.0 vs 67.0%, p=0.04), had higher SDI (68.0 vs 56.2, p=0.0003), ADI (7.9 vs 7.2, p=0.009), and cervical cord compression on MRI (78.0 vs 42.3% Grade III, p DISCUSSION/SIGNIFICANCE: Compared to DCM patients undergoing elective surgery, those admitted through the ED were more likely to be male, non-White, and socioeconomically disadvantaged, as measured by SDI and ADI. Postoperative outcomes were less favorable for these patients, including longer hospital stay, discharge disposition, and less Nurick grading improvement. |
| first_indexed | 2024-04-09T16:15:14Z |
| format | Article |
| id | doaj.art-f0c34fa90f9a444e842fd873a42df335 |
| institution | Directory Open Access Journal |
| issn | 2059-8661 |
| language | English |
| last_indexed | 2024-04-09T16:15:14Z |
| publishDate | 2023-04-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Journal of Clinical and Translational Science |
| spelling | doaj.art-f0c34fa90f9a444e842fd873a42df3352023-04-24T05:55:56ZengCambridge University PressJournal of Clinical and Translational Science2059-86612023-04-017686910.1017/cts.2023.294223 Surgical Management of Degenerative Cervical Myelopathy: Comparing Outcomes Between Patients Admitted Through Clinic Versus Emergency DepartmentDagoberto Pina0Jared Watson1Alex Villegas2Zachary Booz3Joseph Holland4Micaela White5Gabriel Santamaria6Joseph Wick7Wyatt Vander Voort8Brandon Ortega9Keegan Conry10Yashar Javidan11Rolando Roberto12Eric Klineberg13Shaina Lipa14Hai Le15University of California, Davis School of Medicine, Sacramento, CAUC Davis Health Department of Orthopaedic Surgery, Sacramento, CAUniversity of California, Davis School of Medicine, Sacramento, CAUniversity of California, Davis School of Medicine, Sacramento, CAU of L School of Medicine, Louisville, KYUniversity of California, Davis School of Medicine, Sacramento, CAUniversity of California, Davis School of Medicine, Sacramento, CAUC Davis Health Department of Orthopaedic Surgery, Sacramento, CAUC Davis Health Department of Orthopaedic Surgery, Sacramento, CAUC Davis Health Department of Orthopaedic Surgery, Sacramento, CAUC Davis Health Department of Orthopaedic Surgery, Sacramento, CAUC Davis Health Department of Orthopaedic Surgery, Sacramento, CAUC Davis Health Department of Orthopaedic Surgery, Sacramento, CAUC Davis Health Department of Orthopaedic Surgery, Sacramento, CABrigham and Women’s Hospital, Boston, MAUC Davis Health Department of Orthopaedic Surgery, Sacramento, CAOBJECTIVES/GOALS: Degenerative cervical myelopathy (DCM) can lead to pain, disability, and permanent spinal cord impairment. Timely diagnosis and surgical intervention is essential to optimize functional outcomes for patients with CSM. Here, we compared patients who were admitted through clinic versus the emergency department (ED) for surgical management of DCM. METHODS/STUDY POPULATION: Patients aged ≥18 years admitted for surgery for DCM through clinic (elective cohort) were compared to a surgical cohort who were evaluated through the ED (call cohort). Basic demographics included age, gender, race, ethnicity, and insurance payor. Sociodemographic characteristics were estimated using the Social Deprivation Index (SDI) and the Area Deprivation Index (ADI) for the state of California, which were obtained through aggregated Zip Code Tabulation Area (ZCTA). Cervical MRI was reviewed to assess severity of spinal cord compression. Other outcomes included number of motion segments operated on, functional outcome using the Nurick classification, length of stay (LOS), disposition, and 30-day reoperation and readmission rates. RESULTS/ANTICIPATED RESULTS: From 2015 to 2021, 327 DCM patients received surgery (227 Elective Cohort, 100 Call Cohort). Elective cohort was mainly female (48.0 vs 30.0%, p=0.002) and white (72.7 vs 51.0%, p=0.0001). Call cohort was mainly uninsured/covered by Medicare/Medicaid (78.0 vs 67.0%, p=0.04), had higher SDI (68.0 vs 56.2, p=0.0003), ADI (7.9 vs 7.2, p=0.009), and cervical cord compression on MRI (78.0 vs 42.3% Grade III, p DISCUSSION/SIGNIFICANCE: Compared to DCM patients undergoing elective surgery, those admitted through the ED were more likely to be male, non-White, and socioeconomically disadvantaged, as measured by SDI and ADI. Postoperative outcomes were less favorable for these patients, including longer hospital stay, discharge disposition, and less Nurick grading improvement.https://www.cambridge.org/core/product/identifier/S2059866123002947/type/journal_article |
| spellingShingle | Dagoberto Pina Jared Watson Alex Villegas Zachary Booz Joseph Holland Micaela White Gabriel Santamaria Joseph Wick Wyatt Vander Voort Brandon Ortega Keegan Conry Yashar Javidan Rolando Roberto Eric Klineberg Shaina Lipa Hai Le 223 Surgical Management of Degenerative Cervical Myelopathy: Comparing Outcomes Between Patients Admitted Through Clinic Versus Emergency Department Journal of Clinical and Translational Science |
| title | 223 Surgical Management of Degenerative Cervical Myelopathy: Comparing Outcomes Between Patients Admitted Through Clinic Versus Emergency Department |
| title_full | 223 Surgical Management of Degenerative Cervical Myelopathy: Comparing Outcomes Between Patients Admitted Through Clinic Versus Emergency Department |
| title_fullStr | 223 Surgical Management of Degenerative Cervical Myelopathy: Comparing Outcomes Between Patients Admitted Through Clinic Versus Emergency Department |
| title_full_unstemmed | 223 Surgical Management of Degenerative Cervical Myelopathy: Comparing Outcomes Between Patients Admitted Through Clinic Versus Emergency Department |
| title_short | 223 Surgical Management of Degenerative Cervical Myelopathy: Comparing Outcomes Between Patients Admitted Through Clinic Versus Emergency Department |
| title_sort | 223 surgical management of degenerative cervical myelopathy comparing outcomes between patients admitted through clinic versus emergency department |
| url | https://www.cambridge.org/core/product/identifier/S2059866123002947/type/journal_article |
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