Incidence and Treatment Patterns in Hospitalizations for Malignant Spinal Cord Compression in the United States, 1998-2006

Journal Article · Fri Jul 01 00:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2010.03.022· OSTI ID:21587568

Mak, Kimberley S ^[1]; Lee, Leslie K ^[2]; Mak, Raymond H ^[3]; Wang, Shuang ^[4]; Pile-Spellman, John ^[2]; Abrahm, Janet L ^[5]; Prigerson, Holly G ^[5]

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1. Harvard Medical School, Boston, MA (United States)
2. Division of Interventional Neuroradiology, Columbia University Medical Center, New York, NY (United States)
3. Harvard Radiation Oncology Program, Boston, MA (United States)
4. Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY (United States)
5. Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute and Harvard Medical School Center for Palliative Care, Boston, MA (United States)

Purpose: To characterize patterns in incidence, management, and costs of malignant spinal cord compression (MSCC) hospitalizations in the United States, using population-based data. Methods and Materials: Using the Nationwide Inpatient Sample, an all-payer healthcare database representative of all U.S. hospitalizations, MSCC-related hospitalizations were identified for the period 1998-2006. Cases were combined with age-adjusted Surveillance, Epidemiology and End Results cancer death data to estimate annual incidence. Linear regression characterized trends in patient, treatment, and hospital characteristics, costs, and outcomes. Logistic regression was used to examine inpatient treatment (radiotherapy [RT], surgery, or neither) by hospital characteristics and year, adjusting for confounding. Results: We identified 15,367 MSCC-related cases, representing 75,876 hospitalizations. Lung cancer (24.9%), prostate cancer (16.2%), and multiple myeloma (11.1%) were the most prevalent underlying cancer diagnoses. The annual incidence of MSCC hospitalization among patients dying of cancer was 3.4%; multiple myeloma (15.0%), Hodgkin and non-Hodgkin lymphomas (13.9%), and prostate cancer (5.5%) exhibited the highest cancer-specific incidence. Over the study period, inpatient RT for MSCC decreased (odds ratio [OR] 0.68, 95% confidence interval [CI] 0.61-0.81), whereas surgery increased (OR 1.48, 95% CI 1.17-1.84). Hospitalization costs for MSCC increased (5.3% per year, p < 0.001). Odds of inpatient RT were greater at teaching hospitals (OR 1.41, 95% CI 1.19-1.67), whereas odds of surgery were greater at urban institutions (OR 1.82, 95% CI 1.29-2.58). Conclusions: In the United States, patients dying of cancer have an estimated 3.4% annual incidence of MSCC requiring hospitalization. Inpatient management of MSCC varied over time and by hospital characteristics, with hospitalization costs increasing. Future studies are required to determine the impact of treatment patterns on MSCC outcomes and strategies for reducing MSCC-related costs.

• OSTI ID: 21587568
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 80, Issue 3; Other Information: DOI: 10.1016/j.ijrobp.2010.03.022; PII: S0360-3016(10)00457-8; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
DIAGNOSIS
LUNGS
LYMPHOMAS
METASTASES
PROSTATE
RADIOTHERAPY
SPINAL CORD
SURGERY
VERTEBRAE
BODY
CENTRAL NERVOUS SYSTEM
DISEASES
GLANDS
IMMUNE SYSTEM DISEASES
MALE GENITALS
MEDICINE
NEOPLASMS
NERVOUS SYSTEM
NUCLEAR MEDICINE
ORGANS
RADIOLOGY
RESPIRATORY SYSTEM
SKELETON
THERAPY