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      A Nation-Wide Epidemiological Study of Newly Diagnosed Primary Spine Tumor in the Adult Korean Population, 2009–2011

      , M.D., Ph.D. 1 , 2 , 3 , 4 , , R.N., Ph.D., M.P.H. 5 , , M.D., Ph.D. 1 , 2 , 3 , 6 , , B.S. 7 , , M.D., Ph.D. 8 , , M.D., Ph.D. 9

      Journal of Korean Neurosurgical Society

      Korean Neurosurgical Society

      Epidemiology, Spine, Neoplasms, Population

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          Abstract

          Objective

          This 2009–2011 nation-wide study of adult Koreans was aimed to provide characteristics, medical utilization states, and survival rates for newly diagnosed patients with primary nonmalignant and malignant spine tumors.

          Methods

          Data for patients with primary spine tumors were selected from the Korean Health Insurance Review and Assessment Service database. The data included their age, sex, health insurance type, co-morbidities, medical cost, and hospital stay duration. Hospital stay duration and medical costs per person occurring in one calendar year were used. In addition, survival rates of patients with primary malignant spine tumors were evaluated.

          Results

          The incidence rate of a primary spine tumor increased with age, and the year of diagnosis ( p≤0.0001). Average annual medical costs ranged from 1627 USD (pelvis & sacrum & coccyx tumors) to 6601 USD (spinal cord tumor) for primary nonmalignant spine tumor and from 12137 USD (spinal meningomas) to 20825 USD (pelvis & sacrum & coccyx tumors) for a primary malignant spine tumor. Overall survival rates for those with a primary malignant spine tumor were 87.0%, 75.3%, and 70.6% at 3, 12, and 24 months, respectively. The Cox regression model results showed that male sex, medicare insurance were significantly positive factors affecting survival after a diagnosis of primary malignant spine tumor.

          Conclusion

          Our study provides a detailed view of the characteristics, medical utilization states, and survival rates of patients newly diagnosed with primary spine tumors in Korea.

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          Most cited references 20

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          Reoperation rates following lumbar spine surgery and the influence of spinal fusion procedures.

          Retrospective cohort study using a hospital discharge registry of all nonfederal acute care hospitals in Washington state. To determine the cumulative incidence of reoperation following lumbar surgery for degenerative disease and, for specific diagnoses, to compare the frequency of reoperation following fusion with that following decompression alone. Repeat lumbar spine operations are generally undesirable, implying persistent symptoms, progression of degenerative changes, or treatment complications. Compared to decompression alone, spine fusion is commonly viewed as a stabilizing treatment that may reduce the need for additional surgery. However, indications for fusion surgery in degenerative spine disorders remain controversial, and the effects of fusion on reoperation rates are unclear. Adults who underwent inpatient lumbar surgery for degenerative spine disorders in 1990-1993 (n = 24,882) were identified from International Classification of Diseases ninth Revision, Clinical Modification codes and then categorized as having either a lumbar decompression surgery or lumbar fusion surgery. We then compared the subsequent incidence of lumbar spine surgery between these groups. Patients who had surgery in 1990-93 had a 19% cumulative incidence of reoperation during the subsequent 11 years. Patients with spondylolisthesis had a lower cumulative incidence of reoperation after fusion surgery than after decompression alone (17.1% vs. 28.0%, P = 0.002). For other diagnoses combined, the cumulative incidence of reoperation was higher following fusion than following decompression alone (21.5% vs. 18.8%, P = 0.008). After fusion surgery, 62.5% of reoperations were associated with a diagnosis suggesting device complication or pseudarthrosis. Patients should be informed that the likelihood of reoperation following a lumbar spine operation is substantial. For spondylolisthesis, reoperation is less likely following fusion than following decompression alone. For other degenerative spine conditions, the cumulative incidence of reoperation is higher or unimproved after a fusion procedure compared to decompression alone.
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            Descriptive epidemiology of primary spinal cord tumors.

            There is little population-based data available on primary spinal cord tumors. Many of the existing statistics are not current or were obtained from surgical series. Historically, population-based data were collected only for malignant tumors, and only recently have data begun to be collected on non-malignant tumors. The objective of this study was to estimate the incidence of both non-malignant and malignant primary spinal cord tumors and to estimate the survival rates for primary malignant spinal cord tumors. Incidence of spinal cord tumors was estimated from cases diagnosed between 1998 and 2002 in 16 CBTRUS collaborating state cancer registries. Age-adjusted rates were generated using SAS (8.2) and standardized to the 2000 US standard population. SEER*Stat 6.1.4 software was used to estimate relative survival for malignant spinal cord tumors for cases diagnosed between 1975 and 2002 in nine SEER regions. Of the spinal cord tumors identified (CBTRUS; n = 3,226), 69% were non-malignant. The most common histologic types were meningiomas (29%), nerve sheath tumors (24%), and ependymomas (23%). The overall incidence of spinal cord tumors was 0.74 per 100,000 person-years, with an incidence of 0.77/100,000 in females and 0.70/100,000 in males. The incidence rate was lowest in children (0.26) and peaked in the 75-84 year age group (1.80). Rates were higher in non-Hispanic whites (0.79) than in Hispanics (0.61) or non-Hispanic blacks (0.45). The 1-, 5-, and 10-year survival rates following diagnosis of a primary malignant spinal cord tumor were 85%, 71%, and 64%, respectively (SEER; n = 1,220).
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              Trends of Antibiotic Consumption in Korea According to National Reimbursement Data (2008–2012)

              Abstract This study determined the trends in the quantities and patterns of nationwide antibiotic consumption in the Republic of Korea (ROK). This nationwide descriptive epidemiological study was conducted in the ROK between 2008 and 2012. The quantities and patterns of total systemic antibiotic prescriptions were analyzed using National Health Insurance claims data collected through the Health Insurance Review and Assessment service. Data concerning systemic antibiotics were collected using measurement units of the defined daily dose (DDD) per 1000 people per day according to the Anatomical Therapeutic Chemical classification. Over the 5-year study period, the annual consumption of systemic antibiotics ranged from 21.68 to 23.12 DDD per 1000 people per day. Outpatient antibiotic use accounted for 80.9% of total consumption. A regression model with autoregressive errors showed significant increased consumption of major antibiotic subgroups, including 3rd-generation cephalosporins, carbapenems, and glycopeptides (P < 0.001). However, the antibiotic use of 1st- (P = 0.003), 2nd- (P = 0.004), and 3rd-generation (P = 0.018) cephalosporins among patients who underwent surgery under monitoring by the antimicrobial stewardship programs for perioperative prescription was significantly lower than in those who underwent surgery without monitoring programs. In time-series analysis, total antibiotic consumption demonstrated significant seasonality (P < 0.001). The consumption of broad-spectrum antibiotics was noted to have increased in the ROK from 2008 to 2012, providing a possible explanation for the changing epidemiology of multidrug resistance. Larger prospective studies are needed to investigate the impact on public health of monitoring programs of perioperative antibiotic usage.
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                Author and article information

                Journal
                J Korean Neurosurg Soc
                J Korean Neurosurg Soc
                Journal of Korean Neurosurgical Society
                Korean Neurosurgical Society
                2005-3711
                1598-7876
                February 2017
                28 February 2017
                : 60
                : 2
                : 195-204
                Affiliations
                [1 ]Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
                [2 ]Neuroscience Research Institute, Seoul National University Medical Research Center, Seoul, Korea
                [3 ]Clinical Research Institute, Seoul National University Hospital, Seoul, Korea
                [4 ]Department of Neurosurgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
                [5 ]Department of Nursing, College of Medicine, Chosun University, Gwangju, Korea
                [6 ]Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Korea
                [7 ]National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
                [8 ]Department of Neurosurgery, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, Korea
                [9 ]Department of Radiation Oncology, St. Vincent’s Hospital, School of Medicine, The Catholic University of Korea, Suwon, Korea
                Author notes
                Address for reprints: Chun Kee Chung, M.D., Ph.D., Department of Neurosurgery, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea, Tel: +82-2-2072-2350, Fax: +82-2-744-8459, E-mail: chungc@ 123456snu.ac.kr
                [*]

                Seil Sohn and Jinhee Kim contributed equally to this work.

                Article
                jkns-60-2-195
                10.3340/jkns.2016.0505.011
                5365297
                28264240
                Copyright © 2017 The Korean Neurosurgical Society

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Clinical Article

                Surgery

                epidemiology, spine, neoplasms, population

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