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      A Nationwide Study of Surgery in a Newly Diagnosed Spine Metastasis Population

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          Abstract

          Objective

          The aim of this nationwide study was to analyze the current state of patients with newly diagnosed metastatic spine tumors according to surgical methods.

          Methods

          Data was extracted from the Korean Health Insurance Review and Assessment Service database. Surgery was categorized into three methods : fusion, decompression, and vertebroplasty. Data included patient age, sex, health insurance type, and co-morbidities. Survival rates of metastatic spine tumor patients according to each surgical method were evaluated.

          Results

          Among 1677 patients who had an operation, 823 patients were treated by fusion, 141 patients underwent decompression, and 713 patients were treated by vertebroplasty. The three most prevalent primary tumor sites were the lung, breast, and liver & biliary. On the other hand, the three most prevalent primary tumor sites of patients who underwent surgery were the lung, liver & biliary, and the prostate. The median survival periods for each surgical method in the metastatic spine tumor patients were 228 days for those who underwent surgery, 249 days for decompression, and 154 days for vertebroplasty. Age, sex, and comorbidities significantly affected survival rate.

          Conclusion

          For every primary tumor site, decompression was the least common surgical method during the study period. Although the three surgical methods did not significantly affect the survival period, patients with a poor prognosis tended to undergo vertebroplasty.

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          Most cited references8

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          Comorbidity measures for use with administrative data.

          This study attempts to develop a comprehensive set of comorbidity measures for use with large administrative inpatient datasets. The study involved clinical and empirical review of comorbidity measures, development of a framework that attempts to segregate comorbidities from other aspects of the patient's condition, development of a comorbidity algorithm, and testing on heterogeneous and homogeneous patient groups. Data were drawn from all adult, nonmaternal inpatients from 438 acute care hospitals in California in 1992 (n = 1,779,167). Outcome measures were those commonly available in administrative data: length of stay, hospital charges, and in-hospital death. A comprehensive set of 30 comorbidity measures was developed. The comorbidities were associated with substantial increases in length of stay, hospital charges, and mortality both for heterogeneous and homogeneous disease groups. Several comorbidities are described that are important predictors of outcomes, yet commonly are not measured. These include mental disorders, drug and alcohol abuse, obesity, coagulopathy, weight loss, and fluid and electrolyte disorders. The comorbidities had independent effects on outcomes and probably should not be simplified as an index because they affect outcomes differently among different patient groups. The present method addresses some of the limitations of previous measures. It is based on a comprehensive approach to identifying comorbidities and separates them from the primary reason for hospitalization, resulting in an expanded set of comorbidities that easily is applied without further refinement to administrative data for a wide range of diseases.
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            Reoperation rate after surgery for lumbar herniated intervertebral disc disease: nationwide cohort study.

            Retrospective cohort study using national health insurance data.
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              Is Open Access

              Measuring the Burden of Disease in Korea

              This paper provides an overview of the Korean Burden of Disease (KBoD) study, which was the first such study to assess the national burden of disease using disability-adjusted life years (DALYs) in an advanced Asian country. The KBoD study generally followed the approach utilized in the original Global Burden of Disease study (GBD), with the exception of the disease classification and epidemiological data estimation methods used, and the relative weightings of disabilities. The results of the present study reveal that the burden of disease per 100,000 of the Korean population originates primarily from; cancer (1,525 Person Years, PYs), cardiovascular disease (1,492 PYs), digestive disease (1,140 PYs), diabetes mellitus (990 PYs), and certain neuro-psychiatric conditions (883 PYs). These results are largely consistent with those of developed countries, but also represent uniquely Korean characteristics.
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                Author and article information

                Journal
                J Korean Neurosurg Soc
                J Korean Neurosurg Soc
                JKNS
                Journal of Korean Neurosurgical Society
                Korean Neurosurgical Society
                2005-3711
                1598-7876
                January 2019
                2 August 2018
                : 62
                : 1
                : 46-52
                Affiliations
                [1 ]Department of Neurosurgery, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam, Korea
                [2 ]Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
                [3 ]Neuroscience Research Institute, Seoul National University Medical Research Center, Seoul, Korea
                [4 ]Clinical Research Institute, Seoul National University Hospital, Seoul, Korea
                [5 ]Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Korea
                [6 ]Department of Biostatistics, The Catholic University of Korea College of Medicine, Seoul, Korea
                [7 ]Department of Nursing, Chosun University College of Medicine, Gwangju, Korea
                [8 ]Department of Neurosurgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Science, Seoul, Korea
                [9 ]Department of Neurosurgery, Neuroscience & Radiosurgery Hybrid Research Center, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Ilsan, Korea
                [10 ]Department of Radiation Oncology, St. Vincent’s Hospital, The Catholic University of Korea School of Medicine, Seoul, 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
                Article
                jkns-2017-0304
                10.3340/jkns.2017.0304
                6328801
                30064201
                b39fef78-2bd9-4fe4-85b3-daa5a8876c26
                Copyright © 2019 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.

                History
                : 15 December 2017
                : 27 January 2018
                : 9 February 2018
                Categories
                Clinical Article
                Spine

                Surgery
                spine,neoplasms,neoplasm metastasis,population,surgery
                Surgery
                spine, neoplasms, neoplasm metastasis, population, surgery

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