SPINAL CORD STIMULATION INFECTION RATE AND RISK FACTORS- RESULTS FROM A US PAYER DATABASE

Author(s)

Falowski SM1, Provenzano DA2, Xia Y3, Doth AH3
1St. Luke's University Health Network, Bethlehem, PA, USA, 2Pain Diagnostics and Interventional Care, Sewickley, PA, USA, 3Medtronic Inc., Minneapolis, MN, USA

OBJECTIVES:  Surgical Site Infections can result in significant negative clinical and economic outcomes. The objectives of this study are to define the infection rate for SCS implants, to identify patient characteristics that increase the risk for SCS infection. METHODS: Data from the Truven MarketScan® Commercial Claims and Medicare Supplemental databases were used to identify patients with a SCS neurostimulator generator implant during the calendar years 2009–2014. Patients were continuously enrolled for at least 12-months before generator implant. Kaplan-Meier curves were conducted to compare the SCS infection rates between the initial implant group and the replacement implant group. COX proportional hazard regression was performed to characterize the risk factors for SCS infection based on patient demographics, common comorbidities, and other clinical characteristics. RESULTS: A total of 13,214 patients were identified. The SCS infection rates were 3.15% in the initial group and 2.96% in the replacement group at the end of 1 year after SCS generator implants. The result of log-rank test showed the difference of infection rates between two groups was not statistically significant (p-value=0.7916). Risk factors for SCS infection included a comorbidity of lumbar disk disease (Hazard Ratio (HR), 1.302; 95% CI: 1.015-1.671; p-value=0.0381) as well as a history of prior all-cause infection (HR, 1.770; 95% CI: 1.342-2.336; p-value <0.0001). In addition, elderly patients were less likely to have a SCS infection (HR, 0.974; 95% CI: 0.962-0.986; p-value <0.0001). CONCLUSIONS: The approximate 3% device-related infection rate within 12-months of SCS implant determined from a large administrative database further emphasizes the need for improvement in SCS infection control practices. Based on these results, research is warranted on methods to limit SCS infection rates in patients with a lumbar disk disease or a history of prior all-cause infection. Further research is needed to evaluate these patient factors in a prospective manner for SCS.

Conference/Value in Health Info

2017-05, ISPOR 2017, Boston, MA, USA

Value in Health, Vol. 20, No. 5 (May 2017)

Code

MD3

Topic

Epidemiology & Public Health

Disease

Infectious Disease (non-vaccine)

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