Table 2.
Patient Demographics, Hospital Characteristics, and Outcomes for ACF in the Treatment of CSMa.
| 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | P | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Number of ACFs | 3226 | 3228 | 3530 | 3623 | 4128 | 4214 | 4494 | 5136 | 5818 | 5721 | 6204 | |
| Age** | 57.4 | 56.7 | 57.6 | 57.3 | 58.0 | 57.8 | 58.8 | 58.6 | 59.4 | 58.9 | 59.6 | <.001 |
| Female | 1475 (46.0) | 1563 (48.5) | 1728 (49.0) | 1731 (47.8) | 1988 (48.2) | 1974 (46.9) | 2096 (46.6) | 2389 (46.5) | 2774 (47.7) | 2732 (47.8) | 2920 (47.1) | .35 |
| Race | ||||||||||||
| White** | 1885 (58.4) | 1760 (54.5) | 2154 (61.0) | 2130 (58.8) | 2329 (56.4) | 2696 (64.0) | 2974 (66.2) | 3436 (66.9) | 4029 (69.3) | 4138 (72.3) | 4511 (72.7) | <.001 |
| Black | 299 (9.3) | 330 (10.2) | 284 (8.0) | 327 (9.0) | 347 (8.4) | 413 (9.8) | 403 (9.0) | 615 (12.0) | 737 (12.7) | 708 (12.4) | 765 (12.3) | .02 |
| Other | 228 (7.1) | 159 (4.9) | 205 (5.8) | 207 (5.7) | 243 (5.9) | 304 (7.2) | 417 (9.3) | 444 (8.6) | 592 (10.2) | 591 (10.3) | 598 (9.6) | .03 |
| Comorbidity | ||||||||||||
| 0** | 1194 (37.0) | 1065 (33.0) | 1115 (31.6) | 999 (27.6) | 1059 (25.7) | 1094 (26.0) | 1082 (24.1) | 1185 (23.1) | 1191 (20.5) | 1210 (21.2) | 1253 (20.2) | <.001 |
| 1** | 963 (29.9) | 1001 (31.0) | 1056 (29.9) | 1096 (30.3) | 1206 (29.2) | 1135 (27.0) | 1255 (27.9) | 1384 (26.9) | 1486 (25.5) | 1505 (26.3) | 1581 (25.5) | <.001 |
| 2** | 623 (19.3) | 666 (20.6) | 705 (20.0) | 818 (22.6) | 932 (22.6) | 1013 (24.0) | 941 (20.9) | 1141 (22.2) | 1328 (22.8) | 1301 (22.7) | 1442 (23.2) | <.001 |
| 3+** | 446 (13.8) | 496 (15.4) | 654 (18.5) | 710 (19.6) | 931 (22.6) | 972 (23.1) | 1216 (27.1) | 1426 (27.8) | 1813 (31.2) | 1705 (29.8) | 1928 (31.1) | <.001 |
| Insurance | ||||||||||||
| Private** | 1693 (52.5) | 1710 (53.0) | 1806 (51.2) | 1952 (53.9) | 2068 (50.1) | 2069 (49.1) | 2192 (48.8) | 2330 (45.4) | 2540 (43.7) | 2425 (42.4) | 2624 (42.3) | <.001 |
| Medicare** | 1074 (33.3) | 998 (30.9) | 1247 (35.3) | 1249 (34.5) | 1486 (36.0) | 1485 (35.2) | 1640 (36.5) | 1960 (38.2) | 2347 (40.3) | 2358 (41.2) | 2596 (41.8) | <.001 |
| Medicaid* | 155 (4.8) | 203 (6.3) | 200 (5.7) | 185 (5.1) | 210 (5.1) | 299 (7.1) | 286 (6.4) | 380 (7.4) | 385 (6.6) | 417 (7.3) | 413 (6.7) | <.01 |
| Uninsured | 48 (1.5) | 71 (2.2) | 49 (1.4) | 43 (1.2) | 79 (1.9) | 64 (1.5) | 72 (1.6) | 94 (1.8) | 99 (1.7) | 108 (1.9) | 117 (1.9) | .33 |
| Academic hospital | 1776 (55.1) | 1919 (59.4) | 1671 (47.3) | 2045 (56.4) | 2347 (56.9) | 2335 (55.4) | 2251 (50.1) | 2744 (53.4) | 3182 (54.7) | 3323 (58.1) | 3664 (59.1) | .37 |
| Hospital size | ||||||||||||
| Small** | 194 (6.0) | 301 (9.3) | 341 (9.7) | 411 (11.3) | 680 (16.5) | 387 (9.2) | 586 (13.0) | 738 (14.4) | 742 (12.8) | 812 (14.2) | 901 (14.5) | <.001 |
| Medium | 904 (28.0) | 694 (21.5) | 738 (20.9) | 784 (21.6) | 840 (20.3) | 910 (21.6) | 858 (19.1) | 959 (18.7) | 1116 (19.2) | 1284 (22.4) | 1425 (23.0) | .29 |
| Large | 2128 (66.0) | 2233 (69.2) | 2451 (69.4) | 2428 (67.0) | 2608 (63.2) | 2917 (69.2) | 2932 (65.2) | 3390 (66.0) | 3899 (67.0) | 3625 (63.4) | 3878 (62.5) | .28 |
| Hospital region | ||||||||||||
| Northeast | 400 (12.4) | 494 (15.3) | 429 (12.2) | 504 (13.9) | 476 (11.5) | 609 (14.5) | 612 (13.6) | 588 (11.4) | 607 (10.4) | 818 (14.3) | 836 (13.5) | .86 |
| Midwest | 554 (17.2) | 619 (19.2) | 799 (22.6) | 710 (19.6) | 844 (20.4) | 783 (18.6) | 855 (19.0) | 1100 (21.4) | 1196 (20.6) | 1119 (19.5) | 1160 (18.7) | .83 |
| South | 1710 (53.0) | 1545 (47.9) | 1711 (48.5) | 1718 (47.4) | 1893 (45.9) | 2011 (47.7) | 2058 (45.8) | 2227 (43.4) | 2715 (46.7) | 2502 (43.7) | 2879 (46.4) | .41 |
| West | 562 (17.4) | 570 (17.7) | 591 (16.7) | 691 (19.1) | 915 (22.2) | 811 (19.2) | 969 (21.6) | 1221 (23.8) | 1300 (22.3) | 1282 (22.4) | 1329 (21.4) | .45 |
| Mortality* | 18 (0.6) | 15 (0.5) | 19 (0.5) | 7 (0.2) | 17 (0.4) | 16 (0.4) | 18 (0.4) | 20 (0.4) | 21 (0.4) | 15 (0.3) | 14 (0.2) | <.01 |
| LOS | 3.2 | 3.4 | 2.9 | 3.1 | 3.1 | 3.0 | 3.1 | 3.3 | 3.2 | 2.9 | 3.1 | .21 |
| Hospital charge, $ (inflated to 2013)** | 46 804 | 49 963 | 51 234 | 56 208 | 61 469 | 68 501 | 71 117 | 77 314 | 85 192 | 78 153 | 83 930 | <.001 |
aAll data is from the NIS and include patients over 18 years of age that underwent ACF in the treatment of CSM from 2003 to 2013. Data is expressed as a raw value with the percentage in parentheses. Data from 2003 was compared with 2013 for a single category to determine statistical significance.
*Denotes statistical significance at P < .01.
**Denotes statistical significance at P < .001.
Abbreviations: ACF, anterior cervical fusion; CSM, cervical spondylotic myelopathy; LOS, length of stay; NIS, National Inpatient Sample.