Table. Patient and Hospital-Level Factors Associated With a Greater Likelihood of Optic Nerve Sheath Fenestration Rather Than Cerebrospinal Fluid Shunting for Pseudotumor Cerebri Syndrome, National Inpatient Sample 2010-2016.
| Factor | No. (%)a | OR (95% CI) | ||
|---|---|---|---|---|
| Optic nerve sheath fenestration (n = 297) | Cerebrospinal fluid shunt (n = 10 423) | Unadjusted (N = 10 720) | Adjusted (N = 10 720)b | |
| Patients | ||||
| Age, y | ||||
| 18-25 | 113 (5.5) | 1953 (94.5) | 1 [Reference] | 1 [Reference] |
| 26-35 | 109 (2.6) | 4117 (97.4) | 0.46 (0.26-0.81) | 0.48 (0.27-0.87) |
| 36-45 | 55 (1.9) | 2916 (98.1) | 0.33 (0.16-0.66) | 0.33 (0.16-0.68) |
| ≥46 | 20 (1.4) | 1437 (98.6) | 0.24 (0.09-0.66) | 0.22 (0.08-0.61) |
| Race/ethnicityc | ||||
| White | 140 (2.0) | 6990 (98.0) | 1 [Reference] | 1 [Reference] |
| Black, Hispanic, Asian or Pacific Islander, and Native American | 133 (5.0) | 2545 (95.0) | 2.61 (1.47-4.65) | 2.37 (1.31-4.30) |
| Other or unknown | 25 (2.7) | 888 (97.3) | 1.41 (0.53-3.74) | 1.57 (0.54-4.56) |
| Sex | ||||
| Male | 20 (2.5) | 790 (97.5) | 1 [Reference] | 1 [Reference] |
| Female | 277 (2.8) | 9633 (97.2) | 1.13 (0.43-2.97) | 1.1 (0.40-3.04) |
| Insurance payer | ||||
| Medicare | 20 (1.3) | 1488 (98.7) | 0.48 (0.17-1.36) | 0.5 (0.17-1.43) |
| Medicaid | 89 (3.2) | 2709 (96.8) | 1.18 (0.66-2.14) | 0.82 (0.44-1.53) |
| Private | 149 (2.7) | 5396 (97.3) | 1 [Reference] | 1 [Reference] |
| Self-pay | 25 (6.8) | 341 (93.1) | 2.62 (0.96-7.15) | 2.2 (0.78-6.15) |
| Other | 15 (3.0) | 489 (97.0) | 1.08 (0.33-3.46) | 1.16 (0.34-3.94) |
| Median income by zip code, percentiled | ||||
| 0-25th | 123 (3.8) | 3104 (96.2) | 2.23 (0.94-5.30) | 1.62 (0.62-4.22) |
| 26th-50th | 85 (2.7) | 3091 (97.3) | 1.54 (0.59-4.03) | 1.43 (0.52-3.92) |
| 51st-75th | 60 (2.3) | 2568 (97.7) | 1.31 (0.49-3.49) | 1.16 (0.43-3.14) |
| 76th-100th | 30 (1.8) | 1659 (98.2) | 1 [Reference] | 1 [Reference] |
| Elixhauser comorbidity indexe | ||||
| 0 | 58 (2.2) | 2579 (97.8) | 1 [Reference] | 1 [Reference] |
| 1 | 90 (3.1) | 2823 (96.9) | 1.41 (0.64-3.13) | 1.45 (0.65-3.23) |
| 2 | 60 (2.5) | 2327 (97.5) | 1.14 (0.52-2.5) | 1.34 (0.59-3.05) |
| ≥3 | 89 (3.2) | 2693 (96.8) | 1.46 (0.70-3.02) | 2.03 (0.96-4.30) |
| Hospitals | ||||
| Hospital sizef | ||||
| Small | 15 (2.6) | 562 (97.4) | 1 [Reference] | 1 [Reference] |
| Medium | 64 (3.8) | 1625 (96.2) | 1.48 (0.39-5.62) | 1.52 (0.38-6.05) |
| Large | 218 (2.6) | 8236 (97.4) | 0.99 (0.32-3.10) | 1.3 (0.40-4.24) |
| Hospital teaching status | ||||
| Ruralg | <10 | 222 | 0.66 (0.10-4.49) | 0.93 (0.13-6.87) |
| Urban | ||||
| Nonteaching | 25 (1.7) | 1458 (98.3) | 0.56 (0.13-2.39) | 0.85 (0.19-3.81) |
| Teaching | 268 (3.0) | 8742 (97.0) | 1 [Reference] | 1 [Reference] |
| Region | ||||
| Northeast | 73 (4.6) | 1523 (95.4) | 1 [Reference] | 1 [Reference] |
| South | 45 (1.9) | 2373 (98.1) | 0.39 (0.15-0.99) | 0.34 (0.13-0.88) |
| Midwest | 164 (3.6) | 4429 (96.4) | 0.77 (0.36-1.66) | 0.66 (0.30-1.45) |
| West | 15 (0.7) | 2098 (99.3) | 0.15 (0.04-0.55) | 0.15 (0.04-0.58) |
Abbreviations: HCUP, Healthcare Cost and Utilization Project; OR, odds ratio.
Row percentages for the first 2 columns are shown in parentheses.
Adjusted for age, race/ethnicity, sex, insurance payer, median income by zip code, Elixhauser comorbidity index, hospital size, teaching status, region, and an International Classification of Diseases, Tenth Revision, Clinical Modification vs International Classification of Diseases, Ninth Revision, Clinical Modification dummy variable (to account for the coding transition in 2015).
Race: The categories for race/ethnicity reflect the options provided for HCUP coding of data elements.13
Income: Descriptions of income quartiles are available from the HCUP website.14
Scores are defined by Elixhauser et al.15
Hospital size categories are defined by the HCUP according to teaching status and geographic location.16
Counts and percentages are not presented for cells with less than 10 individuals to protect patient confidentiality per HCUP regulations.