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08.05.2017 | Original Paper | Ausgabe 8/2017

Child's Nervous System 8/2017

Treatment patterns of children with spine and spinal cord tumors: national outcomes and review of the literature

Zeitschrift:
Child's Nervous System > Ausgabe 8/2017
Autoren:
Faris Shweikeh, Carolyn Quinsey, Roger Murayi, Ryan Randle, Miriam Nuño, Mark D. Krieger, J. Patrick Johnson
Wichtige Hinweise
The abstract was presented in poster form at the 82nd American Association of Neurological Surgeons Annual Scientific Meeting in San rancisco, California on April 5, 2014.

Abstract

Background

Tumors of the spine in children are rare, and further clinical description is necessary.

Objective

This study investigated epidemiology, interventions, and outcomes of pediatric patients with spine and spinal cord tumors.

Methods

The National Inpatient Sample and Kids’ Inpatient Database were used for the study. Outcomes were studied, and bivariate significant trends were analyzed in a multivariate setting.

Results

Analysis of 2870 patients between 2000 and 2009 found a median age of diagnosis of 11 years (Tables 1 and 2). Most were white (65.2%) and had private insurance (62.3%), and 46.8% of procedures were emergent operations. Treatment occurred at teaching (93.6%) and non-children’s hospitals (81.1%). Overall mortality rate was 1.7%, non-routine discharges occurred at a rate 19.9%, complications at 21.1%, and average total charges were $66,087. A majority of patients (87.5%) had no intervention, and of those patients receiving treatment, 78.2% underwent surgery and 23.1% had radiotherapy. Treatment with surgery alone increased significantly over time (p < 0.0001). Odds ratio (OR) of mortality was significantly higher in 2006 (OR 3.5) and 2009 (OR 2.6) when compared to 2000. Complications (OR 7.9) and disease comorbidities (OR 1.5) were associated with significantly increased odds of mortality.

Conclusions

Hospital characteristics, length of stay, and charges remained relatively unchanged. In recent years, there has been a decreasing incidence of spine and spinal cord tumors in children. Notably, a higher mortality rate is evident over time in addition to an increase in the proportion of patients undergoing surgery. The high percentage of emergent operations suggests a weak recognition of spine tumors in children and should prompt a call for increased awareness of this cancer. In spite of these findings, lack of tumor type identification was a limitation to this study.

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