Trends of Utilization of Preoperative Embolization for Spinal Metastases

Speaker Credentials

MS-II

Speaker Credentials

MS

College

College of Allopathic Medicine

Format

Poster

Start Date

6-11-2020 10:30 AM

End Date

6-11-2020 10:45 AM

Abstract

Trends of Utilization of Preoperative Embolization for Spinal Metastases Authors: Waseem Wahood, MS1,2,3; Alex Yohan Alexander, HSD1,2,4;Yagiz Ugur Yolcu, MD2,3; Waleed Brinjikji, MD5; David F. Kallmes, MD5; Giuseppe Lanzino, MD2; Mohamad Bydon, MD2,3 Affiliations 1. Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA 2. Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA 3. Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Davie, FL 4. Department of Neuroscience, University of Minnesota, Minneapolis, MN 5. Department of Radiology, Mayo Clinic, Rochester, Minnesota, MN Introduction: While previous studies suggest that preoperative embolization of hypervascular spinal metastases may alleviate intraoperative blood loss and improve resectability, trends and driving factors for choosing this approach have not been extensively explored. Therefore, we evaluated the trends and assessed the factors associated with preoperative embolization utilization for spinal metastatic tumors using a national inpatient database. Methods: Nationwide Inpatient Sample (NIS) database of the Healthcare Cost and Utilization Project (HCUP) was queried for patients undergoing surgical resection for spinal metastasis between January 1, 2005 and December 31, 2017. Patients undergoing preoperative embolization were identified; trends in the utilization of preoperative embolization were analyzed using Cochran-Armitage Test. Multivariable regression was conducted to assess factors associated with higher preoperative embolization utilization. Results: A total of 11,508 patients with spinal metastasis were identified; 105 (0.91%) underwent preoperative embolization. Of the 105 patients, 79 (75.2%) patients had a primary renal cancer as compared to 1,732 (15.19%) for those who did not undergo preoperative embolization (p0.05). Trends in preoperative embolization indicated an increase of 0.16% (std error: 0.024%, p Conclusion: Utilization of preoperative embolization for spinal metastasis is increasing yearly, especially for patients with renal cancer, suggesting that surgeons may increasingly consider embolization before surgical resection for hypervascular tumors. Additionally, the literature has shown the intraoperative and postoperative benefits of this procedure. Grants: None

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Nov 6th, 10:30 AM Nov 6th, 10:45 AM

Trends of Utilization of Preoperative Embolization for Spinal Metastases

Trends of Utilization of Preoperative Embolization for Spinal Metastases Authors: Waseem Wahood, MS1,2,3; Alex Yohan Alexander, HSD1,2,4;Yagiz Ugur Yolcu, MD2,3; Waleed Brinjikji, MD5; David F. Kallmes, MD5; Giuseppe Lanzino, MD2; Mohamad Bydon, MD2,3 Affiliations 1. Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA 2. Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA 3. Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Davie, FL 4. Department of Neuroscience, University of Minnesota, Minneapolis, MN 5. Department of Radiology, Mayo Clinic, Rochester, Minnesota, MN Introduction: While previous studies suggest that preoperative embolization of hypervascular spinal metastases may alleviate intraoperative blood loss and improve resectability, trends and driving factors for choosing this approach have not been extensively explored. Therefore, we evaluated the trends and assessed the factors associated with preoperative embolization utilization for spinal metastatic tumors using a national inpatient database. Methods: Nationwide Inpatient Sample (NIS) database of the Healthcare Cost and Utilization Project (HCUP) was queried for patients undergoing surgical resection for spinal metastasis between January 1, 2005 and December 31, 2017. Patients undergoing preoperative embolization were identified; trends in the utilization of preoperative embolization were analyzed using Cochran-Armitage Test. Multivariable regression was conducted to assess factors associated with higher preoperative embolization utilization. Results: A total of 11,508 patients with spinal metastasis were identified; 105 (0.91%) underwent preoperative embolization. Of the 105 patients, 79 (75.2%) patients had a primary renal cancer as compared to 1,732 (15.19%) for those who did not undergo preoperative embolization (p0.05). Trends in preoperative embolization indicated an increase of 0.16% (std error: 0.024%, p Conclusion: Utilization of preoperative embolization for spinal metastasis is increasing yearly, especially for patients with renal cancer, suggesting that surgeons may increasingly consider embolization before surgical resection for hypervascular tumors. Additionally, the literature has shown the intraoperative and postoperative benefits of this procedure. Grants: None