Diaphragm pacing decreases hospital charges for patients with acute cervical spinal cord injury Article Swipe
Andrew J. Kerwin
,
Yohan Diaz Zuniga
,
Brian K. Yorkgitis
,
Jennifer Mull
,
Albert Hsu
,
Firas Madbak
,
David J. Ebler
,
David Skarupa
,
Joseph Shiber
,
Marie Crandall
·
YOU?
·
· 2020
· Open Access
·
· DOI: https://doi.org/10.1136/tsaco-2020-000528
YOU?
·
· 2020
· Open Access
·
· DOI: https://doi.org/10.1136/tsaco-2020-000528
Background Cervical spinal cord injury (CSCI) is devastating and costly. Previous research has demonstrated that diaphragm pacing (DPS) is safe and improves respiratory mechanics. This may decrease hospital stays, vent days, and costs. We hypothesized DPS implantation would facilitate liberation from ventilation and would impact hospital charges. Methods We performed a retrospective review of patients with acute CSCI between January 2005 and May 2017. Routine demographics were collected. Patients underwent propensity matching based on age, injury severity score, ventilator days, hospital length of stay, and need for tracheostomy. We then adjusted total hospital charges by year using US Bureau of Labor Statistics annual adjusted Medical Care Prices. Bivariate and multivariate linear regression statistics were performed using STATA V.15. Results Between July 2011 and May 2017, all patients with acute CSCI were evaluated for DPS implantation. 40 patients who had laparoscopic DPS implantation (DPS) were matched to 61 who did not (NO DPS). Following DPS implantation, there was a statistically significant increase in spontaneous Vt compared with NO DPS (+88 mL vs −13 mL; 95% CI 46 to 131 vs −78 to 51 mL, respectively; p=0.004). Median time to liberation after DPS was significantly shorter (10 vs 29 days; 95% CI 6.5 to 13.6 vs 23.1 to 35.3 days; p<0.001). Adjusted hospital charges were significantly lower for DPS on multivariate linear regression models controlling for year of injury, sex, race, injury severity, and age (p=0.003). Discussion DPS implantation in patients with acute CSCI produces significant improvements in spontaneous Vt and reduces time to liberation, which translated into reduced hospital charges on a risk-adjusted, inflation-adjusted model. DPS implantation for patients with acute CSCI should be considered. Level of evidence Level III.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1136/tsaco-2020-000528
- https://tsaco.bmj.com/content/tsaco/5/1/e000528.full.pdf
- OA Status
- gold
- Cited By
- 10
- References
- 11
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W3114335575
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W3114335575Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1136/tsaco-2020-000528Digital Object Identifier
- Title
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Diaphragm pacing decreases hospital charges for patients with acute cervical spinal cord injuryWork title
- Type
-
articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2020Year of publication
- Publication date
-
2020-12-01Full publication date if available
- Authors
-
Andrew J. Kerwin, Yohan Diaz Zuniga, Brian K. Yorkgitis, Jennifer Mull, Albert Hsu, Firas Madbak, David J. Ebler, David Skarupa, Joseph Shiber, Marie CrandallList of authors in order
- Landing page
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https://doi.org/10.1136/tsaco-2020-000528Publisher landing page
- PDF URL
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https://tsaco.bmj.com/content/tsaco/5/1/e000528.full.pdfDirect link to full text PDF
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YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://tsaco.bmj.com/content/tsaco/5/1/e000528.full.pdfDirect OA link when available
- Concepts
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Medicine, Propensity score matching, Spinal cord injury, Retrospective cohort study, Anesthesia, Mechanical ventilation, Logistic regression, Multivariate analysis, Internal medicine, Surgery, Spinal cord, PsychiatryTop concepts (fields/topics) attached by OpenAlex
- Cited by
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10Total citation count in OpenAlex
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2025: 1, 2024: 2, 2023: 3, 2022: 4Per-year citation counts (last 5 years)
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11Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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