Real-world outcomes in spinal cord stimulation: predictors of reported effect and explantation using a comprehensive registry-based approach
| العنوان: | Real-world outcomes in spinal cord stimulation: predictors of reported effect and explantation using a comprehensive registry-based approach |
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| المؤلفون: | Kirketeig, Terje, Söreskog, Emma, Jacobson, Trolle, Karlsten, Rolf, Zethraeus, Niklas, Borgström, Fredrik |
| المصدر: | Pain Reports. 8(6) |
| مصطلحات موضوعية: | Neuromodulation, Administrative register, Chronic pain, Effectiveness, Education, Real-world evidence |
| الوصف: | Introduction: Despite advancements in implanted hardware and development of novel stimulation paradigms in Spinal Cord Stimulation (SCS), real world evidence suggests a large variation in patient reported outcomes and a proportion of patients are later explanted due to loss of analgesia. Possible predictors for outcome have been explored in smaller short-term evaluations, but few clinically applicable robust measures for long term outcome have emerged.Methods: We performed a comprehensive retrospective study based on an assembled patient-level aggregated database from multiple local and national registries in Sweden. Variables associated with risk of explantation (due to insufficient analgesia) and analgesic effect was analyzed using a Cox regression analysis and an ordered logit regression model, respectively.Results: We found the accumulated risk of explantation due to loss of analgesia to be 10% and 21% at two and ten years follow up, respectively. The use of 10 kHz spinal cord stimulation (compared with Tonic waveform; p = 0.003), and being 60 years or older (reference 18-40 years; p = 0.003) were associated with an increased risk of explantation.At a mean follow up at 1 year, 48% of patients reported a pain intensity reduction from baseline of at least 30%. Secondary (p = 0.030) and post-secondary (p = 0.001) education (compared with primary education) was associated with an increased probability of successful patient reported outcomes.Results:We found the accumulated risk of explantation due to loss of analgesia to be 10% and 21% at two and ten years follow up, respectively. The use of 10 kHz spinal cord stimulation (compared with Tonic waveform; p = 0.003), and being 60 years or older (reference 18-40 years; p = 0.003) were associated with an increased risk of explantation.At a mean follow up at 1 year, 48% of patients reported a pain intensity reduction from baseline of at least 30%. Secondary (p = 0.030) and post-secondary (p = 0.001) education (compared with primary education) was associated with an increased probability of successful patient reported outcomes.Conclusion: This study suggests that a higher educational level and being employed are associated with successful treatment outcome in patients with chronic pain treated with SCS in Sweden. |
| وصف الملف: | electronic |
| الوصول الحر: | https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-516899Test https://doi.org/10.1097/PR9.0000000000001107Test https://uu.diva-portal.org/smash/get/diva2:1816442/FULLTEXT01.pdfTest |
| قاعدة البيانات: | SwePub |
| تدمد: | 24712531 |
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| DOI: | 10.1097/PR9.0000000000001107 |