Burden of Sciatica on US Medicare Recipients. Issue 10 (15th May 2020)

• Record Type: Journal Article
• Authors: Maslak, Joseph P.; Jenkins, Tyler J.; Weiner, Joseph A.; Kannan, Abhishek S.; Patoli, Daneel M.; McCarthy, Michael H.; Hsu, Wellington K.; Patel, Alpesh A.
• Is Part Of: Journal of the American Academy of Orthopaedic Surgeons. Volume 28:Issue 10(2020)
• Publication Date: 2020-05-15
• Subjects: Orthopedics -- Periodicals; Orthopedic surgery -- Periodicals; Joint Diseases -- Periodicals; Orthopedics -- Periodicals; Orthopedic surgery; Orthopedics; Periodicals; 616.7005
• DOI: 10.5435/JAAOS-D-19-00174
• Languages: English
• ISSNs: 1067-151X

Abstract

Abstract : Objective: This study evaluates the disease burden of sciatica on the US Medicare cohort. Background Data: Sciatica is a common disability that has important physical, mental, and economic effects. The Medicare Health Outcomes Survey (HOS) is a demographic and outcomes survey used to monitor the performance of Medicare Advantage health plans in the United States. The HOS includes data on demographics, chronic medical conditions, and patient-reported outcomes. Methods: Medicare HOS data for cohorts from 2007 to 2013 were obtained. Patients were placed into two categories based on the survey results: with or without a history of sciatica. Baseline demographics, chronic medical conditions, and physical health symptoms were aggregated. In addition, average VR-12 physical component summary and mental component summary scores were calculated for each group at baseline and at 2-year follow-up. A Fisher exact test was used to assess significance for categorical variables, and a t -test was used for continuous variables. VR-12 changes as small as 1 to 2 units have been found to be clinically and socially relevant. Results: The baseline cohort data of 1, 000, 952 patients yielded 250, 869 patients (25%) who reported the diagnosis of sciatica, compared with 750, 083 patients (75%) without sciatica. Patients with a history of sciatica tended to be younger, less educated, and notably with more medical comorbidities. Physical component summary outcomes were approximately 8 units lower in the sciatica group at baseline and 7 units lower at 2-year follow-up. Mental component summary outcomes were 6 units lower in the sciatica group at baseline and 5 units lower at 2-year follow-up. Conclusion: A large percentage of the US Medicare cohort suffers from symptomatic sciatica. Our study identified a 25% prevalence in the Medicare cohort. In addition, sciatica is associated with an increased incidence of comorbid medical conditions and poor health-related quality of life. Level of Evidence: Level III Study Design: Observational-Cohort Study