The rising incidence of spontaneous cerebrospinal fluid leaks in the United States and the association with obesity and obstructive sleep apnea

Rick F Nelson; Bruce J Gantz; Marlan R Hansen

doi:10.1097/MAO.0000000000000535

Back

The rising incidence of spontaneous cerebrospinal fluid leaks in the United States and the association with obesity and obstructive sleep apnea

Journal article

Peer reviewed

The rising incidence of spontaneous cerebrospinal fluid leaks in the United States and the association with obesity and obstructive sleep apnea

Rick F Nelson, Bruce J Gantz and Marlan R Hansen

Otology & neurotology, Vol.36(3), pp.476-480

03/2015

DOI: 10.1097/MAO.0000000000000535

PMID: 25111523

View Online

Abstract

To determine the national rates of spontaneous CSF leaks and to determine the association with risk factors. Retrospective review from 2002 to 2012. University HealthSystem Consortium (UHC) database of 127 of the leading academic medical centers in the United States (81 centers participated all years of the study). Those who underwent craniotomy for CSF leak repair in the UHC database and those who have undergone repair of spontaneous CSF leaks at one UHC center. Assessment of procedure code rates and patient demographics from 2002 to 2012. National rates of craniotomy for spontaneous CSF leak repair each year, the relation to U.S. regional obesity rates, and the proportion of patients with coincident obstructive sleep apnea. Spontaneous CSF leak patient characteristics (age, sex, BMI, hypertension, and OSA) were calculated. The rate of craniotomy for spontaneous CSF leak repair has risen 2 fold from 2002 (218 cases per year) to 2012 (488 cases per year). There was no change in the rate of nonspontaneous CSF leaks over the same period. The rate of spontaneous CSF leak repair is twice as high (2.54 versus 1.07 per million people per year) in regions of the United States with the highest obesity rate (Midwest) compared with the lowest obesity rate (West). All patients with spontaneous CSF leaks were overweight (BMI, >25 kg/m2) with an average BMI of 37.8 kg/m2. The average age was 57.03 years, and 72% were female. Patients with spontaneous CSF leaks presented with high rate of OSA (14.8% nationally and 37.1% at the University of Iowa) and hypertension (85.7%). The national rate of craniotomy for spontaneous CSF leak repair is rising. This condition is yet another public health problem related to the rising obesity epidemic. All patients with spontaneous CSF leaks should be evaluated for OSA.

Body Mass Index

United States - epidemiology

Comorbidity

Humans

Middle Aged

Risk Factors

Male

Treatment Outcome

Incidence

Young Adult

Cerebrospinal Fluid Leak - surgery

Obesity - epidemiology

Adolescent

Aged, 80 and over

Adult

Cerebrospinal Fluid Leak - epidemiology

Craniotomy

Female

Aged

Retrospective Studies

Sleep Apnea, Obstructive - epidemiology

Child

Details

Title: Subtitle: The rising incidence of spontaneous cerebrospinal fluid leaks in the United States and the association with obesity and obstructive sleep apnea
Creators: Rick F Nelson - Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, Indiana; and Departments of †Otolaryngology-Head and Neck Surgery, and ‡Neurosurgery, University of Iowa, Iowa City, Iowa, U.S.A
Bruce J Gantz
Marlan R Hansen
Resource Type: Journal article
Publication Details: Otology & neurotology, Vol.36(3), pp.476-480
Publisher: United States
DOI: 10.1097/MAO.0000000000000535
PMID: 25111523
ISSN: 1531-7129
eISSN: 1537-4505
Language: English
Date published: 03/2015
Academic Unit: Molecular Physiology and Biophysics; Neurosurgery; Otolaryngology
Record Identifier: 9984006484402771

Metrics

28 Record Views

99 Times Cited - Web of Science

See more details