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Abstract Details

Sex Disparities in the Utilization of Deep Brain Stimulation for Essential Tremor and Parkinson Disease
Movement Disorders
Movement Disorders Posters (7:00 AM-5:00 PM)
098
Examine sex differences in deep brain stimulation (DBS) surgery for Essential Tremor (ET) and Parkinson disease (PD) in the United States.
DBS is an FDA-approved treatment for multiple medication-refractory movement disorders, including PD and ET. Despite comparable safety and efficacy between sexes, women consistently comprise only 23-30% of recipients with PD. We sought to determine if this same disparity exists in ET, a disorder with equal prevalence among men and women.

We queried the National Readmissions Database (NRD) to identify patients >40 years old with ET and PD who received DBS from 2016-2017. We calculated the proportion of men and women for both diagnoses and compared demographic, clinical, and admission characteristics using chi-square and t-tests. Sampling weights were used to produce national estimates. Patients at the University of Colorado were identified using referral logs from 2011-2018.

From 2016-2017, 6,954 individuals with PD received DBS, including 2,118 women (30.5%) and 4,836 men (69.5%). There were no differences in age, primary payer, income, length of stay (LOS), or discharge disposition between sexes. Three thousand ten patients with ET underwent DBS, including 1,287 women (42.8%) and 1,723 (57.2%) men. More women had Medicare as the primary payer (77.9% vs 66.1%) and women averaged a slightly longer LOS (1.8 vs 1.4 days). Twice as many women were discharged to inpatient rehabilitation than men, however, numbers were low overall.

Sixty-eight patients with ET were referred to the University of Colorado for DBS from 2011-2018, including 48 (70.6%) men and 20 (29.4%) women. Of the 36 men approved, 30 underwent surgery, while 12 women were approved but only six pursued surgery (83.3% men vs 50% women, p=0.02).

Lower DBS utilization by women with ET despite equal disease prevalence among the sexes suggests that additional factors contribute to sex disparities in DBS for PD and ET.
Authors/Disclosures
Lisa M. Deuel, MD (University of Vermont)
PRESENTER
Dr. Deuel has nothing to disclose.
Michelle Fullard, MD (University of Colorado Anschutz) Dr. Fullard has received research support from Davis Phinney Foundation. Dr. Fullard has received research support from Michael J. Fox Foundation. The institution of Dr. Fullard has received research support from NIH BIRCWH K12. Dr. Fullard has received research support from Lorna G. Moore Faculty Launch Fund.
Stefan Sillau Stefan Sillau has nothing to disclose.
Drew S. Kern, MD, FÂé¶¹´«Ã½Ó³»­ (University of Colorado) Dr. Kern has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. The institution of Dr. Kern has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Scientific. The institution of Dr. Kern has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Kern has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbott. The institution of Dr. Kern has received research support from Boston Scientific. The institution of Dr. Kern has received research support from AbbVie Pharmaceticals. Dr. Kern has received research support from Medtronic.
Michelle Fullard, MD (University of Colorado Anschutz) Dr. Fullard has received research support from Davis Phinney Foundation. Dr. Fullard has received research support from Michael J. Fox Foundation. The institution of Dr. Fullard has received research support from NIH BIRCWH K12. Dr. Fullard has received research support from Lorna G. Moore Faculty Launch Fund.