STUDY DESIGN: A retrospective review of instrumented spine registry from an integrated US healthcare system. OBJECTIVE: Investigate the 30-day readmission rate and risk factors after instrumented spine surgery. SUMMARY OF BACKGROUND DATA: Published readmission rates range from 2% to over 20%. We were interested in learning which patients were at greatest risk, when did readmissions occur, and why. METHOD: 30-day readmission rates were determined for 14,939 patients after an index spine procedure between 1/2009 and 3/2013. Data were analyzed with descriptive statistics, univariate, and multivariate logistic regression analysis. RESULT: The average age of the cohort was 59 (SD = 13.4) and 52% were female. The 30-day readmission rate was 5.5% (821/14,939). The temporal pattern for readmission was: 17% (140) at week 1, 48% (394) at week 2, 72% (591) at week 3, and 100% (821) at week 4. The leading causes were wound complications (infection, hematoma, dehiscence, seroma), sepsis, pain management, pneumonia, and pulmonary emboli/deep venous thrombosis. In a multivariate model, readmission risk factors were: malignancy (OR 2.99, 95% CI: 1.56, 5.73), operative time more than 400 minutes (OR 2.59, 95% CI: 1.66, 4.02), operative time 300-399 minutes (OR 2.33, 95% CI: 1.54-3.52), hospital stay 6-10 days (OR 2.03, 95% CI: 1.31-3.14), hospital stay more than 10 days (OR 1.85, 95% CI: 1.1, -3.08), surgical complications (OR 1.67, 95% CI: 1.18, 2.36), operative time 200-299 (OR 1.52, 95% CI: 1.04, 2.22), depression (OR 1.48, 95% CI: 1.14, 1.93), rheumatoid arthritis (OR 1.45, 95% CI: 1.05, 2.01), deficiency anemia (OR 1.30, 95% CI: 1.05, 1.61), and hypothyroidism (OR 1.29, 95% CI: 1.01, 1.64). CONCLUSION: Surgical complications (dural tear, deep infections, superficial infections, epidural hematoma), malignancy, lengthy operative times, and lengthy initial hospitalizations are all risk factors for 30-day readmission. These findings should be considered during preoperative assessment and surgical planning. LEVEL OF EVIDENCE: 3.
STUDY DESIGN: A retrospective review of instrumented spine registry from an integrated US healthcare system. OBJECTIVE: Investigate the 30-day readmission rate and risk factors after instrumented spine surgery. SUMMARY OF BACKGROUND DATA: Published readmission rates range from 2% to over 20%. We were interested in learning which patients were at greatest risk, when did readmissions occur, and why. METHOD: 30-day readmission rates were determined for 14,939 patients after an index spine procedure between 1/2009 and 3/2013. Data were analyzed with descriptive statistics, univariate, and multivariate logistic regression analysis. RESULT: The average age of the cohort was 59 (SD = 13.4) and 52% were female. The 30-day readmission rate was 5.5% (821/14,939). The temporal pattern for readmission was: 17% (140) at week 1, 48% (394) at week 2, 72% (591) at week 3, and 100% (821) at week 4. The leading causes were wound complications (infection, hematoma, dehiscence, seroma), sepsis, pain management, pneumonia, and pulmonary emboli/deep venous thrombosis. In a multivariate model, readmission risk factors were: malignancy (OR 2.99, 95% CI: 1.56, 5.73), operative time more than 400 minutes (OR 2.59, 95% CI: 1.66, 4.02), operative time 300-399 minutes (OR 2.33, 95% CI: 1.54-3.52), hospital stay 6-10 days (OR 2.03, 95% CI: 1.31-3.14), hospital stay more than 10 days (OR 1.85, 95% CI: 1.1, -3.08), surgical complications (OR 1.67, 95% CI: 1.18, 2.36), operative time 200-299 (OR 1.52, 95% CI: 1.04, 2.22), depression (OR 1.48, 95% CI: 1.14, 1.93), rheumatoid arthritis (OR 1.45, 95% CI: 1.05, 2.01), deficiency anemia (OR 1.30, 95% CI: 1.05, 1.61), and hypothyroidism (OR 1.29, 95% CI: 1.01, 1.64). CONCLUSION: Surgical complications (dural tear, deep infections, superficial infections, epidural hematoma), malignancy, lengthy operative times, and lengthy initial hospitalizations are all risk factors for 30-day readmission. These findings should be considered during preoperative assessment and surgical planning. LEVEL OF EVIDENCE: 3.
Authors: Kevin Cooper; Chad A Glenn; Michael Martin; Julie Stoner; Ji Li; Timothy Puckett Journal: J Clin Neurosci Date: 2015-10-21 Impact factor: 1.961
Authors: Keaton F Piper; Samuel B Tomlinson; Gabrielle Santangelo; Joseph Van Galen; Ian DeAndrea-Lazarus; James Towner; Kristopher T Kimmell; Howard Silberstein; George Edward Vates Journal: Surg Neurol Int Date: 2017-11-01
Authors: Emanuele M Giusti; Giada Pietrabissa; Gian Mauro Manzoni; Roberto Cattivelli; Enrico Molinari; Hester R Trompetter; Karlein M G Schreurs; Gianluca Castelnuovo Journal: Front Psychol Date: 2017-10-31
Authors: Jun S Kim; Robert K Merrill; Varun Arvind; Deepak Kaji; Sara D Pasik; Chuma C Nwachukwu; Luilly Vargas; Nebiyu S Osman; Eric K Oermann; John M Caridi; Samuel K Cho Journal: Spine (Phila Pa 1976) Date: 2018-06-15 Impact factor: 3.241