STUDY DESIGN: Retrospective study of prospectively collected data. OBJECTIVE: To perform a multiinstitutional assessment on the incidence and risk factors for unplanned readmissions following elective posterior lumbar fusion (PLF) surgery. SUMMARY OF BACKGROUND DATA: Understanding what may drive rehospitalizations is a necessary step toward higher quality care. Identifying risk factors for unplanned readmission is especially important for elective PLF, which is a common procedure that is known to be associated with significant adverse events. METHODS: Adult patients undergoing PLF were identified using current procedure terminology (CPT) from the American College of Surgeons National Surgical Quality Improvement Program. Both descriptive and comparative statistics were performed for patient characteristics, clinical factors, and postoperative complications. Subsequently, a step-wise multivariate logistic regression was employed. RESULTS: Of the 2301 patients who met inclusion criteria for this study, 117 were unplanned readmissions (5.1%). These occurred at a mean of 15.9 days (range: 3-30 days) after surgery. The risk-adjusted analysis revealed that bleeding disorder (odds ratio, OR = 2.8, confidence intervals, CI = 1.0-7.6, P = 0.043), insulin dependent diabetes (OR = 2.5, CI = 1.4-4.4, P = 0.004), and total length of stay > 5 days (OR = 1.8, CI = 1.2-2.8, P = 0.009) were independent predictors for unplanned readmission. Significant postoperative complications included wound complications (OR = 27.6, CI = 13.9-54.8, P < 0.0001), pulmonary embolism and/or deep vein thrombosis/thrombophlebitis (OR = 11.9, CI = 5.0-28.5, P < 0.0001), sepsis (OR = 8.5, CI = 2.3-32.1, P = 0.002), and urinary tract infections (OR = 2.4, CI = 0.9-6.9, P = 0.094). CONCLUSION: The unplanned readmission rate for patients undergoing PLF was low, but this study's findings of potentially modifiable risk factors suggest that substantial improvement with this quality metric is possible. LEVEL OF EVIDENCE: N/A.
STUDY DESIGN: Retrospective study of prospectively collected data. OBJECTIVE: To perform a multiinstitutional assessment on the incidence and risk factors for unplanned readmissions following elective posterior lumbar fusion (PLF) surgery. SUMMARY OF BACKGROUND DATA: Understanding what may drive rehospitalizations is a necessary step toward higher quality care. Identifying risk factors for unplanned readmission is especially important for elective PLF, which is a common procedure that is known to be associated with significant adverse events. METHODS: Adult patients undergoing PLF were identified using current procedure terminology (CPT) from the American College of Surgeons National Surgical Quality Improvement Program. Both descriptive and comparative statistics were performed for patient characteristics, clinical factors, and postoperative complications. Subsequently, a step-wise multivariate logistic regression was employed. RESULTS: Of the 2301 patients who met inclusion criteria for this study, 117 were unplanned readmissions (5.1%). These occurred at a mean of 15.9 days (range: 3-30 days) after surgery. The risk-adjusted analysis revealed that bleeding disorder (odds ratio, OR = 2.8, confidence intervals, CI = 1.0-7.6, P = 0.043), insulin dependent diabetes (OR = 2.5, CI = 1.4-4.4, P = 0.004), and total length of stay > 5 days (OR = 1.8, CI = 1.2-2.8, P = 0.009) were independent predictors for unplanned readmission. Significant postoperative complications included wound complications (OR = 27.6, CI = 13.9-54.8, P < 0.0001), pulmonary embolism and/or deep vein thrombosis/thrombophlebitis (OR = 11.9, CI = 5.0-28.5, P < 0.0001), sepsis (OR = 8.5, CI = 2.3-32.1, P = 0.002), and urinary tract infections (OR = 2.4, CI = 0.9-6.9, P = 0.094). CONCLUSION: The unplanned readmission rate for patients undergoing PLF was low, but this study's findings of potentially modifiable risk factors suggest that substantial improvement with this quality metric is possible. LEVEL OF EVIDENCE: N/A.
Authors: David N Bernstein; Aakash Keswani; Debbie Chi; James E Dowdell; Samuel C Overley; Saad B Chaudhary; Addisu Mesfin Journal: J Spine Surg Date: 2019-03
Authors: Akash A Shah; Sai K Devana; Changhee Lee; Amador Bugarin; Elizabeth L Lord; Arya N Shamie; Don Y Park; Mihaela van der Schaar; Nelson F SooHoo Journal: World Neurosurg Date: 2021-05-28 Impact factor: 2.210
Authors: Kevin Phan; Alexander E Dunn; Jun S Kim; John Di Capua; Sulaiman Somani; Parth Kothari; Nathan J Lee; Joshua Xu; James E Dowdell; Samuel K Cho Journal: Global Spine J Date: 2017-06-30
Authors: Kevin Phan; Khushdeep S Vig; Yam Ting Ho; Awais K Hussain; John Di Capua; Jun S Kim; Samuel J W White; Nathan J Lee; Parth Kothari; Samuel K Cho Journal: Global Spine J Date: 2018-08-13
Authors: Nathaniel T Ondeck; Daniel D Bohl; Patawut Bovonratwet; Ryan P McLynn; Jonathan J Cui; Andre M Samuel; Matthew L Webb; Jonathan N Grauer Journal: Int J Spine Surg Date: 2018-10-15
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