Aladine A Elsamadicy1, Owoicho Adogwa2, Victoria D Vuong3, Ankit I Mehta4, Raul A Vasquez5, Joseph Cheng6, Isaac O Karikari1, Carlos A Bagley7. 1. Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA. 2. Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, USA. Electronic address: owoicho.adogwa@gmail.com. 3. Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, USA. 4. Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA. 5. Department of Neurosurgery, University of Kentucky, Lexington, Kentucky, USA. 6. Department of Neurosurgery, Yale University, New Haven, Connecticut, USA. 7. Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Abstract
BACKGROUND: Hospital readmission within 30 days of index surgery is receiving increased scrutiny as an indicator of poor quality of care. Reducing readmissions achieves the dual benefit of improving quality and reducing costs. With the growing prevalence of obesity, understanding its impact on 30-day unplanned readmissions and patients' perception of health status is important for appropriate risk stratification of patients. The aim of this study was to determine if obesity is an independent risk factor for unplanned 30-day readmissions after elective spine surgery. METHODS: The medical records of 500 patients (nonobese, n = 281; obese, n = 219) undergoing elective spine surgery at a major academic medical center were reviewed. Preoperative body mass index (BMI) was measured on all patients. BMI that was ≥30 kg/m2 was classified as obese. Patient demographics, comorbidities, and postoperative complication rates were collected. The primary outcome investigated was unplanned all-cause 30-day hospital readmission. The association between preoperative obesity and 30-day readmission rate was assessed via multivariate logistic regression analysis. RESULTS: Baseline characteristics and operative variables and complication profiles were similar between both cohorts. Overall, 8.6% of patients were readmitted within 30 days of discharge; obese patients experienced a 2-fold increase in 30-day readmission rates (obese 12.33% vs. nonobese 5.69%, P = 0.01). In a multivariate logistic regression analysis, preoperative obesity (BMI ≥30 kg/m2) was found to be an independent predictor of 30-day readmission after elective spine surgery (P = 0.001). CONCLUSIONS: Preoperative obesity is an independent risk factor for readmission within 30 days of discharge after elective spine surgery. In a cost-conscious health care climate, preoperative BMI can identify patients at risk for early unplanned hospital readmission. Copyright Â
BACKGROUND: Hospital readmission within 30 days of index surgery is receiving increased scrutiny as an indicator of poor quality of care. Reducing readmissions achieves the dual benefit of improving quality and reducing costs. With the growing prevalence of obesity, understanding its impact on 30-day unplanned readmissions and patients' perception of health status is important for appropriate risk stratification of patients. The aim of this study was to determine if obesity is an independent risk factor for unplanned 30-day readmissions after elective spine surgery. METHODS: The medical records of 500 patients (nonobese, n = 281; obese, n = 219) undergoing elective spine surgery at a major academic medical center were reviewed. Preoperative body mass index (BMI) was measured on all patients. BMI that was ≥30 kg/m2 was classified as obese. Patient demographics, comorbidities, and postoperative complication rates were collected. The primary outcome investigated was unplanned all-cause 30-day hospital readmission. The association between preoperative obesity and 30-day readmission rate was assessed via multivariate logistic regression analysis. RESULTS: Baseline characteristics and operative variables and complication profiles were similar between both cohorts. Overall, 8.6% of patients were readmitted within 30 days of discharge; obesepatients experienced a 2-fold increase in 30-day readmission rates (obese 12.33% vs. nonobese 5.69%, P = 0.01). In a multivariate logistic regression analysis, preoperative obesity (BMI ≥30 kg/m2) was found to be an independent predictor of 30-day readmission after elective spine surgery (P = 0.001). CONCLUSIONS:Preoperative obesity is an independent risk factor for readmission within 30 days of discharge after elective spine surgery. In a cost-conscious health care climate, preoperative BMI can identify patients at risk for early unplanned hospital readmission. Copyright Â
Authors: Shubing Cai; Sijiu Wang; Dana B Mukamel; Thomas Caprio; Helena Temkin-Greener Journal: J Am Med Dir Assoc Date: 2019-03-08 Impact factor: 4.669
Authors: William A Ranson; Zoe B Cheung; John Di Capua; Nathan J Lee; Chierika Ukogu; Samantha Jacobs; Khushdeep S Vig; Jun S Kim; Samuel J W White; Samuel K Cho Journal: Global Spine J Date: 2018-04-22
Authors: Kee D Kim; Dinesh Ramanathan; Jason Highsmith; William Lavelle; Peter Gerszten; Fernando Vale; Neill Wright Journal: Global Spine J Date: 2018-08-13