Takahiro Makino1, Shota Takenaka1, Yusuke Sakai1, Hideki Yoshikawa1, Takashi Kaito2. 1. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. 2. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. Electronic address: takashikaito@ort.med.osaka-u.ac.jp.
Abstract
BACKGROUND: Postoperative recovery of activities of daily living after surgery in elderly patients often takes a longer time because of their frailty. However, it is unclear how long it takes for patients with adult spinal deformity (ASD) to recover their abilities to live their daily lives in their home after corrective fusion surgery. This study aimed to investigate the length of hospital stay required to perform activities of daily living (ADL) in patients undergoing two-stage corrective fusion surgery for ASD in our institution and to detect factors associated with the length of hospital stay. METHODS: Thirty-four consecutive female ASD patients (median age, 70 years) who underwent two-stage corrective fusion surgery (lateral lumbar interbody fusion at the first stage and posterior corrective fusion at the second stage) from T9 or T10 to the pelvis were included. The length of hospital stay from admission to return home was determined, and correlations between length of hospital stay and demographics, skeletal muscle mass, operative invasion and perioperative complications, and spino-pelvic alignment were investigated. RESULTS: The median length of hospital stay was 51 days, exceeding 100 days in 25% of cases. Age at surgery (ρ = 0.545, p = 0.001), estimated glomerular filtration rate (ρ = -0.603, p < 0.001), age-adjusted Charlson comorbidity index (ρ = 0.437, p = 0.01), and preoperative pelvic incidence (ρ = 0.356, p = 0.04) were correlated with length of hospital stay. Preoperative skeletal muscle mass, preoperative spinal imbalance, perioperative changes in spino-pelvic alignment, operative invasion, and perioperative complications were not correlated with length of hospital stay. CONCLUSIONS: After >50 days, ADL performance of each patient reached the extent required for daily living to return home after two-stage corrective fusion surgery for ASD. Factors related to length of hospital stay were age and indices related to frailty.
BACKGROUND: Postoperative recovery of activities of daily living after surgery in elderly patients often takes a longer time because of their frailty. However, it is unclear how long it takes for patients with adult spinal deformity (ASD) to recover their abilities to live their daily lives in their home after corrective fusion surgery. This study aimed to investigate the length of hospital stay required to perform activities of daily living (ADL) in patients undergoing two-stage corrective fusion surgery for ASD in our institution and to detect factors associated with the length of hospital stay. METHODS: Thirty-four consecutive female ASDpatients (median age, 70 years) who underwent two-stage corrective fusion surgery (lateral lumbar interbody fusion at the first stage and posterior corrective fusion at the second stage) from T9 or T10 to the pelvis were included. The length of hospital stay from admission to return home was determined, and correlations between length of hospital stay and demographics, skeletal muscle mass, operative invasion and perioperative complications, and spino-pelvic alignment were investigated. RESULTS: The median length of hospital stay was 51 days, exceeding 100 days in 25% of cases. Age at surgery (ρ = 0.545, p = 0.001), estimated glomerular filtration rate (ρ = -0.603, p < 0.001), age-adjusted Charlson comorbidity index (ρ = 0.437, p = 0.01), and preoperative pelvic incidence (ρ = 0.356, p = 0.04) were correlated with length of hospital stay. Preoperative skeletal muscle mass, preoperative spinal imbalance, perioperative changes in spino-pelvic alignment, operative invasion, and perioperative complications were not correlated with length of hospital stay. CONCLUSIONS: After >50 days, ADL performance of each patient reached the extent required for daily living to return home after two-stage corrective fusion surgery for ASD. Factors related to length of hospital stay were age and indices related to frailty.
Authors: Iride Francesca Ceresa; Gabriele Savioli; Valentina Angeli; Viola Novelli; Alba Muzzi; Giuseppina Grugnetti; Lorenzo Cobianchi; Federica Manzoni; Catherine Klersy; Paolo Lago; Pierantonio Marchese; Carlo Marena; Giovanni Ricevuti; Maria Antonietta Bressan Journal: Open Access Emerg Med Date: 2020-11-16