Causes and Risk Factors for 30-Day Unplanned Readmissions After Lumbar Spine Surgery

Abstract

3.

What Are the 30-day Readmission Rates Across Orthopaedic Subspecialties?

“…We recommend that future studies examine the benefits of close monitoring and rigorous followup on the readmission rate of patients with extended lengths of stay. The correlation of ASA score to increased 30-day readmissions aligns with results reported in the orthopaedic spine literature [3,16,23,25]. We believe that an increased ASA score aligns with increased comorbidities, thus increasing the likelihood of 30-day readmission.…”

“…This is low compared with other orthopaedic studies [9,27]. As we would expect with a low incidence of surgical readmission, our medical 30-day readmission rate of 42% is high when compared with other studies [18,20,23]. The most common cause of surgical readmission is surgical site infection.…”

“…Length of stay has been well studied and shown to be a risk factor for readmission in the orthopaedic literature [8,9,22,23,27]. We believe this is because patients typically have longer admissions if they have had a more intense procedure or have other medical conditions requiring treatment, both of which could impart a greater risk of 30-day readmission.…”

The National Neurosurgery Quality and Outcomes Database Qualified Clinical Data Registry: 2015 measure specifications and rationale

“…The most common etiology was wound complications (38.6%), including superficial and deep infection, hematoma, or seroma development. 113 In neurosurgery-specific data, a study of 4970 patients undergoing lumbar spine surgery in the N 2 QOD registry demonstrated an overall 30-day readmission rate of 3.7%, with a 90-day readmission rate of 8.9%. 9 Read-missions varied by pathology and operation, with 2.4% of patients with disc herniation, 3.4% of patients with spondylolisthesis, and 4.9% of patients with spinal stenosis requiring readmission within 30 days.…”

“…Wound infection was found to be the most common precipitating event (38.6%) of 30-day readmissions in the 2012 ACS NSQIP data for 15,668 patients undergoing lumbar spine surgery. 113 The National Healthcare Safety Network (2006)(2007) demonstrated an SSI rate of 2.8%-9.7% for spine surgery. 37 Given the magnitude and the potential impact of postoperative infections on spine patients, establishing process measures to, in part, prevent these complications is of paramount importance.…”