Ninety-day readmissions after degenerative cervical spine surgery: A single-center administrative database study

Akamnonu, Chibuikem; Cheriyan, Thomas; Goldstein, Jeffrey A.; Errico, Thomas J.; Bendo, John A.

doi:10.14444/2019

Cited by 24 publications

(16 citation statements)

References 13 publications

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“…40 The reported 90-day readmission rate following various types of spine surgery (degenerative cervical spine to scoliosis deformity correction) ranges from 1.0% to 12.3%. 4,5,32 The 90-day readmission rate in our study falls into the higher range of the reported rates (11.6%), with average hospital readmission costs totaling $20,078. This cost is significant, especially when taking into account the number of patients who undergo spine tumor surgery.…”

Section: Discussioncontrasting

confidence: 46%

Costs and readmission rates for the resection of primary and metastatic spinal tumors: a comparative analysis of 181 patients

Lau¹,

Chan²,

Theologis

et al. 2016

SPI

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OBJECTIVE Because the surgical strategies for primary and metastatic spinal tumors are different, the respective associated costs and morbidities associated with those treatments likely vary. This study compares the direct costs and 90-day readmission rates between the resection of extradural metastatic and primary spinal tumors. The factors associated with cost and readmission are identified. METHODS Adults (age 18 years or older) who underwent the resection of spinal tumors between 2008 and 2013 were included in the study. Patients with intradural tumors were excluded. The direct costs of index hospitalization and 90-day readmission hospitalization were evaluated. The direct costs were compared between patients who were treated surgically for primary and metastatic spinal tumors. The independent factors associated with costs and readmissions were identified using multivariate analysis. RESULTS A total of 181 patients with spinal tumors were included (63 primary and 118 metastatic tumors). Overall, the mean index hospital admission cost for the surgical management of spinal tumors was $52,083. There was no significant difference in the cost of hospitalization between primary ($55,801) and metastatic ($50,098) tumors (p = 0.426). The independent factors associated with higher cost were male sex (p = 0.032), preoperative inability to ambulate (p = 0.002), having more than 3 comorbidities (p = 0.037), undergoing corpectomy (p = 0.021), instrumentation greater than 7 levels (p < 0.001), combined anterior-posterior approach (p < 0.001), presence of a perioperative complication (p < 0.001), and longer hospital stay (p < 0.001). The perioperative complication rate was 21.0%. Of this cohort, 11.6% of patients were readmitted within 90 days, and the mean hospitalization cost of that readmission was $20,078. Readmission rates after surgical treatment for primary and metastatic tumors were similar (11.1% vs 11.9%, respectively) (p = 0.880). Prior hospital stay greater than 15 days (OR 6.62, p = 0.016) and diagnosis of lung metastasis (OR 52.99, p = 0.007) were independent predictors of readmission. CONCLUSIONS Primary and metastatic spinal tumors are comparable with regard to the direct costs of the index surgical hospitalization and readmission rate within 90 days. The factors independently associated with costs are related to preoperative health status, type and complexity of surgery, and postoperative course.

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Section: Discussioncontrasting

confidence: 46%

Costs and readmission rates for the resection of primary and metastatic spinal tumors: a comparative analysis of 181 patients

Lau¹,

Chan²,

Theologis

et al. 2016

SPI

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“…In these cases, well-designed interventions would successfully reduce the rate of avoidable readmissions by up to 45%. 2 Several factors are involved in the readmission of patients after cervical spine surgery, among them the existence or not of health insurance, age, ethnicity, length of the hospital stay after the first surgery, and the presence of various comorbidities. 3 Among the comorbidities particularly related to orthopedics, heart and kidney failure, chronic obstructive pulmonary disease, diabetes mellitus, cancer, and infection stand out.…”

Section: Introductionmentioning

confidence: 99%

Identification of Risk Factors Associated With 30-Day Readmission of Patients Submitted to Anterior or Posterior Access Cervical Spine Surgery

et al. 2022

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Aim: To conduct a systematic review of the literature to identify risk factors associated with 30-day readmission of patients submitted to anterior or posterior access cervical spine surgery. Methods: The databases used to select the papers were PubMed, Web of Science, and Cochrane, using the following search strategy: patient AND readmission AND (30 day OR “thirty day” OR 30-day OR thirty-day) AND (spine AND cervical). Results: Initially, 179 papers that satisfied the established search stringwere selected. After reading the titles and abstracts, 46 were excluded from the sample for not effectively discussing the theme proposed for this review. Of the 133 remaining papers, 109 were also excluded after a detailed reading of their content, leaving 24 that were included in the sample for the meta-analysis. Conclusions: The average readmission rate in the studies evaluated was 4.85%. Only the occurrence of infections, as well as the presence of patients classified by the American Society of Anesthesiology (ASA) assessment system with scores greater than III, were causal factors that influenced the readmission of patients. No significant differences were noted when comparing the anterior and posterior surgical access routes. Level of evidence II; Systematic Review of Level II or Level I Studies with discrepant results.

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“…Readmission rates and causes have been reported for a number of spinal surgical procedures. For cervical spine, Akamnonu et al reported 90-day readmission rates of 1.5 % and 3.13 % in 640 and 128 patients undergoing anterior and posterior degenerative cervical spine procedures [ 4 ]. For lumbar spine, Chibuikem et al reported a readmission rate of 2.82 % in a cohort of 140 Medicare patients who underwent surgery for degenerative lumbar stenosis within the 90-day postdischarge period [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Unplanned hospital readmission after surgical treatment for thoracic spinal stenosis: incidence and causative factors

Wang

Sun

et al. 2021

BMC Musculoskelet Disord

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Background To assess the incidence and causative factors of unplanned hospital readmission within 90 days after surgical treatment of thoracic spinal stenosis (TSS). Methods Hospital administrative database was queried to identify patients who underwent surgical treatment of TSS from July 2010 through December 2017. All unplanned readmissions within 90 days of discharge were reviewed for causes and the rate of unplanned readmissions was calculated. Patients of unplanned readmission were matched 1:3 to a control cohort without readmission. Results Twenty-one patients (incidence of 1.7 % in 1239 patients) presented unplanned hospital readmission within a 90-day period and enrolled as the study group, 63 non-readmission patients (a proportion of 1: 3) were randomly selected as the control group. Causes of readmission include pseudomeningocele (8 patients; 38 %), CSF leakage combined with poor incision healing (6 patients; 29 %), wound dehiscence (2 patient; 9 %), surgical site infection (2 patients; 9 %), spinal epidural hematoma (1 patient; 5 %), inadequate original surgical decompression (2 patients; 9 %). Mean duration from re-admission to the first surgery was 39.6 ± 28.2 days, most of the patients readmitted at the first 40 days (66.7 %, 14/21 patients). When compared to the non-readmitted patients, diagnosis of OPLL + OFL, circumferential decompression, dural injury, long hospital stay were more to be seen in readmitted patients. Conclusions The incidence of 90-day unplanned readmission after surgical treatment for TSS is 1.7 %, CSF leakage and pseudomeningocele were the most common causes of readmission, the peak period of readmission occurred from 10 to 40 days after surgery, patients should be closely followed up within this period.

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Ninety-day readmissions after degenerative cervical spine surgery: A single-center administrative database study

Cited by 24 publications

References 13 publications

Costs and readmission rates for the resection of primary and metastatic spinal tumors: a comparative analysis of 181 patients

Costs and readmission rates for the resection of primary and metastatic spinal tumors: a comparative analysis of 181 patients

Identification of Risk Factors Associated With 30-Day Readmission of Patients Submitted to Anterior or Posterior Access Cervical Spine Surgery

Unplanned hospital readmission after surgical treatment for thoracic spinal stenosis: incidence and causative factors

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