The Relation of Surgical Procedures And Diagnosis Groups To Unplanned Readmission In Spinal Neurosurgery. A Retrospective Single Center Study.

Abstract

PurposeUnplanned readmission has gained increasing interest as a quality marker for inpatient care, as it is associated with patient mortality and higher economic costs. Spinal neurosurgery is characterized by a lack of epidemiologic readmission data. The aim of this study was to identify causes and predictors for unplanned readmissions related to index diagnoses and surgical procedures. MethodsIn this study from 2015-2017, spinal neurosurgical procedures were recorded. The main reasons for an unplanned readmission in between 30 days after discharge were identified. Multivariate logarithmic regression revealed predictors of unplanned readmission. Results1172 patient records were examined, of which 4.27 % disclosed unplanned readmissions. Among the surgical patients the readmission rate was 4.06 % mainly due to surgical site infections, for the non-surgical patients 5.06 % due to uncontrolled pain. A night-time surgery presented as independent predictive factor. ConclusionIn the heterogeneous group of spinal neurosurgical patients, stratification into diagnostic groups is necessary for statistical analysis. Degenerative lumbar spinal stenosis and spinal abscesses are mainly affected by unplanned readmission. The surgical procedure dorsal root ganglion stimulation is an independent predictor of unplanned re-hospitalizations, as is timing of surgery.