1. The Effect of Discharging Patients with Low Hemoglobin Levels on Hospital Readmission and Quality of Life after Adult Spinal Deformity Surgery
- Author
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Nabi, Vugar, Ayhan, Selim, Yuksel, Selcen, Adhikari, Prashant, Vila-Casademunt, Alba, Pellise, Ferran, Perez-Grueso, Francisco Sanchez, Alanay, Ahmet, Obeid, Ibrahim, Kleinstueck, Frank, Acaroglu, Emre, Grp, European Spine Study, Acibadem University Dspace, Institut Català de la Salut, [Nabi V] Department of Orthopaedics and Traumatology, Antalya Research and Education Hospital, Ministry of Health, University of Health Science, Antalya, Turkey. [Ayhan S] Department of Neurosurgery, Baskent University Hospital, Ankara, Turkey. [Yuksel S] Department of Biostatistics, Yildirim Beyazit University, Ankara, Turkey. [Adhikari P] ARTES Spine Center, Acibadem Ankara Hospital, Ankara, Turkey. [Vila-Casademunt A, Pellise F] Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
- Subjects
medicine.medical_specialty ,Blood management ,Anemia ,Health-related quality of life ,sistema musculoesquelético::esqueleto::huesos::columna vertebral [ANATOMÍA] ,Adult spine deformity ,Scoliosis ,Quality of life ,Statistical significance ,medicine ,Columna vertebral - Malformacions - Cirurgia ,Orthopedics and Sports Medicine ,Patient outcome assessment ,Hospitals - Ingressos i altes ,Hospital readmission ,business.industry ,diagnóstico::pronóstico::resultado del tratamiento [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Otros calificadores::Otros calificadores::/cirugía [Otros calificadores] ,Retrospective cohort study ,Diagnosis::Prognosis::Treatment Outcome [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,medicine.disease ,Other subheadings::Other subheadings::/surgery [Other subheadings] ,Surgery ,Therapeutics::Patient Care::Hospitalization::Patient Readmission [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Avaluació de resultats (Assistència sanitària) ,terapéutica::asistencia al paciente::hospitalización::reingreso de pacientes [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Hemoglobin ,business ,Musculoskeletal System::Skeleton::Bone and Bones::Spine [ANATOMY] - Abstract
Adult spine deformity; Anemia; Patient outcome assessment Deformidad de la columna en adultos; Anemia; Evaluación del resultado del paciente Deformitat de la columna en adults; Anèmia; Avaluació dels resultats del pacient Study Design Retrospective cohort. Purpose This study aims to evaluate the impact of anemia on functional outcomes, health-related quality of life (HRQoL), and early hospital readmission (EHR) rates after adult spinal deformity (ASD) surgery at the time of discharge from the hospital. Overview of Literature Concerns with risks of transfusion, insufficient evidence for its benefits, and the possibility of associated adverse outcomes have led to restrictive transfusion practices. Therefore, patients are discharged according to patient blood management programs that are implemented in hospitals nationwide to reduce unnecessary blood transfusions. However, not many comprehensive kinds of studies exist on the effect of postoperative anemia on functional life and complications. Methods Anemia severity was defined following the 2011 World Health Organization guidelines. All patients had HRQoL tests as well as complete blood counts pre- and postoperatively. EHR is the admission within 30 days of discharge and was used as the dependent parameter. Results This study comprised 225 surgically treated ASD patients with a median age of 62.0 years, predominantly women (80%). Of the 225 patients, 82, 137, and six had mild, moderate, and severe anemia at the time of discharge, respectively. Seventeen of the patients (mild [11, 64.7%]; moderate [5, 29.4%]; severe [1, 5.9%]) were readmitted within 30 days. The mean hemoglobin values were higher in readmitted patients (p=0.071). Infection was the leading cause of readmission (n=12), but a low hemoglobin level was not observed in any of these patients at the time of discharge. Except for Scoliosis Research Society-22 questionnaire, HRQoL improvements did not reach statistical significance in early readmitted patients in the first year after surgery. Conclusions The results of this study demonstrated that the occurrence and the severity of postoperative anemia are not associated with EHR in surgically treated patients with ASD. The findings of the current research suggested that clinical awareness of the parameters other than postoperative anemia may be crucial. Thus, improvements in HRQoL scores were poor in early readmitted patients 1 year after surgery. European Spine Study Group is a clinical research group funded by a research grant from DePuy-Synthes.
- Published
- 2022