Nationwide study of risk factors for reoperation after surgical treatment for degenerative spinal disease in Poland

Background The aim of the study is to evaluate the reoperation rate after surgical treatment for degenerative spinal diseases (DSD) in Poland and to identify risk factors for reoperation, including comorbidities and other variables. Methods A retrospective analysis of hospitalisations in 2018 that were reported to the National Health Fund (NHF) using ICD-10 codes: M43.1, M47, M48, M50, M51, M53 and Diagnosis Related Group (DRG) codes: A22, A23, A27, H51, H52, H53, H55. Reoperations were identified using the same codes provided that they were reported within 365 days after discharge. The analysis involved demographic factors and patient multimorbidity. A logistic regression model was then performed to assess risk factors for reoperation. Results In 2018, 38,953 surgical hospitalisations for DSD were reported. A total of 3,942 hospitalised patients (10.12%) needed reoperation within 365 days. Patients requiring reoperation were predominantly women (1.34:1) and the elderly (mean age: 56.66 vs. 53.24). The percentage of reoperations correlated with the multimorbidity rate (from 8.81–15.31%). The risk of reoperation was most increased by concomitant depression, neurological diseases, obesity and older age. The risk of reoperation was reduced by instrumented spinal surgery, operations in a neurosurgical department and hospitalisations other than day-surgery. Conclusions Reoperations within the first year of surgical treatment for DSD are common. Identification of risk factors for reoperation, including those related to the presence of comorbidities and the phenomenon of multimorbidity, can be an important tool in reducing the reoperation rate.