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Predictors of 30-Day Hospital Readmission After Posterior Cervical Fusion in 3401 Patients
- Source :
- Spine. 43:356-363
- Publication Year :
- 2018
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2018.
-
Abstract
- Retrospective cohort study.The aim of the study was to determine readmission rates and predictors of readmission after posterior cervical fusion (PCF).PCFs are common spinal operations for a variety of spinal disorders including cervical myelopathy, unstable fractures, cervical deformity, and tumors. Data elaborating on risk factors for 30-day readmission are limited.Data were collected from the 2006 to 2013 American College of Surgeons National Surgical Quality Improvement Program database. Predictors of 30-day readmission comprising patient demographics, comorbidities, operative features, and postoperative complications were identified through logistic multivariable regression.A total of 3401 patients met study criteria. Rate of 30-day readmission was 6.20%. Multilevel fusion was performed in 69.16% of patients. Postoperative infection was the most reason, accounting for 17.06% of all readmissions. Age older than 70 years (odds ratio [OR] = 1.61, P = 0.012), renal failure requiring dialysis (OR = 3.69, P = 0.011), anemia (OR = 1.57, P = 0.006), multilevel fusion (OR = 1.61, P = 0.012), surgical site infections (OR = 20.4, P 0.001), wound dehiscence (OR = 19.08, P 0.001), postoperative pneumonia (OR = 2.75, P = 0.01), pulmonary embolism (OR = 15.39, P 0.001), and progressing renal insufficiency (OR = 10.13, P = 0.061) were significant predictors of hospital readmission.The identified predictors of readmission after PCF can improve patient counseling, identification of high-risk patients, and guide changes in healthcare delivery pathways. Patients with modifiable risk factors such as anemia and kidney failure may benefit from preoperative optimization. In addition, postoperative complications represent a key target for intervention.3.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
Anemia
medicine.medical_treatment
Patient Readmission
Cohort Studies
03 medical and health sciences
Myelopathy
Postoperative Complications
0302 clinical medicine
Predictive Value of Tests
Risk Factors
medicine
Humans
Surgical Wound Infection
Orthopedics and Sports Medicine
030212 general & internal medicine
Cervical fusion
Dialysis
Aged
Retrospective Studies
business.industry
Wound dehiscence
Retrospective cohort study
Pneumonia
Middle Aged
medicine.disease
Pulmonary embolism
Surgery
Spinal Fusion
Cervical Vertebrae
Female
Spinal Diseases
Neurology (clinical)
Complication
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15281159 and 03622436
- Volume :
- 43
- Database :
- OpenAIRE
- Journal :
- Spine
- Accession number :
- edsair.doi.dedup.....c9ef3fe12a2e6da7d3421dc0cf47787d