Octogenarians Are Independently Associated With Extended LOS and Non-Routine Discharge After Elective ACDF for CSM.

Autor:	Elsamadicy AA; Department of Neurosurgery, 12228Yale University School of Medicine, New Haven, CT, USA., Koo AB; Department of Neurosurgery, 12228Yale University School of Medicine, New Haven, CT, USA., Reeves BC; Department of Neurosurgery, 12228Yale University School of Medicine, New Haven, CT, USA., Freedman IG; Department of Neurosurgery, 12228Yale University School of Medicine, New Haven, CT, USA., David WB; Department of Neurosurgery, 12228Yale University School of Medicine, New Haven, CT, USA., Ehresman J; Department of Neurosurgery, 1500John Hopkins School of Medicine, Baltimore, MD, USA., Pennington Z; Department of Neurosurgery, 1500John Hopkins School of Medicine, Baltimore, MD, USA., Laurans M; Department of Neurosurgery, 12228Yale University School of Medicine, New Haven, CT, USA., Kolb L; Department of Neurosurgery, 12228Yale University School of Medicine, New Haven, CT, USA., Sciubba DM; Department of Neurosurgery, 1500John Hopkins School of Medicine, Baltimore, MD, USA.
Jazyk:	angličtina
Zdroj:	Global spine journal [Global Spine J] 2022 Oct; Vol. 12 (8), pp. 1792-1803. Date of Electronic Publication: 2021 Jan 29.
DOI:	10.1177/2192568221989293
Abstrakt:	Study Design: Retrospective cohort study. Objective: The aim of this study was to determine the impact age has on LOS and discharge disposition following elective ACDF for cervical spondylotic myelopathy (CSM). Methods: A retrospective cohort study was performed using the National Inpatient Sample (NIS) database from 2016 and 2017. All adult patients >50 years old undergoing ACDF for CSM were identified using the ICD-10-CM diagnosis and procedural coding system. Patients were then stratified by age: 50 to 64 years-old, 65 to 79 years-old, and greater than or equal to 80 years-old. Weighted patient demographics, comorbidities, perioperative complications, LOS, discharge disposition, and total cost of admission were assessed. Results: A total of 14 865 patients were identified. Compared to the 50-64 and 65-79 year-old cohorts, the 80+ years cohort had a significantly higher rate of postoperative complication (50-64 yo:10.2% vs. 65-79 yo:12.6% vs. 80+ yo:18.9%, P = 0.048). The 80+ years cohort experienced significantly longer hospital stays (50-64 yo: 2.0 ± 2.4 days vs. 65-79 yo: 2.2 ± 2.8 days vs. 80+ yo: 2.3 ± 2.1 days, P = 0.028), higher proportion of patients with extended LOS (50-64 yo:18.3% vs. 65-79 yo:21.9% vs. 80+ yo:28.4%, P = 0.009), and increased rates of non-routine discharges (50-64 yo:15.1% vs. 65-79 yo:23.0% vs. 80+ yo:35.8%, P < 0.001). On multivariate analysis, age 80+ years was found to be a significant independent predictor of extended LOS [OR:1.97, 95% CI:(1.10,3.55), P = 0.023] and non-routine discharge [OR:2.46, 95% CI:(1.44,4.21), P = 0.001]. Conclusions: Our study demonstrates that octogenarian age status is a significant independent risk factor for extended LOS and non-routine discharge after elective ACDF for CSM.
Databáze:	MEDLINE
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