Readmission and Associated Factors in Surgical Versus Non-Surgical Management of Spinal Epidural Abscess: A Nationwide Readmissions Database Analysis.

Autor:	Pitaro NL; Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Tang JE; Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Arvind V; Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Cho BH; Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Geng EA; Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Amakiri UO; Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Cho SK; Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Kim JS; Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Jazyk:	angličtina
Zdroj:	Global spine journal [Global Spine J] 2023 Jul; Vol. 13 (6), pp. 1533-1540. Date of Electronic Publication: 2021 Dec 05.
DOI:	10.1177/21925682211039185
Abstrakt:	Study Design: Retrospective cohort study. Objectives: Spinal epidural abscess (SEA) is a rare but potentially life-threatening infection treated with antimicrobials and, in most cases, immediate surgical decompression. Previous studies comparing medical and surgical management of SEA are low powered and limited to a single institution. As such, the present study compares readmission in surgical and non-surgical management using a large national dataset. Methods: We identified all hospital admissions for SEA using the Nationwide Readmissions Database (NRD), which is the largest collection of hospital admissions data. Patients were grouped into surgically and non-surgically managed cohorts using ICD-10 coding and compared using information retrieved from the NRD such as demographics, comorbidities, length of stay and cost of admission. Results: We identified 350 surgically managed and 350 non-surgically managed patients. The 90-day readmission rates for surgical and non-surgical management were 26.0% and 35.1%, respectively ( P < .05). Expectedly, surgical management was associated with a significantly higher charge and length of stay at index hospital admission. Surgically managed patients had a significantly lower risk of readmission for osteomyelitis ( P < .05). Finally, in patients with a low comorbidity burden, we observed a significantly lower 90-day readmission rate for surgically managed patients (surgical: 23.0%, non-surgical: 33.8%, P < .05). Conclusion: In patients with a low comorbidity burden, we observed a significantly lower readmission rate for surgically managed patients than non-surgically managed patients. The results of this study suggest a lower readmission rate as an advantage to surgical management of SEA and emphasize the importance of SEA as a not-to-miss diagnosis.
Databáze:	MEDLINE
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