Late-week Multilevel Anterior Cervical Discectomy and Fusion Associated With Increased Length of Stay.

Autor:	Miller EM; Department of Orthopaedic Surgery, Atrium Health Wake Forest Baptist., Polascik BW; Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA., Kitchen ST; Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA., Wahbeh EE; Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA., Abouhaif TM; Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA., Contillo NJ; Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA., Elashker AL; Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA., Hsia MW; Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA., Marsh KA; Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA., Thometz KJ; Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA., Yin TC; Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA., O'Gara TJ; Department of Orthopaedic Surgery, Atrium Health Wake Forest Baptist.
Jazyk:	angličtina
Zdroj:	Clinical spine surgery [Clin Spine Surg] 2024 Aug 01; Vol. 37 (7), pp. E335-E338. Date of Electronic Publication: 2024 Feb 22.
DOI:	10.1097/BSD.0000000000001590
Abstrakt:	Study Design: Retrospective analysis of clinical data from a single institution. Objective: To assess the day of surgery during the week as a possible predictor of length of stay (LOS) following anterior cervical discectomy and fusion (ACDF). Summary of Background Data: Surgeries later in the week may result in longer LOS and higher costs for joint arthroplasty, yet this is unclear following spine surgery. Procedures performed later in the week may lead to weekend admissions when there are limited services that may contribute to an extended LOS. We attempt to identify associations between day of surgery and LOS, readmission, and complications following single- and multilevel ACDF. Materials and Methods: Patients at a single institution undergoing ACDF by 7 primary surgeons in both orthopedic and neurosurgery spine departments between 2015 and 2019 were retrospectively reviewed. Patients were stratified by surgery day at either the beginning (Monday/Tuesday) or end (Thursday/Friday) of the week and by single- or multilevel ACDF. Surgery for trauma, infections, adjacent level disease, or revision were excluded. Patient demographics, Charlson Comorbidity Index (CCI), LOS, postoperative complications, and readmission rates were assessed. Results: Six hundred fifty-two patients underwent ACDF. For single-level ACDF, 222 were reviewed, with 112 having surgery at the beginning and 110 at the end of the week. For multilevel ACDF, 431 were reviewed, with 192 having surgery at the beginning and 239 at the end of the week. No differences in pre- or postoperative variables were determined for single-level ACDF. Despite no differences in pre-operative variables, CCI, operative duration, or number of levels, late-week multilevel ACDF had longer average LOS (2.8±3.0 days) compared to early-week surgery (2.0±2.0 days) ( P =0.018). Conclusions: Late-week multilevel ACDF was associated with an increased LOS, as it may prove beneficial to surgical planning. This conflicts with previous reports that day of week was not associated with LOS following ACDF. Level of Evidence: III. Competing Interests: The authors declare no conflict of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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