Incremental Increase in Hospital Length of Stay Due to Complications of Surgery for Adult Spinal Deformity.

Autor:	Lafage R; Department of Orthopedic Surgery, Northwell Health, Lenox Hill Hospital, New York, NY, USA., Sheehan C; Department of Orthopedic Surgery, Northwell Health, Lenox Hill Hospital, New York, NY, USA.; Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA., Smith JS; Department of Neurosurgery, University of Virginia Medical Center, Charlottesville, VA, USA., Daniels A; Department of Orthopedic Surgery, Brown University, Providence, RI, USA., Diebo B; Department of Orthopedic Surgery, Brown University, Providence, RI, USA., Ames C; Department of Neurosurgery, University of California School of Medicine, San Francisco, CA, USA., Bess S; Denver International Spine Center, Presbyterian St. Luke's/Rocky Mountain Hospital for Children, Denver, CO, USA., Eastlack R; Department of Orthopedic Surgery, Scripps Clinic Torrey Pines, La Jolla, CA, USA., Gupta M; Department of Orthopedic Surgery, Washington University, St Louis, MO, USA., Hostin R; Southwest Scoliosis and Spine Institute, Dallas, TX, USA., Kim HJ; Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA., Klineberg E; Department of Orthopedic Surgery, UTHealth, Hoston, TX, USA., Mundis G; Department of Orthopedic Surgery, Scripps Clinic Torrey Pines, La Jolla, CA, USA., Hamilton K; Department of Neurological Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA., Shaffrey C; Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA., Schwab F; Department of Orthopedic Surgery, Northwell Health, Lenox Hill Hospital, New York, NY, USA., Lafage V; Department of Orthopedic Surgery, Northwell Health, Lenox Hill Hospital, New York, NY, USA., Burton D; Department of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, KS, USA.
Jazyk:	angličtina
Zdroj:	Global spine journal [Global Spine J] 2024 Sep 05, pp. 21925682241283724. Date of Electronic Publication: 2024 Sep 05.
DOI:	10.1177/21925682241283724
Abstrakt:	Study Design: Retrospective Cohort Study. Objectives: Length of Stay (LOS) and resource utilization are of primary importance for hospital administration. This study aimed to understand the incremental effect of having a specific complication on LOS among ASD patients. Methods: A retrospective examination of prospective multicenter data utilized patients without a complication prior to discharge to develop a patient-adjusted and surgery-adjusted predictive model of LOS among ASD patients. The model was later applied to patients with at least 1 complication prior to discharge to investigate incremental effect of each identified complication on LOS vs the expected LOS. Results: 571/1494 (38.2%) patients experienced at least 1 complication before discharge with a median LOS of 7 [IQR 5 to 9]. Univariate analysis demonstrated that LOS was significantly affected by patients' demographics (age, CCI, sex, disability, deformity) and surgical strategy (invasiveness, fusion length, posterior MIS fusion, direct decompression, osteotomy severity, IBF use, EBL, ASA, ICU stay, day between stages, Date of Sx). Using patients with at least 1 complication prior discharge and compared to the patient-and-surgery adjusted prediction, having a minor complication increased the expected LOS by 0.9 day(s), a major complication by 3.9 days, and a major complication with reoperation by 6.3 days. Conclusion: Complications following surgery for ASD correction have different, but predictable impact on LOS. Some complications requiring minimal intervention are associated with significant and substantial increases in LOS, while complications with significant impact on patient quality of life may have no influence on LOS. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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