Incidence and Risk Factors for 30-Day Unplanned Readmissions After Elective Posterior Lumbar Fusion
| Autor: | Parth Kothari, Holt S. Cutler, Samuel K. Cho, Dante M. Leven, Kevin Phan, Nikita Lakomkin, John I. Shin, Nathan J. Lee, Javier Z. Guzman |
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| Rok vydání: | 2018 |
| Předmět: |
030222 orthopedics
medicine.medical_specialty business.industry Deep vein Incidence (epidemiology) Retrospective cohort study Odds ratio Logistic regression medicine.disease Confidence interval Pulmonary embolism 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Internal medicine Medicine Orthopedics and Sports Medicine Neurology (clinical) Young adult business 030217 neurology & neurosurgery |
| Zdroj: | Spine. 43:41-48 |
| ISSN: | 1528-1159 0362-2436 |
| DOI: | 10.1097/brs.0000000000001586 |
| Popis: | STUDY DESIGN Retrospective study of prospectively collected data. OBJECTIVE To perform a multiinstitutional assessment on the incidence and risk factors for unplanned readmissions following elective posterior lumbar fusion (PLF) surgery. SUMMARY OF BACKGROUND DATA Understanding what may drive rehospitalizations is a necessary step toward higher quality care. Identifying risk factors for unplanned readmission is especially important for elective PLF, which is a common procedure that is known to be associated with significant adverse events. METHODS Adult patients undergoing PLF were identified using current procedure terminology (CPT) from the American College of Surgeons National Surgical Quality Improvement Program. Both descriptive and comparative statistics were performed for patient characteristics, clinical factors, and postoperative complications. Subsequently, a step-wise multivariate logistic regression was employed. RESULTS Of the 2301 patients who met inclusion criteria for this study, 117 were unplanned readmissions (5.1%). These occurred at a mean of 15.9 days (range: 3-30 days) after surgery. The risk-adjusted analysis revealed that bleeding disorder (odds ratio, OR = 2.8, confidence intervals, CI = 1.0-7.6, P = 0.043), insulin dependent diabetes (OR = 2.5, CI = 1.4-4.4, P = 0.004), and total length of stay > 5 days (OR = 1.8, CI = 1.2-2.8, P = 0.009) were independent predictors for unplanned readmission. Significant postoperative complications included wound complications (OR = 27.6, CI = 13.9-54.8, P |
| Databáze: | OpenAIRE |
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