30-Day Readmission After Spine Surgery
- 1 April 2017
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Spine
- Vol. 42 (7), 520-524
- https://doi.org/10.1097/brs.0000000000001779
Abstract
Retrospective cohort review. To identify the rates, causes, and risk factors for 30-day unplanned readmissions in after elective spine surgery at our institution. Early readmission after spine surgery is being used as a proxy for quality of care. One-fifth of patients are rehospitalized within 30 days after spine surgery. Nearly 60% of these readmissions are unplanned, which translates into billions of dollars in healthcare costs. A total of 1400 patients undergoing elective spine surgery at Duke University Hospital between 2008 and 2010 were included in the study. We identified all unplanned readmissions within 30 days of discharge. Unplanned readmissions were defined to have occurred as a result of either a surgical or a nonsurgical complication. Patient records were reviewed to determine the cause of readmission and the length of hospital stay. A total of 132 (9.4%) unplanned early readmissions were identified. The mean ± SD age was 58.6 ± 15.1 years. Lumbar decompression and fusion was the most common procedure The most common causes for readmission were infection or a concern for infection (34.8%) and pain (19.7%), and 26.5% of readmissions required a return to the operating room. The majority of patients that were readmitted presented to the emergency department from home (58.0%) whereas 25.2% were readmitted from a skilled nursing facility. The mean ± SD number of days from discharge to readmission was 9.8 ± 7.9 days and the average length of hospital stay for the readmissions was 7.5 days. This study suggests that infection and refractory pain were the most common primary reasons for unplanned readmission. Efforts at reducing unplanned early readmission after elective spine surgery should be focused on more effective post discharge care. Level of Evidence: 3Keywords
This publication has 10 references indexed in Scilit:
- Utility of Readmission Rates as a Quality of Care Measure and Predictors of Readmission Within 30 Days After Spinal SurgerySpine, 2015
- Thirty-day readmission rates in spine surgery: systematic review and meta-analysisNeurosurgical Focus, 2015
- Risk Factors Associated With 30-day Readmissions After Instrumented Spine Surgery in 14,939 PatientsSpine, 2015
- Unplanned Hospital Readmission After Surgical Treatment of Common Lumbar PathologiesSpine, 2015
- Same-day Discharge After Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Series of 808 CasesClinical Orthopaedics and Related Research, 2014
- Predictors of unplanned readmission in patients undergoing lumbar decompression: multi-institutional analysis of 7016 patientsJournal of Neurosurgery: Spine, 2014
- Predictors of Thirty-Day Readmission After Anterior Cervical FusionSpine, 2014
- An Analysis of Causes of Readmission After Spine SurgerySpine, 2012
- Revisiting Readmissions — Changing the Incentives for Shared AccountabilityNew England Journal of Medicine, 2009
- Rehospitalizations among Patients in the Medicare Fee-for-Service ProgramNew England Journal of Medicine, 2009