TY - JOUR
T1 - 30-and 90-day readmissions in lumbar spine surgery. Differences in prevalence and causes
AU - Duc, Anna
AU - Solumsmoen, Stian
AU - Bari, Tanvir Johanning
AU - Bech-Azeddine, Rachid
N1 - Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.
PY - 2023/11
Y1 - 2023/11
N2 - BACKGROUND: The morbidity associated with surgical treatment of lumbar degenerative conditions has attracted increasing interest due to the economic impact on society, especially postoperative readmission. Limited studies have assessed this risk in a prospective, single-center consecutive fashion.OBJECTIVE: To assess the incidence and causes of 30- and 90-day unplanned readmission and revision surgery following surgical treatment for lumbar degenerative spine conditions at a tertiary treatment center.STUDY DESIGN: Prospective, single-center cohort study.METHODS: All patients undergoing degenerative lumbar spine surgery in a 1-year period from February 1st, 2016, were prospectively included. Patient characteristics, surgical information and information regarding postoperative complications, including readmission (30- and 90-days) and revision surgery were recorded. Readmissions were classified according to whether they were due to the surgical intervention specifically, or a medical complication.RESULTS: A total of 1399 patients underwent surgery for various lumbar degenerative pathologies in the study period and all were included. Of these, 9.4% (n = 132) were readmitted within 30 days of surgery and in some cases, multiple readmissions occurred (up to 3). The total 90-day readmission rate was 17.6%. Of these, 15% were related to the surgical procedure. The predominant medical related causes were systemic infection (30-day: 14.4%, 90-day: 10.7%), neurological symptoms (30-day: 6.3%, 90-day: 5.0%) and cardiovascular events (30-day: 8.1%, 90-day: 12.9%). The surgical related causes for readmission were pain (30-day: 13.1%, 90-day: 2.9%), wound complications (30-day: 11.3%, 90-day: 5.0% and re-herniation (30-day: 13.1%, 90-day: 2.9%). Age was the only factor with significant influence on readmission.CONCLUSION: The incidence of medical conditions causing unplanned 30-day readmissions following surgery for lumbar degenerative conditions, is significantly higher compared to readmissions related specifically to the surgical procedure. Examples of medical treatment included antibiotics, analgesics, laxatives, anticoagulants and beta blockers. The difference is even more pronounced for the 90-day readmissions. The predominant medical causes were systemic infections, neurological and cardiovascular events. Predominant causes related to the surgery were pain, wound complications and re-herniations. Readmissions may be reduced by optimizing the medical treatment and the pain management before discharge of the patient.
AB - BACKGROUND: The morbidity associated with surgical treatment of lumbar degenerative conditions has attracted increasing interest due to the economic impact on society, especially postoperative readmission. Limited studies have assessed this risk in a prospective, single-center consecutive fashion.OBJECTIVE: To assess the incidence and causes of 30- and 90-day unplanned readmission and revision surgery following surgical treatment for lumbar degenerative spine conditions at a tertiary treatment center.STUDY DESIGN: Prospective, single-center cohort study.METHODS: All patients undergoing degenerative lumbar spine surgery in a 1-year period from February 1st, 2016, were prospectively included. Patient characteristics, surgical information and information regarding postoperative complications, including readmission (30- and 90-days) and revision surgery were recorded. Readmissions were classified according to whether they were due to the surgical intervention specifically, or a medical complication.RESULTS: A total of 1399 patients underwent surgery for various lumbar degenerative pathologies in the study period and all were included. Of these, 9.4% (n = 132) were readmitted within 30 days of surgery and in some cases, multiple readmissions occurred (up to 3). The total 90-day readmission rate was 17.6%. Of these, 15% were related to the surgical procedure. The predominant medical related causes were systemic infection (30-day: 14.4%, 90-day: 10.7%), neurological symptoms (30-day: 6.3%, 90-day: 5.0%) and cardiovascular events (30-day: 8.1%, 90-day: 12.9%). The surgical related causes for readmission were pain (30-day: 13.1%, 90-day: 2.9%), wound complications (30-day: 11.3%, 90-day: 5.0% and re-herniation (30-day: 13.1%, 90-day: 2.9%). Age was the only factor with significant influence on readmission.CONCLUSION: The incidence of medical conditions causing unplanned 30-day readmissions following surgery for lumbar degenerative conditions, is significantly higher compared to readmissions related specifically to the surgical procedure. Examples of medical treatment included antibiotics, analgesics, laxatives, anticoagulants and beta blockers. The difference is even more pronounced for the 90-day readmissions. The predominant medical causes were systemic infections, neurological and cardiovascular events. Predominant causes related to the surgery were pain, wound complications and re-herniations. Readmissions may be reduced by optimizing the medical treatment and the pain management before discharge of the patient.
UR - http://www.scopus.com/inward/record.url?scp=85172666572&partnerID=8YFLogxK
U2 - 10.1016/j.clineuro.2023.107991
DO - 10.1016/j.clineuro.2023.107991
M3 - Journal article
C2 - 37774526
SN - 0303-8467
VL - 234
JO - Clinical Neurology and Neurosurgery
JF - Clinical Neurology and Neurosurgery
M1 - 107991
ER -