90-Day Emergency Department Utilization and Readmission Rate After Full-Endoscopic Spine Surgery: A Multicenter, Retrospective Analysis of 821 Patients-Reference-Cited by-同舟云学术

90-Day Emergency Department Utilization and Readmission Rate After Full-Endoscopic Spine Surgery: A Multicenter, Retrospective Analysis of 821 Patients

Published:2024-07-18 Issue: Volume: Page:
ISSN:0148-396X
Container-title:Neurosurgery
language:en
Short-container-title:

Author:

Leyendecker Jannik¹²^ORCID,Prasse Tobias²^ORCID,Park Christine¹,Köster Malin²,Rumswinkel Lena²,Shenker Tara³,Bieler Eliana¹,Eysel Peer²^ORCID,Bredow Jan²⁴^ORCID,Zaki Mark M.⁵^ORCID,Kathawate Varun⁵^ORCID,Harake Edward⁵^ORCID,Joshi Rushikesh S.⁵,Konakondla Sanjay⁶^ORCID,Kashlan Osama N.⁵^ORCID,Derman Peter⁷,Telfeian Albert⁸^ORCID,Hofstetter Christoph P.¹^ORCID

Affiliation:

1. Department of Neurological Surgery, University of Washington, Seattle, Washington, USA;

2. Department of Orthopedics and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany;

3. College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale-Davie, Florida, USA;

4. Department of Orthopedics and Trauma Surgery, Krankenhaus Porz am Rhein, University of Cologne, Cologne, Germany;

5. Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA;

6. Department of Neurosurgery, Geisinger Neuroscience Institute, Danville, Pennsylvania, USA;

7. Texas Back Institute, Plano, Texas, USA;

8. Department of Neurosurgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA

Abstract

BACKGROUND AND OBJECTIVES: Emergency department (ED) utilization and readmission rates after spine surgery are common quality of care measures. Limited data exist on the evaluation of quality indicators after full-endoscopic spine surgery (FESS). The objective of this study was to detect rates, causes, and risk factors for unplanned postoperative clinic utilization after FESS. METHODS: This retrospective multicenter analysis assessed ED utilization and clinic readmission rates after FESS performed between 01/2014 and 04/2023 for degenerative spinal pathologies. Outcome measures were ED utilizations, hospital readmissions, and revision surgeries within 90 days postsurgery. RESULTS: Our cohort includes 821 patients averaging 59 years of age, who underwent FESS. Most procedures targeted the lumbar or sacral spine (85.75%) while a small fraction involved the cervical spine (10.11%). The most common procedures were lumbar unilateral laminotomies for bilateral decompression (40.56%) and lumbar transforaminal discectomies (25.58%). Within 90 days postsurgery, 8.0% of patients revisited the ED for surgical complications. A total of 2.2% of patients were readmitted to a hospital of which 1.9% required revision surgery. Primary reasons for ED visits and clinic readmissions were postoperative pain exacerbation, transient neurogenic bladder dysfunction, and recurrent disk herniations. Our multivariate regression analysis revealed that female patients had a significantly higher likelihood of using the ED (P = .046; odds ratio: 1.77, 95% CI 1.01-3.1 5.69% vs 10.33%). Factors such as age, American Society of Anesthesiologists class, body mass index, comorbidities, and spanned spinal levels did not significantly predict postoperative ED utilization. CONCLUSION: This analysis demonstrates the safety of FESS, as evidenced by acceptable rates of ED utilization, clinic readmission, and revision surgery. Future studies are needed to further elucidate the safety profile of FESS in comparison with traditional spinal procedures.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Reference54 articles.

1. Rehospitalizations among patients in the Medicare fee-for-service program;Jencks;N Engl J Med.,2009

2. Causes and timing of unplanned 90-day readmissions following spine surgery;Hills;Spine.,2018

3. Thirty-day readmission rates in spine surgery: systematic review and meta-analysis;Bernatz;Neurosurg Focus.,2015

4. Post-operative delirium is an independent predictor of 30-day hospital readmission after spine surgery in the elderly (≥65 years old): a study of 453 consecutive elderly spine surgery patients;Elsamadicy;J Clin Neurosci.,2017

5. Thirty-day readmissions after elective spine surgery for degenerative conditions among US Medicare beneficiaries;Wang;Spine J.,2012