19 Harley St, London, W1G 9QJ, UK

The effects of hospital and surgeon volume on postoperative complications after LumbarSpine surgery

STUDY DESIGN: Retrospective review. OBJECTIVE: To determine the correlation of surgeon/hospital volume with complication/mortality rates and with in-hospital health care utilization in lumbar spine surgery. SUMMARY OF BACKGROUND DATA: Studies have shown improved outcomes in patients treated by high-volume surgeons and hospitals. To our knowledge, no studies evaluate this relationship for lumbar spine surgery. METHODS: To evaluate the 1992-2005 data in the National Inpatient Sample, we used the International Classification of Diseases, ninth Revision, Clinical Modification (ICD-9-CM) codes for lumbar spine surgery to identify relevant hospitalizations. We assessed 232,668 hospitalization records listed as posterolateral lumbar decompression with fusion and/or exploration/decompression of the spinal canal. Annual surgeon and hospital volumes were stratified into quartiles via identifier codes. Patient demographics and comorbidity status were recorded for each group. Mortality and morbidity were primary endpoints. We used the Shapiro-Wilk test for normality for the distribution of variables; one-way analysis of variance to assess continuous measures; chi statistics for categorical measures; and logistic regression for the effect of procedure on the probability of morbidity and mortality, adjusting for confounding variables, including patient demographics. Logistic regression data were tabulated as odd ratios (ORs) and 95% confidence intervals (CIs) (statistical significance, P < 0.05). RESULTS: When controlled for other variables, mortality was significantly lower in the highest volume hospitals (OR, 0.78; 95% CI 0.66 to 0.89) and among the highest volume surgeons (OR, 0.66; 95% CI 0.59 to 0.89) than in their lowest volume counterparts. The complication rate was slightly lower in the highest volume hospitals (OR, 0.94; 95% CI 0.81 to 0.99) and significantly lower among the highest volume surgeons (OR, 0.73; 95% CI 0.68 to 0.91) than in their lowest volume counterparts. CONCLUSION: The mortality and complication rates associated with lumbar spine surgery are lower when patients are treated by high-volume surgeons and hospitals Keywords : adverse effects,African Americans,analysis,Analysis of Variance,Baltimore,classification,Comorbidity,complications,Confidence Intervals,Decompression,Surgical,ethnology,etiology,European Continental Ancestry Group,Female,Hispanic Americans,Hospital Mortality,Hospitalization,Hospitals,Humans,Length of Stay,Logistic Models,Lumbar Vertebrae,Male,methods,Middle Aged,Morbidity,mortality,Multivariate Analysis,Patients,Physicians,Postoperative Complications,Probability,Retrospective Studies,Spinal Canal,Spinal Fusion,Spine,statistics & numerical data,surgery,Universities,, Effects,Hospital,Surgeon, pain infusion therapy

Date of Publication : 2011 Nov 15

Authors : Farjoodi P;Skolasky RL;Riley LH;

Organisation : Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA

Journal of Publication : Spine (Phila Pa 1976 )

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21343869

The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery

Make an Appointment 

Trustpilot Reviews
Doctify Reviews
Top Doctor Reviews

Utility of serum tartrate-resistant acid phosphatase isoform 5b, bone alkaline phosphatase and osteocalcin in osteoporotic fractures in Chinese patients | Lumbar decompression surgery - How it's performed - NHSUK

What our patients say ...

Consultant Spine Surgeon
Consultant Spine Surgeon
Consultant Spine Surgeon

This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus

Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.
What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

treatment of all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810