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Unplanned Readmissions Following Ambulatory Spine Surgery: Assessing Common Reasons and Risk Factors – Lumbar Spinal Stenosis

This article discusses the issue of unplanned readmission following outpatient spine surgery in the United States. The study aimed to describe the incidence and timing of 30-day unplanned readmission after ambulatory lumbar and cervical spine surgery, evaluate the common reasons for readmission, and identify factors associated with readmission. The study analyzed data from the National Surgical Quality Improvement Program (NSQIP) database between 2015 and 2020. The results showed that the incidences of 30-day readmission were 3.37% for cervical patients and 3.07% for lumbar patients. The most common reasons for readmission included uncontrolled pain, recurrence of disc herniation or major symptom, and postoperative hematoma/seroma. Factors associated with readmission varied for cervical and lumbar patients, and they included age, BMI, functional dependence, diabetes, smoking, COPD, and hypertension. The study highlights the importance of considering these factors for appropriate patient selection for ambulatory spine surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best rated spine clinic on Harley Street UK

Published article

CONCLUSION: This study highlights the common reasons and factors associated with unplanned readmission following ambulatory spine surgery. Consideration of these factors may be critical to ensuring appropriate patient selection for ambulatory spine surgery.

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Spine J. 2023 Sep 14:S1529-9430(23)03380-6. doi: 10.1016/j.spinee.2023.09.005. Online ahead of print.ABSTRACTBACKGROUND CONTEXT: Although outpatient spine surgery is becoming increasingly popular in the United States, unplanned readmission following outpatient surgery remains a significant postoperative concern.PURPOSE: This study aimed to (1) describe the incidence and timing of 30-day unplanned readmission after ambulatory lumbar and cervical spine surgery,

Spine J. 2023 Sep 14:S1529-9430(23)03380-6. doi: 10.1016/j.spinee.2023.09.005. Online ahead of print.

ABSTRACT

BACKGROUND CONTEXT: Although outpatient spine surgery is becoming increasingly popular in the United States, unplanned readmission following outpatient surgery remains a significant postoperative concern.

PURPOSE: This study aimed to (1) describe the incidence and timing of 30-day unplanned readmission after ambulatory lumbar and cervical spine surgery (2) evaluate the common reasons for readmission, and (3) identify factors associated with readmission in this population.

STUDY DESIGN/SETTING: Retrospective cohort study.

PATIENT SAMPLE: Patients who underwent ambulatory cervical or lumbar spine surgery between 2015 and 2020 identified in the National Surgical Quality Improvement Program (NSQIP) database.

OUTCOME MEASURES: Hospital readmission within 30 postoperative days.

METHODS: Patients who underwent ambulatory cervical or lumbar spine surgery between 2015-2020 were identified using the National Surgical Quality Improvement Program (NSQIP) database. Reasons for and timing of unplanned readmissions were recorded. Multivariable Poisson regressions were employed to determine any independent predictors of readmission.

RESULTS: A total of 33,092 ambulatory cervical and 68,115 ambulatory lumbar spine surgery patients were identified. Incidences of 30-day readmission were 3.37% and 3.07% among cervical and lumbar patients, respectively. The most common surgical site-related reasons for readmission included uncontrolled pain, recurrence of disc herniation or major symptom, and postoperative hematoma/seroma. Common non-surgical site-related reasons included gastrointestinal, neurological, and cardiovascular complications. Factors associated with readmission among cervical patients included age ≥55, BMI ≥35, functional dependence, diabetes, smoking, COPD, and steroid use, whereas factors associated with readmission following lumbar spine surgery included age ≥65, female sex, BMI ≥35, functional dependence, ASA ≥3, diabetes, smoking, COPD, and hypertension (p<0.05 for all).

CONCLUSION: This study highlights the common reasons and factors associated with unplanned readmission following ambulatory spine surgery. Consideration of these factors may be critical to ensuring appropriate patient selection for ambulatory spine surgery.

PMID:37716549 | DOI:10.1016/j.spinee.2023.09.005

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Unplanned Readmissions Following Ambulatory Spine Surgery: Assessing Common Reasons and Risk Factors

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Spine J. 2023 Sep 14:S1529-9430(23)03380-6. doi: 10.1016/j.spinee.2023.09.005. Online ahead of print.ABSTRACTBACKGROUND CONTEXT: Although outpatient spine surgery is becoming increasingly popular in the United States, unplanned readmission following outpatient surgery remains a significant postoperative concern.PURPOSE: This study aimed to (1) describe the incidence and timing of 30-day unplanned readmission after ambulatory lumbar and cervical spine surgery
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