Spine surgery and readmission: Risk factors in lumbar corpectomy patients

IF 2.5 Q3 Medicine North American Spine Society Journal Pub Date : 2025-01-20 DOI:10.1016/j.xnsj.2025.100587
Julius Gerstmeyer MD , Anna Gorbacheva , August Avantaggio , Clifford Pierre MD , Emre Yilmaz MD , Thomas A. Schildhauer MD , Amir Abdul-Jabbar MD , Rod J Oskouian MD , Jens R Chapman MD
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Abstract

Background

A corpectomy of the lumbar spine is a widely performed surgical procedure with numerous indications. Previous research predominantly focused on various surgical techniques and their outcomes, lacking a general and comprehensive analysis of factors affecting this procedure. With this study, we aimed to assess the all-cause 90-day readmission rate and identify risk factors for adverse events following a lumbar corpectomy.

Methods

Utilizing the 2020 Nationwide Readmissions Database adults (>18 years) were selected by ICD-10 procedure category codes for lumbar corpectomy. Patients with adult deformity or degenerative conditions were excluded due to coding inconsistencies. Demographic information and clinical data, including comorbidities, was extracted. Patients were categorized by their readmission status. The primary outcome was readmission, with multivariable logistic regression analysis used to identify independent risk factors.

Results

A total of 3,238 patients were included, with 20.8% readmitted. The readmission group was significantly older and had higher comorbidity burdens. Malignancy had the greatest odds of readmission (OR 3.172, p=.002), with spondylodiscitis also showing significant association (OR 2.177, p=.030). Fractures were significantly more frequent in the single admission group and not associated with readmission (OR 1.235, p=.551). Medical comorbidities differed significantly between the groups with a variety of them being identified as risk factors.

Conclusions

We established an all-cause 90-day readmission rate of 20.8%, which is in range of other procedures in spine surgery but underscores the severity of lumbar corpectomy. Underlying pathologies have a greater impact on the readmission rate compared to medical comorbidities. These findings highlight the importance of preoperative patient selection, especially when performing more invasive procedures. However, the study's limitations may limit the generalizability of the findings.
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脊柱手术和再入院:腰椎椎体切除术患者的危险因素
腰椎椎体切除术是一种广泛应用的外科手术,有许多适应症。以往的研究主要集中于各种手术技术及其结果,缺乏对影响该手术的因素的一般和全面的分析。在这项研究中,我们旨在评估腰椎椎体切除术后90天的全因再入院率,并确定不良事件的危险因素。方法利用2020年全国再入院数据库,采用ICD-10手术分类代码选择成人(18岁)腰椎椎体切除术。由于编码不一致,成人畸形或退行性疾病的患者被排除在外。提取人口统计信息和临床数据,包括合并症。根据再入院状态对患者进行分类。主要结局为再入院,多变量logistic回归分析用于确定独立危险因素。结果共纳入3238例患者,再入院率为20.8%。再入院组明显年龄较大,合并症负担较高。恶性肿瘤的再入院率最高(OR 3.172, p= 0.002),脊柱炎的再入院率也有显著相关性(OR 2.177, p= 0.030)。单次入院组骨折发生率明显更高,且与再入院无关(OR 1.235, p=.551)。医学合并症在两组之间存在显著差异,其中许多被确定为危险因素。结论:我们发现全因90天再入院率为20.8%,与脊柱外科的其他手术相同,但强调了腰椎椎体切除术的严重性。与医学合并症相比,潜在病理对再入院率的影响更大。这些发现强调了术前患者选择的重要性,特别是在进行更具侵入性的手术时。然而,这项研究的局限性可能会限制研究结果的普遍性。
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来源期刊
CiteScore
1.80
自引率
0.00%
发文量
71
审稿时长
48 days
期刊最新文献
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