Cost Implications of Primary Versus Revision Surgery in Adult Spinal Deformity

Rabia Qureshi, Varun Puvanesarajah, Amit Jain, Khaled Kebaish, Adam Shimer, Francis Shen, Hamid Hassanzadeh

Research output: Research - peer-reviewArticle

Abstract

Background Adult spinal deformity (ASD) is an important problem to consider in the elderly. Although studies have examined the complications of ASD surgery and have compared functional and radiographic results of primary surgery versus revision, no studies have compared the costs of primary procedures with revisions. We assessed the in-hospital costs of these 2 surgery types in patients with ASD. Methods The PearlDiver Database, a database of Medicare records, was used in this study. Mutually exclusive groups of patients undergoing primary or revision surgery were identified. Patients in each group were queried for age, sex, and comorbidities. Thirty-day readmission rates, 30-day and 90-day complication rates, and postoperative costs of care were assessed with multivariate analysis. For analyses, significance was set at P < 0.001. Results The average reimbursement of the primary surgery cohort was $57,078 ± $30,767. Reimbursement of revision surgery cohort was $52,999 ± $27,658. The adjusted difference in average costs between the 2 groups is $4773 ± $1069 (P < 0.001). The 30-day and 90-day adjusted difference in cost of care when sustaining any of the major medical complications in primary surgery versus revision surgery was insignificant. Conclusions Patients undergoing primary and revision corrective procedures for ASD have similar readmission rates, lengths of stays, and complication rates. Our data showed a higher cost of primary surgery compared with revision surgery, although costs of sustaining postoperative complications were similar. This finding supports the decision to perform revision procedures in patients with ASD when indicated because neither outcomes nor costs are a hindrance to correction.

LanguageEnglish (US)
Pages68-73
Number of pages6
JournalWorld Neurosurgery
Volume104
DOIs
StatePublished - Aug 1 2017
Externally publishedYes

Fingerprint

Reoperation
Costs and Cost Analysis
Databases
Postoperative Care
Hospital Costs
Medicare
Comorbidity
Length of Stay
Multivariate Analysis

Keywords

  • Adult spinal deformity
  • Complications
  • Cost
  • Degenerative disease
  • Medicare
  • Reimbursement
  • Revision Fusion
  • Thoracolumbar

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Qureshi, R., Puvanesarajah, V., Jain, A., Kebaish, K., Shimer, A., Shen, F., & Hassanzadeh, H. (2017). Cost Implications of Primary Versus Revision Surgery in Adult Spinal Deformity. World Neurosurgery, 104, 68-73. DOI: 10.1016/j.wneu.2017.05.002

Cost Implications of Primary Versus Revision Surgery in Adult Spinal Deformity. / Qureshi, Rabia; Puvanesarajah, Varun; Jain, Amit; Kebaish, Khaled; Shimer, Adam; Shen, Francis; Hassanzadeh, Hamid.

In: World Neurosurgery, Vol. 104, 01.08.2017, p. 68-73.

Research output: Research - peer-reviewArticle

Qureshi, R, Puvanesarajah, V, Jain, A, Kebaish, K, Shimer, A, Shen, F & Hassanzadeh, H 2017, 'Cost Implications of Primary Versus Revision Surgery in Adult Spinal Deformity' World Neurosurgery, vol 104, pp. 68-73. DOI: 10.1016/j.wneu.2017.05.002
Qureshi R, Puvanesarajah V, Jain A, Kebaish K, Shimer A, Shen F et al. Cost Implications of Primary Versus Revision Surgery in Adult Spinal Deformity. World Neurosurgery. 2017 Aug 1;104:68-73. Available from, DOI: 10.1016/j.wneu.2017.05.002
Qureshi, Rabia ; Puvanesarajah, Varun ; Jain, Amit ; Kebaish, Khaled ; Shimer, Adam ; Shen, Francis ; Hassanzadeh, Hamid. / Cost Implications of Primary Versus Revision Surgery in Adult Spinal Deformity. In: World Neurosurgery. 2017 ; Vol. 104. pp. 68-73
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