Hospital Readmission within Two Years Following Adult Thoracolumbar Spinal Deformity Surgery: Prevalence, Predictors, and Effect on Patient-Derived Outcome Measures

Peter G. Passias, Eric O. Klineberg, Cyrus M. Jalai, Nancy Worley, Gregory W. Poorman, Breton Line, Cheongeun Oh, Douglas C. Burton, Han Jo Kim, Daniel Sciubba, D. K. Hamilton, Christopher P. Ames, Justin S. Smith, Christopher I. Shaffrey, Virginie Lafage, Shay Bess

Research output: Contribution to journalArticle

Abstract

STUDY DESIGN.: Retrospective review of prospective multicenter database. OBJECTIVE.: Identify factors influencing readmission, reoperation, and the impact on health related quality of life outcomes (HRQoLʼs) in adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA.: Many ASD patients experience complications requiring readmission. It is important to identify baseline/operative factors leading to rehospitalizations and reoperation, which may impact outcomes. METHODS.: Inclusion criteria: ASD surgical patients (age?>?18years, major coronal Cobb≥20°, SVA≥5?cm, PT≥25° and/or TK?>?60°) with complete baseline, 1-, and 2-year follow-up. Patients were grouped on the basis of readmission occurrence (yes/no) and type (medical [no reoperation] vs. surgical [revision surgery]). Readmissions caused by infections requiring surgical treatment (e.g. deep infections) were considered reoperations. Univariate and multivariate analyses determined readmission and reoperation predictors. Repeated measures mixed models evaluated readmission impact on HRQoLʼs at 1- and 2-years. RESULTS.: 334 patients were included: 76 (22.8%) readmissions, involving 65 (85.5% of 76) reoperations (surgical readmission) and 11 (14.5% of 76) medical readmissions. The most common surgical readmission indication (n?=?65) was implant complications (36.9%; rod breakage n?=?13); the most common medical readmission indication was infection (36.4%, n?=?4), treated with antibiotics. Non-infectious medical readmission (n?=?7) included: pleural effusion, DTV, intra-operative blood loss, neurologic, and unspecified. Readmission predictors: increased number of major peri-operative complications (OR 5.13, p?=?0.014), infection presence (OR 25.02, p?=?0.001), implant complications (OR 6.12, p?

Original languageEnglish (US)
JournalSpine
DOIs
StateAccepted/In press - Mar 8 2016

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Patient Readmission
Reoperation
Outcome Assessment (Health Care)
Infection
Quality of Life
Pleural Effusion
Nervous System
Multivariate Analysis
Databases
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine

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Hospital Readmission within Two Years Following Adult Thoracolumbar Spinal Deformity Surgery : Prevalence, Predictors, and Effect on Patient-Derived Outcome Measures. / Passias, Peter G.; Klineberg, Eric O.; Jalai, Cyrus M.; Worley, Nancy; Poorman, Gregory W.; Line, Breton; Oh, Cheongeun; Burton, Douglas C.; Kim, Han Jo; Sciubba, Daniel; Hamilton, D. K.; Ames, Christopher P.; Smith, Justin S.; Shaffrey, Christopher I.; Lafage, Virginie; Bess, Shay.

In: Spine, 08.03.2016.

Research output: Contribution to journalArticle

Passias, PG, Klineberg, EO, Jalai, CM, Worley, N, Poorman, GW, Line, B, Oh, C, Burton, DC, Kim, HJ, Sciubba, D, Hamilton, DK, Ames, CP, Smith, JS, Shaffrey, CI, Lafage, V & Bess, S 2016, 'Hospital Readmission within Two Years Following Adult Thoracolumbar Spinal Deformity Surgery: Prevalence, Predictors, and Effect on Patient-Derived Outcome Measures', Spine. https://doi.org/10.1097/BRS.0000000000001552
Passias, Peter G. ; Klineberg, Eric O. ; Jalai, Cyrus M. ; Worley, Nancy ; Poorman, Gregory W. ; Line, Breton ; Oh, Cheongeun ; Burton, Douglas C. ; Kim, Han Jo ; Sciubba, Daniel ; Hamilton, D. K. ; Ames, Christopher P. ; Smith, Justin S. ; Shaffrey, Christopher I. ; Lafage, Virginie ; Bess, Shay. / Hospital Readmission within Two Years Following Adult Thoracolumbar Spinal Deformity Surgery : Prevalence, Predictors, and Effect on Patient-Derived Outcome Measures. In: Spine. 2016.
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abstract = "STUDY DESIGN.: Retrospective review of prospective multicenter database. OBJECTIVE.: Identify factors influencing readmission, reoperation, and the impact on health related quality of life outcomes (HRQoLʼs) in adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA.: Many ASD patients experience complications requiring readmission. It is important to identify baseline/operative factors leading to rehospitalizations and reoperation, which may impact outcomes. METHODS.: Inclusion criteria: ASD surgical patients (age?>?18years, major coronal Cobb≥20°, SVA≥5?cm, PT≥25° and/or TK?>?60°) with complete baseline, 1-, and 2-year follow-up. Patients were grouped on the basis of readmission occurrence (yes/no) and type (medical [no reoperation] vs. surgical [revision surgery]). Readmissions caused by infections requiring surgical treatment (e.g. deep infections) were considered reoperations. Univariate and multivariate analyses determined readmission and reoperation predictors. Repeated measures mixed models evaluated readmission impact on HRQoLʼs at 1- and 2-years. RESULTS.: 334 patients were included: 76 (22.8{\%}) readmissions, involving 65 (85.5{\%} of 76) reoperations (surgical readmission) and 11 (14.5{\%} of 76) medical readmissions. The most common surgical readmission indication (n?=?65) was implant complications (36.9{\%}; rod breakage n?=?13); the most common medical readmission indication was infection (36.4{\%}, n?=?4), treated with antibiotics. Non-infectious medical readmission (n?=?7) included: pleural effusion, DTV, intra-operative blood loss, neurologic, and unspecified. Readmission predictors: increased number of major peri-operative complications (OR 5.13, p?=?0.014), infection presence (OR 25.02, p?=?0.001), implant complications (OR 6.12, p?",
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T2 - Prevalence, Predictors, and Effect on Patient-Derived Outcome Measures

AU - Passias, Peter G.

AU - Klineberg, Eric O.

AU - Jalai, Cyrus M.

AU - Worley, Nancy

AU - Poorman, Gregory W.

AU - Line, Breton

AU - Oh, Cheongeun

AU - Burton, Douglas C.

AU - Kim, Han Jo

AU - Sciubba, Daniel

AU - Hamilton, D. K.

AU - Ames, Christopher P.

AU - Smith, Justin S.

AU - Shaffrey, Christopher I.

AU - Lafage, Virginie

AU - Bess, Shay

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N2 - STUDY DESIGN.: Retrospective review of prospective multicenter database. OBJECTIVE.: Identify factors influencing readmission, reoperation, and the impact on health related quality of life outcomes (HRQoLʼs) in adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA.: Many ASD patients experience complications requiring readmission. It is important to identify baseline/operative factors leading to rehospitalizations and reoperation, which may impact outcomes. METHODS.: Inclusion criteria: ASD surgical patients (age?>?18years, major coronal Cobb≥20°, SVA≥5?cm, PT≥25° and/or TK?>?60°) with complete baseline, 1-, and 2-year follow-up. Patients were grouped on the basis of readmission occurrence (yes/no) and type (medical [no reoperation] vs. surgical [revision surgery]). Readmissions caused by infections requiring surgical treatment (e.g. deep infections) were considered reoperations. Univariate and multivariate analyses determined readmission and reoperation predictors. Repeated measures mixed models evaluated readmission impact on HRQoLʼs at 1- and 2-years. RESULTS.: 334 patients were included: 76 (22.8%) readmissions, involving 65 (85.5% of 76) reoperations (surgical readmission) and 11 (14.5% of 76) medical readmissions. The most common surgical readmission indication (n?=?65) was implant complications (36.9%; rod breakage n?=?13); the most common medical readmission indication was infection (36.4%, n?=?4), treated with antibiotics. Non-infectious medical readmission (n?=?7) included: pleural effusion, DTV, intra-operative blood loss, neurologic, and unspecified. Readmission predictors: increased number of major peri-operative complications (OR 5.13, p?=?0.014), infection presence (OR 25.02, p?=?0.001), implant complications (OR 6.12, p?

AB - STUDY DESIGN.: Retrospective review of prospective multicenter database. OBJECTIVE.: Identify factors influencing readmission, reoperation, and the impact on health related quality of life outcomes (HRQoLʼs) in adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA.: Many ASD patients experience complications requiring readmission. It is important to identify baseline/operative factors leading to rehospitalizations and reoperation, which may impact outcomes. METHODS.: Inclusion criteria: ASD surgical patients (age?>?18years, major coronal Cobb≥20°, SVA≥5?cm, PT≥25° and/or TK?>?60°) with complete baseline, 1-, and 2-year follow-up. Patients were grouped on the basis of readmission occurrence (yes/no) and type (medical [no reoperation] vs. surgical [revision surgery]). Readmissions caused by infections requiring surgical treatment (e.g. deep infections) were considered reoperations. Univariate and multivariate analyses determined readmission and reoperation predictors. Repeated measures mixed models evaluated readmission impact on HRQoLʼs at 1- and 2-years. RESULTS.: 334 patients were included: 76 (22.8%) readmissions, involving 65 (85.5% of 76) reoperations (surgical readmission) and 11 (14.5% of 76) medical readmissions. The most common surgical readmission indication (n?=?65) was implant complications (36.9%; rod breakage n?=?13); the most common medical readmission indication was infection (36.4%, n?=?4), treated with antibiotics. Non-infectious medical readmission (n?=?7) included: pleural effusion, DTV, intra-operative blood loss, neurologic, and unspecified. Readmission predictors: increased number of major peri-operative complications (OR 5.13, p?=?0.014), infection presence (OR 25.02, p?=?0.001), implant complications (OR 6.12, p?

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