Predicting Extended Length of Hospital Stay in an Adult Spinal Deformity Surgical Population

International Spine Study Group

Research output: Contribution to journalArticle

Abstract

STUDY DESIGN.: Retrospective review of a prospective multicenter database. OBJECTIVE.: Identify variables associated with extended length of stay (ExtLOS) and this impact on health related quality of life (HRQoL) scores in adult spinal deformity (ASD) patients. SUMMARY OF BACKGROUND DATA.: ASD surgery is complex and associated with complications including extLOS. Though variables contributing to extLOS have been considered, specific complications and pre-disposing factors among ASD surgical patients remain to be investigated. METHODS.: Inclusion criteria: ASD surgical patients (age>18yrs, scoliosis≥20°, SVA≥5?cm, PT≥25° and/or TK>60°) with complete demographic, radiographic and HRQoL data at baseline, 6 weeks, and 2 years post-operative. ExtLOS was based on 75 percentile (≥9 days). Univariate and multivariate analyses identified predictors and evaluated effects on outcomes. Repeated measures mixed models analyzed impact of ExtLOS on HRQoL (ODI; SF-36?PCS/MCS; SRS22r Activity (AC), Pain (P), Appearance (AP), Satisfaction (S), Mental (M) and Total (T)). RESULTS.: 380 patients met inclusion criteria: 105 (27.6%) had extLOS (≥9 days), 275 (72.4%) did not. Average LOS was 8 days (range: 1–30 days). Age (OR 1.04), # levels fused (OR 1.12), # infections (OR 2.29), # neurologic complications (OR 2.51), Charlson Comorbidity Index Score (CCI) predicted ExtLOS (OR 3.92), and # intra-op complications predicted ExtLOS (OR 3.56). ExtLOS patients had more intra cardiopulmonary (pleural effusion: 1.9% vs. 0%), and operative complications (dural tear: 13.3% vs. 5.1%; excessive blood loss: 18% vs. 5.8%) (p?

Original languageEnglish (US)
JournalSpine
DOIs
StateAccepted/In press - Dec 14 2015

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Length of Stay
Population
Quality of Life
Pleural Effusion
Tears
Nervous System
Comorbidity
Multivariate Analysis
Demography
Databases
Pain
Infection

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Predicting Extended Length of Hospital Stay in an Adult Spinal Deformity Surgical Population. / International Spine Study Group.

In: Spine, 14.12.2015.

Research output: Contribution to journalArticle

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title = "Predicting Extended Length of Hospital Stay in an Adult Spinal Deformity Surgical Population",
abstract = "STUDY DESIGN.: Retrospective review of a prospective multicenter database. OBJECTIVE.: Identify variables associated with extended length of stay (ExtLOS) and this impact on health related quality of life (HRQoL) scores in adult spinal deformity (ASD) patients. SUMMARY OF BACKGROUND DATA.: ASD surgery is complex and associated with complications including extLOS. Though variables contributing to extLOS have been considered, specific complications and pre-disposing factors among ASD surgical patients remain to be investigated. METHODS.: Inclusion criteria: ASD surgical patients (age>18yrs, scoliosis≥20°, SVA≥5?cm, PT≥25° and/or TK>60°) with complete demographic, radiographic and HRQoL data at baseline, 6 weeks, and 2 years post-operative. ExtLOS was based on 75 percentile (≥9 days). Univariate and multivariate analyses identified predictors and evaluated effects on outcomes. Repeated measures mixed models analyzed impact of ExtLOS on HRQoL (ODI; SF-36?PCS/MCS; SRS22r Activity (AC), Pain (P), Appearance (AP), Satisfaction (S), Mental (M) and Total (T)). RESULTS.: 380 patients met inclusion criteria: 105 (27.6{\%}) had extLOS (≥9 days), 275 (72.4{\%}) did not. Average LOS was 8 days (range: 1–30 days). Age (OR 1.04), # levels fused (OR 1.12), # infections (OR 2.29), # neurologic complications (OR 2.51), Charlson Comorbidity Index Score (CCI) predicted ExtLOS (OR 3.92), and # intra-op complications predicted ExtLOS (OR 3.56). ExtLOS patients had more intra cardiopulmonary (pleural effusion: 1.9{\%} vs. 0{\%}), and operative complications (dural tear: 13.3{\%} vs. 5.1{\%}; excessive blood loss: 18{\%} vs. 5.8{\%}) (p?",
author = "{International Spine Study Group} and Klineberg, {Eric O.} and Passias, {Peter G.} and Jalai, {Cyrus M.} and Nancy Worley and Daniel Sciubba and Burton, {Douglas C.} and Gupta, {Munish C.} and Alex Soroceanu and Zebala, {Luke P.} and Mundis, {Gregory M.} and Kim, {Han Jo} and Hamilton, {D. K.} and Hart, {Robert A.} and Ames, {Christopher P.} and Virginie Lafage",
year = "2015",
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AU - International Spine Study Group

AU - Klineberg, Eric O.

AU - Passias, Peter G.

AU - Jalai, Cyrus M.

AU - Worley, Nancy

AU - Sciubba, Daniel

AU - Burton, Douglas C.

AU - Gupta, Munish C.

AU - Soroceanu, Alex

AU - Zebala, Luke P.

AU - Mundis, Gregory M.

AU - Kim, Han Jo

AU - Hamilton, D. K.

AU - Hart, Robert A.

AU - Ames, Christopher P.

AU - Lafage, Virginie

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N2 - STUDY DESIGN.: Retrospective review of a prospective multicenter database. OBJECTIVE.: Identify variables associated with extended length of stay (ExtLOS) and this impact on health related quality of life (HRQoL) scores in adult spinal deformity (ASD) patients. SUMMARY OF BACKGROUND DATA.: ASD surgery is complex and associated with complications including extLOS. Though variables contributing to extLOS have been considered, specific complications and pre-disposing factors among ASD surgical patients remain to be investigated. METHODS.: Inclusion criteria: ASD surgical patients (age>18yrs, scoliosis≥20°, SVA≥5?cm, PT≥25° and/or TK>60°) with complete demographic, radiographic and HRQoL data at baseline, 6 weeks, and 2 years post-operative. ExtLOS was based on 75 percentile (≥9 days). Univariate and multivariate analyses identified predictors and evaluated effects on outcomes. Repeated measures mixed models analyzed impact of ExtLOS on HRQoL (ODI; SF-36?PCS/MCS; SRS22r Activity (AC), Pain (P), Appearance (AP), Satisfaction (S), Mental (M) and Total (T)). RESULTS.: 380 patients met inclusion criteria: 105 (27.6%) had extLOS (≥9 days), 275 (72.4%) did not. Average LOS was 8 days (range: 1–30 days). Age (OR 1.04), # levels fused (OR 1.12), # infections (OR 2.29), # neurologic complications (OR 2.51), Charlson Comorbidity Index Score (CCI) predicted ExtLOS (OR 3.92), and # intra-op complications predicted ExtLOS (OR 3.56). ExtLOS patients had more intra cardiopulmonary (pleural effusion: 1.9% vs. 0%), and operative complications (dural tear: 13.3% vs. 5.1%; excessive blood loss: 18% vs. 5.8%) (p?

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