The impact of weekend hospital admission on the timing of intervention and outcomes after surgery for spinal metastases.

Hormuzdiyar H. Dasenbrock, Gustavo Pradilla, Timothy F Witham, Ziya L. Gokaslan, Ali Bydon

Research output: Contribution to journalArticle

Abstract

Many studies have found that patients admitted on the weekend have inferior outcomes compared with those admitted on a weekday, which may be due partially to decreased availability of procedures. To evaluate the impact of weekend admission on the timing of intervention and outcomes after surgery for metastatic spine disease. Data from the Nationwide Inpatient Sample (2005-2008) were retrospectively extracted. Patients were included if they had metastatic disease and underwent spine surgery; elective hospital admissions were excluded. Multivariate logistic regression analyses were conducted to calculate the odds of undergoing early surgery, in-hospital death, and the development of a complication for patients admitted on the weekend compared with those admitted on a weekday. All analyses were adjusted for differences in age, sex, comorbid disease, primary tumor histology, myelopathy, visceral metastases, and expected primary payer, as well as hospital volume, bed size, and teaching status. We evaluated 2714 admissions. Weekend admission was associated with a significantly lower adjusted odds of receiving surgery within 1 day (odds ratio, 0.66, 95% confidence interval, 0.54-0.81; P <.001) and within 2 days (odds ratio, 0.68; 95% confidence interval, 0.56-0.83; P <.001) of admission. The adjusted odds of in-hospital death and developing a postoperative complication were not significantly different for those admitted on the weekend. In this nationwide study examining patients with spinal metastases, those admitted on the weekend were significantly less likely to receive early intervention. Future studies are needed to delineate the reasons for differences in the timing of surgery.

Original languageEnglish (US)
Pages (from-to)586-593
Number of pages8
JournalNeurosurgery
Volume70
Issue number3
StatePublished - Mar 2012
Externally publishedYes

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Neoplasm Metastasis
Spine
Hospital Bed Capacity
Odds Ratio
Confidence Intervals
Spinal Cord Diseases
Inpatients
Histology
Teaching
Logistic Models
Regression Analysis
Neoplasms

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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The impact of weekend hospital admission on the timing of intervention and outcomes after surgery for spinal metastases. / Dasenbrock, Hormuzdiyar H.; Pradilla, Gustavo; Witham, Timothy F; Gokaslan, Ziya L.; Bydon, Ali.

In: Neurosurgery, Vol. 70, No. 3, 03.2012, p. 586-593.

Research output: Contribution to journalArticle

Dasenbrock, Hormuzdiyar H. ; Pradilla, Gustavo ; Witham, Timothy F ; Gokaslan, Ziya L. ; Bydon, Ali. / The impact of weekend hospital admission on the timing of intervention and outcomes after surgery for spinal metastases. In: Neurosurgery. 2012 ; Vol. 70, No. 3. pp. 586-593.
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