Early Discharged Lumbar Spine Fusion Reduced Postoperative Readmissions: A Retrospective Cohort Study
Abstract
:1. Introduction
2. Material and Methods
2.1. Data Source and Ethical Concerns
2.2. Study Cohort
2.3. ED Group vs. Comparison Group
2.4. Follow-Up Outcomes and Covariates
2.5. Statistical Analysis
3. Results
3.1. Demographics of the Cohort
3.2. Readmission Rates
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Demographic Characteristics, Comorbidities, and Outcomes | Comparison Group | ED 1 Group | p-Value | |||||
---|---|---|---|---|---|---|---|---|
n = 15,836 | (%) | n = 2172 | (%) | |||||
Gender | <0.001 | |||||||
Female | 9988 | (63.1) | 1196 | (55.1) | ||||
Male | 5848 | (36.9) | 976 | (44.9) | ||||
Age, mean (SD 2) | 60.7 | (5.74) | 59.9 | (5.76) | <0.001 | |||
Comorbidities | ||||||||
Anemia | 1041 | (6.6) | 85 | (3.9) | <0.001 | |||
Chronic pulmonary disease | 2463 | (15.6) | 269 | (12.4) | <0.001 | |||
Congestive heart failure | 535 | (3.4) | 47 | (2.2) | 0.003 | |||
Depression | 910 | (5.7) | 103 | (4.7) | 0.057 | |||
Diabetes | 4406 | (27.8) | 522 | (24.0) | <0.001 | |||
Hypertension | 7120 | (45.0) | 887 | (40.8) | <0.001 | |||
Liver disease | 2307 | (14.6) | 279 | (12.8) | 0.032 | |||
Neurologic disorders | 420 | (2.7) | 44 | (2.0) | 0.084 | |||
Chronic kidney disease | 270 | (1.7) | 31 | (1.4) | 0.340 | |||
Chronic peptic ulcer disease | 820 | (5.2) | 107 | (4.9) | 0.620 | |||
Outcome | ||||||||
All-cause readmission | ||||||||
30-day readmission | 636 | (4.0) | 64 | (2.9) | 0.016 | |||
60-day readmission | 962 | (6.1) | 89 | (4.1) | <0.001 | |||
180-day readmission | 2015 | (12.7) | 207 | (9.5) | <0.001 | |||
Re-operation for L-spine | ||||||||
30-day re-operation | 33 | (0.2) | 9 | (0.4) | 0.062 | |||
60-day re-operation | 66 | (0.4) | 14 | (0.6) | 0.130 | |||
180-day re-operation | 188 | (1.2) | 33 | (1.5) | 0.190 |
Readmission during 180-Day-Follow-Up | Comparison Group | ED Group | ||||
---|---|---|---|---|---|---|
All-cause readmission | ||||||
Incidence of readmission (per 1000 person-years) | 275.2 | 201.7 | ||||
Number of occurrences | 2015 | 207 | ||||
Observed person-years | 7320.9 | 1026.3 | ||||
Crude hazard ratio (95% C.I.) 1 | 1.00 | 0.73 | (0.63–0.85) ***,3 | |||
Adjusted hazard ratio (95% C.I.) 2 | 1.00 | 0.75 | (0.65–0.87) ***,3 | |||
Reoperation for L-spine | ||||||
Incidence of reoperation (per 1000 person-years) | 24.0 | 30.7 | ||||
Number of occurrences | 188 | 33 | ||||
Observed person-years | 7842.1 | 1075.1 | ||||
Crude hazard ratio (95% C.I.) 1 | 1.00 | 1.28 | (0.86–1.86) | |||
Adjusted hazard ratio (95% C.I.) 2 | 1.00 | 1.26 | (0.87–1.83) |
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Huang, W.-C.; Wu, J.-C.; Chang, H.-K.; Chen, Y.-C. Early Discharged Lumbar Spine Fusion Reduced Postoperative Readmissions: A Retrospective Cohort Study. Int. J. Environ. Res. Public Health 2020, 17, 1335. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17041335
Huang W-C, Wu J-C, Chang H-K, Chen Y-C. Early Discharged Lumbar Spine Fusion Reduced Postoperative Readmissions: A Retrospective Cohort Study. International Journal of Environmental Research and Public Health. 2020; 17(4):1335. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17041335
Chicago/Turabian StyleHuang, Wen-Cheng, Jau-Ching Wu, Hsuan-Kan Chang, and Yu-Chun Chen. 2020. "Early Discharged Lumbar Spine Fusion Reduced Postoperative Readmissions: A Retrospective Cohort Study" International Journal of Environmental Research and Public Health 17, no. 4: 1335. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17041335