Incremental Increase in Hospital Length of Stay Due to Complications of Surgery for Adult Spinal Deformity
Year: 2024
Type: article
Study design: Observational Study
Abstract: Study DesignRetrospective Cohort Study.ObjectivesLength of Stay (LOS) and resource utilization are of primary importance for hospital administration. This study aimed to understand the incremental effect of having a specific complication on LOS among ASD patients.MethodsA retrospective examination of prospective multicenter data utilized patients without a complication prior to discharge to develop a patient-adjusted and surgery-adjusted predictive model of LOS among ASD patients. The model was later applied to patients with at least 1 complication prior to discharge to investigate incremental effect of each identified complication on LOS vs the expected LOS.Results571/1494 (38.2%) patients experienced at least 1 complication before discharge with a median LOS of 7 [IQR 5 to 9]. Univariate analysis demonstrated that LOS was significantly affected by patients' demographics (age, CCI, sex, disability, deformity) and surgical strategy (invasiveness, fusion length, posterior MIS fusion, direct decompression, osteotomy severity, IBF use, EBL, ASA, ICU stay, day between stages, Date of Sx). Using patients with at least 1 complication prior discharge and compared to the patient-and-surgery adjusted prediction, having a minor complication increased the expected LOS by 0.9 day(s), a major complication by 3.9 days, and a major complication with reoperation by 6.3 days.ConclusionComplications following surgery for ASD correction have different, but predictable impact on LOS. Some complications requiring minimal intervention are associated with significant and substantial increases in LOS, while complications with significant impact on patient quality of life may have no influence on LOS.
Source: Global Spine Journal
Authors: Renaud Lafage, Connor Sheehan, Justin S. Smith, Alan Daniels, Bassel Diebo, Christopher Ames, Shay Bess, Robert Eastlack, Munish Gupta, Richard Hostin, Han Jo Kim, Eric Klineberg, Gregory Mundis, Kojo Hamilton, Christopher Shaffrey, Frank Schwab, Virginie Lafage, Douglas Burton, On behalf of the International Spine Study Group (ISSG)
Institutions: Northwell Health, Lenox Hill Hospital, Temple University, University of Virginia Hospital, University of Virginia Medical Center, Brown University, University of California, San Francisco, University of California System, University of California San Francisco Medical Center, Rocky Mountain Hospital for Children, Scripps Clinic, Washington University in St. Louis, Southwest Scoliosis Institute, Hospital for Special Surgery, The University of Texas Health Science Center at Houston, University of Pittsburgh, Duke Medical Center, University of Kansas Medical Center
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,650
OpenAlex ID: W4402326436