Incremental Increase in Hospital Length of Stay Due to Complications of Surgery for Adult Spinal Deformity

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.

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Publication Details

Journal
Global Spine Journal
Published
2024-09-05
DOI
https://doi.org/10.1177/21925682241283724
Citations
3
Primary Topic
Scoliosis diagnosis and treatment
Type
article
Field-Weighted Citation Impact
1.72
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article

Incremental Increase in Hospital Length of Stay Due to Complications of Surgery for Adult Spinal Deformity

Renaud Lafage, Christopher Pearson Ames, Kojo Hamilton, Bassel Georges Diebo et al.
3 citations
Global Spine Journal
Scoliosis diagnosis and treatment
1.72
article

Incremental Increase in Hospital Length of Stay Due to Complications of Surgery for Adult Spinal Deformity

Renaud Lafage, Christopher Pearson Ames, Kojo Hamilton, Bassel Georges Diebo, Christopher I. Shaffrey, Eric O. Klineberg, Alan H. Daniels, Douglas C. Burton, Connor Sheehan, Justin S. Smith, Gregory M. Mundis, Richard A. Hostin, Shay R. Bess, Munish Chandra Gupta, Virginie Lafage, Han Jo Kim, Frank J. Schwab, Robert K. Eastlack
article en
3 citations

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.

Global Spine JournalVol. 15(4)
OhioHealth (US), Hospital for Special Surgery (US), Northwell Health (US), Scripps Health (US), University of Pittsburgh (US), John Brown University (US), University of California, San Francisco (US), Washington University in St. Louis (US), Brown University (US), Lenox Hill Hospital (US), Temple College (US), University of California System (US), Duke Medical Center (US), University of Kansas Medical Center (US), Rocky Mountain Hospital for Children (US), University of Virginia Medical Center (US), Southwest Scoliosis Institute (US), Scripps Clinic (US), Duke University Hospital (US), Neurological Surgery (US), Temple University (US), The University of Texas Health Science Center at Houston (US)
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Openalex Percentile: Top 15%
Scoliosis diagnosis and treatment
1.72
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