TY - JOUR
T1 - Incremental Increase in Hospital Length of Stay Due to Complications of Surgery for Adult Spinal Deformity
AU - on behalf of the International Spine Study Group (ISSG)
AU - Lafage, Renaud
AU - Sheehan, Connor
AU - Smith, Justin S.
AU - Daniels, Alan
AU - Diebo, Bassel
AU - Ames, Christopher
AU - Bess, Shay
AU - Eastlack, Robert
AU - Gupta, Munish
AU - Hostin, Richard
AU - Kim, Han Jo
AU - Klineberg, Eric
AU - Mundis, Gregory
AU - Hamilton, Kojo
AU - Shaffrey, Christopher
AU - Schwab, Frank
AU - Lafage, Virginie
AU - Burton, Douglas
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024
Y1 - 2024
N2 - Study Design: Retrospective Cohort Study. Objectives: Length 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. Methods: A 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. Results: 571/1494 (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. Conclusion: Complications 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.
AB - Study Design: Retrospective Cohort Study. Objectives: Length 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. Methods: A 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. Results: 571/1494 (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. Conclusion: Complications 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.
KW - adult spinal deformity
KW - adverse event
KW - complications
KW - in-hospital outcomes
KW - length of stay
UR - http://www.scopus.com/inward/record.url?scp=85204052876&partnerID=8YFLogxK
U2 - 10.1177/21925682241283724
DO - 10.1177/21925682241283724
M3 - Article
C2 - 39235925
AN - SCOPUS:85204052876
SN - 2192-5682
JO - Global Spine Journal
JF - Global Spine Journal
ER -