Early Discharged Lumbar Spine Fusion Reduced Postoperative Readmissions: A Retrospective Cohort Study

Wen-Cheng Huang, Jau-Ching Wu, Hsuan-Kan Chang and Yu-Chun Chen
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Wen-Cheng Huang: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 11217, Taiwan
Jau-Ching Wu: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 11217, Taiwan
Hsuan-Kan Chang: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 11217, Taiwan
Yu-Chun Chen: Department of Family Medicine, School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan

IJERPH, 2020, vol. 17, issue 4, 1-10

Abstract: Early discharge (ED) has emerged and gained popularity in spine surgery. However, the benefits of ED in lumbar fusion have not yet been validated by large cohort studies. To evaluate the effects of ED on readmissions and reoperations in lumbar fusion, this study utilized a national database to enroll patients who had undergone lumbar fusion surgery at age 50–70 years, and grouped them into an ED group or a comparison group. In the comprehensive follow-up of 180 days post-operation, the two groups were compared. There were 18,008 patients in the cohort, including 2172 in the ED group and 15,836 in the comparison group. The ED group was slightly younger (59.9 vs. 60.7 years, p < 0.001), more male predominant (44.9% vs. 36.9%, p < 0.001), and had fewer medical comorbidities. The ED group had less incidences of readmission than the comparison group. (Crude hazard ratio = 0.73, and adjusted HR = 0.75, both p < 0.001). Overall, the cumulative incidences of readmission in the ED group (9.5%) were lower than those in the comparison group (12.8%, p < 0.001), whereas reoperations were insignificantly different (1.5% vs. 1.2%, p = 0.189). For patients aged 50–70 years and who require lumbar fusion surgery, ED could yield a 25% reduced risk of readmission for any cause within 180 days post-operation. Since the reoperation rates remained similar, our results suggest that ED may be a promising option for elderly patients undergoing lumbar spinal fusion surgery.

Keywords: lumbar spinal fusion; early discharge (ED); incidence; readmission; reoperation; risk management (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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