Late-week spine surgeries linked to longer hospital stays, study finds

Spine

Spine surgeries performed late in the week are associated with increased lengths of stay, especially when patients are discharged to a skilled nursing facility or rehabilitation center, according to a study published in the April issue of Journal of Neurosurgery: Spine.

Seven notes:

1. Researchers assessed clinical and nonclinical drivers of patient length of stay in the hospital after elective lumbar laminectomy.

2. The study focused on 1,359 patients undergoing laminectomy surgery for degenerative lumbar spinal stenosis within the Cleveland Clinic health system between March 1, 2016, and Feb. 1, 2019.

3. The mean length of stay ranged from 2.01 days on Monday to 2.47 days on Friday.

4. Longer length of stay for surgeries later in the week was not associated with greater underlying health risks, but led to greater costs of care, with average total surgical costs 20 percent greater for Friday cases versus Monday cases.

5. Comorbidity burden, surgery at a tertiary care center versus a community hospital, and the incidence of postoperative complications were associated with significantly longer length of stay.

6. Significant nonclinical predictors of increased length of stay included discharge to home health care, skilled nursing facilities, or rehab facilities and late-week surgery, even after adjusting for underlying health risks and insurance.

7. The study highlights an opportunity to lower costs and improve outcomes associated with elective spine surgery. Optimizing surgical scheduling and perioperative care coordination could help reduce length of stay  and lower costs, researchers said.

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