Inpatient surgery, obesity among significant cost drivers in lumbar discectomies: study

Spine

Obese patients and patients who had inpatient surgery tend to have higher costs when undergoing lumbar discectomies, according to a study published in the August 2021 issue of The Spine Journal.

Researchers analyzed 622 patients and screened for initial, unilateral, single-level lumbar discectomies done between 2014 and 2018 at one facility. They measured total direct cost, clinical length of stay and time in the operating room.

A univariate analysis found factors including older age, obesity, being retired and being male were associated with increased costs. Outpatient procedures and being a student were among factors associated with decreased costs.

A multivariate analysis found obese patients had higher average costs and time in the operating room. Outpatient surgical costs and operating time were significantly lower than inpatient procedures.

The study concluded: "Significant drivers of total direct cost in multivariate generalized linear model analysis were obesity, severe systemic disease and inpatient surgery. Average length of stay was increased due to age and inpatient status, conversely it was decreased by unemployment and retirement. Significant variables in operating time were male sex, Hispanic race and both obese and overweight BMIs.

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