6 key points on spinal deformity 30-day unplanned readmissions

Laura Dyrda -   Print  |

A new study published in Spine examines the cause and risk factors for unplanned readmission after pediatric spinal deformity surgery.

The researchers examined a multicenter registry collecting data on surgical outcomes for patients who underwent deformity surgery in 2012. The patients were divided into groups for those who had unplanned readmission within 30 days of surgery and those who did not. There were 1,890 pediatric patients all together.


Here are six key findings from the study:


1. There were 75 patients who experienced unplanned readmissions within 30 days of surgery. This is 3.96 percent of the overall patient group.


2. The readmission rate was highest among patients with neuromuscular issues — 6.83 percent — and lowest for idiopathic patients, at 2.66 percent, and infantile patients at 1.31 percent.


3. The top reasons for readmission were:


• Wound complications: 73.3 percent
• Gastrointestinal disturbances: 13.3 percent


4. Factors associated with readmissions included increased surgical complexity and a larger comorbidity burden.


5. The independent variables associated with readmissions were:


• Isolated anterior fusions — odds ratio of 7.65
• Structural pulmonary abnormalities — odds ratio of 2.53
• American Society of Anesthesiologists class of three or four — odds ratio of 2.18


6. The study authors concluded the pediatric deformity rate was low, but not "insignificant."


"Surgeons should consider discharge optimization in the at-risk patient cohorts defined here, and should focus on wound complications and gastrointestinal disturbances to minimize readmissions," the study authors advised. "Quality reporting metrics should incorporate these risk factors to avoid unduly penalizing surgeons who take on complex cases."


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