About 7% of patients go to the emergency department within 90 days of elective spine surgery, and those patients keep using more healthcare for the rest of the year, according to a study published in the October issue of Clinical Spine Surgery.
Researchers at Chicago-based Northwestern Medicine, including spine surgeons Wellington Hsu, MD, and Alpesh Patel, MD, reviewed 618 patients who had elective spine surgery for degenerative conditions from 2013 to 2018. After propensity score matching, they compared patients who had an ED visit within 90 days of surgery with those who did not.
Forty-four patients, or 7.1%, visited the ED in that window. Obesity, diabetes, congestive heart failure, a history of heart attack and opioid use before surgery were independent risk factors for an early visit.
The early ED patients also used more care over the following year. They had more MRI studies, repeat ED visits, urgent care visits and opioid prescriptions than matched patients without an ED visit.
The findings carry financial stakes as well as clinical ones. CMS penalizes unplanned 30-day readmissions after surgery, and the authors said predicting which patients will return matters to both payers and providers. They recommended focusing on optimizing patients’ health before surgery.
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