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

Author

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  • Wen-Cheng Huang

    (Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 11217, Taiwan
    School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan)

  • Jau-Ching Wu

    (Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 11217, Taiwan
    School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan)

  • Hsuan-Kan Chang

    (Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 11217, Taiwan
    School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan
    Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei 11221, Taiwan)

  • Yu-Chun Chen

    (Department of Family Medicine, School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan
    Department of Family Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
    Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei 11221, Taiwan)

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.

Suggested Citation

  • Wen-Cheng Huang & Jau-Ching Wu & Hsuan-Kan Chang & Yu-Chun Chen, 2020. "Early Discharged Lumbar Spine Fusion Reduced Postoperative Readmissions: A Retrospective Cohort Study," IJERPH, MDPI, vol. 17(4), pages 1-10, February.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:4:p:1335-:d:322479
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    References listed on IDEAS

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    1. Yu-Chun Chen & Jau-Ching Wu & Hsuan-Kan Chang & Wen-Cheng Huang, 2019. "Early Discharge for Anterior Cervical Fusion Surgery: Prediction of Readmission and Special Considerations for Older Adults," IJERPH, MDPI, vol. 16(4), pages 1-13, February.
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