The 90-Day Reoperations and Readmissions in Complex Adult Spinal Deformity Surgery

Nathan J. Lee, Lawrence G. Lenke, Meghan Cerpa, Joseph Lombardi, Alex Ha, Paul Park, Eric Leung, Zeeshan M. Sardar, Ronald A. Lehman

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Study Design: Retrospective review. Objective: Identify surgical complex adult spine deformity patients who are at increased risk for an unplanned postoperative 90-day readmission and/or reoperation. Methods: A total of 227 consecutive records of complex adult (≥18 years old) spine deformity surgeries from 2015 to 2018 were reviewed. Demographics, comorbidities, operative details, and postoperative complication data was collected. Chi-square/Fisher’s exact test and t tests were used for bivariate analysis. To determine independent predictors for readmissions/reoperations, stepwise multivariate logistic regressions were employed. The C-statistic and Hosmer-Lemeshow (HL) value was used to measure concordance and goodness of fit. Results: Average age was 50.5 ± 17.8 years and 67.8% were female. Ninety-day readmission and reoperation rates were 7.0% and 5.3%, respectively. Median number of days after index discharge date resulting in readmission and reoperation were 16.5 and 28, respectively. The multivariate regression for 90-day readmissions included pulmonary comorbidity, depression, history of deep vein thrombosis/pulmonary embolism (DVT/PE), and gastrointestinal comorbidity (C-statistic = 0.82; HL = 0.79). Pulmonary comorbidity, depression, and history of DVT/PE increased risk for 90-day readmission by 5-, 3.5-, and 10.2-fold, respectively. The multivariate regression for 90-day reoperations was similar to readmissions (C-statistic = 0.89; HL = 0.31). Operative time>7 hours and history of DVT/PE increased risk for early reoperation by 5.8- and 8.7-fold, respectively. Conclusions: An emphasis on medically optimizing patients with preexisting pulmonary comorbidities, depression, and history of DVT/PE may have a substantial impact on improving short-term outcomes in this population. The present study provides benchmark data and may serve as an initial model to predict unplanned reoperations and readmissions.

Original languageEnglish (US)
Pages (from-to)415-422
Number of pages8
JournalGlobal Spine Journal
Volume12
Issue number3
DOIs
StatePublished - Apr 2022
Externally publishedYes

Keywords

  • adult spine deformity
  • complications
  • readmission
  • reoperations
  • spine surgery

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

Fingerprint

Dive into the research topics of 'The 90-Day Reoperations and Readmissions in Complex Adult Spinal Deformity Surgery'. Together they form a unique fingerprint.

Cite this