The association between surgical start time and spine surgery outcomes

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2024-11-26 DOI:10.1016/j.clineuro.2024.108663

Claudia Hejazi-Garcia , Susanna D. Howard , Addison Quinones , Jesse Y. Hsu , Zarina S. Ali

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引用次数: 0

Abstract

Objective

Neurosurgical operations, including spine surgeries, often occur outside “normal business hours” due to the urgent or emergent nature of cases. This study investigates the association of surgical start time (SST) with spine surgery outcomes.

Methods

A retrospective cross-sectional study was performed using electronic health record data from a multi-hospital academic health system from 2017 to 2024. Eligible patients included adults who underwent spine surgery with a recorded SST. Patients were separated into a regular hours group (7:00 A.M. to 5:00 P.M.) and an afterhours group (SST outside this time window). The association between SST and extended length of stay (greater than 3 days), readmission, and discharge disposition was examined.

Results

The sample included 12,658 patients with 10,737 (84.8 %) patients in the regular hours group and 1921 (15.2 %) patients in the afterhours group. Afterhours SST had significantly increased rates of extended length of stay, non-home discharge disposition, and readmission compared to regular hours SST. Adjusting for age, comorbidities, case classification, the time from admission to SST, and surgery type, afterhours SST was significantly associated with non-home discharge disposition (OR 1.27, 95 % CI 1.12 – 1.45, p < 0.001).

Conclusion

This is the largest study to examine the association of SST with outcomes of spine surgery. Controlling for potential confounders, afterhours SST was significantly associated with non-home discharge disposition.

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手术开始时间与脊柱手术结果之间的关系

目的神经外科手术，包括脊柱手术，由于病例的紧急或急诊性质，往往发生在 "正常工作时间 "之外。本研究调查了手术开始时间（SST）与脊柱手术结果之间的关系。研究方法利用一个多医院学术医疗系统 2017 年至 2024 年的电子病历数据进行了一项回顾性横断面研究。符合条件的患者包括接受脊柱手术并记录了SST的成年人。患者被分为正常时间组（上午 7:00 至下午 5:00）和非正常时间组（在此时间窗之外的 SST）。结果样本包括 12658 名患者，其中正常时间组有 10737 名患者（84.8%），非正常时间组有 1921 名患者（15.2%）。与正常时间的 SST 相比，下班后 SST 的住院时间延长率、非居家出院处置率和再入院率明显增加。在对年龄、合并症、病例分类、入院到 SST 的时间以及手术类型进行调整后，下班后 SST 与非居家出院处置显著相关（OR 1.27，95 % CI 1.12 - 1.45，p <0.001）。在控制了潜在的混杂因素后，下班后 SST 与非居家出院处置显著相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.