30- and 90-Day Readmission Rates Following Traumatic Spinal Cord Injury: A Systematic Review and Meta-Analyses.

Abstract

Study design: Systematic Review and Meta-Analyses.

Objective: To assess the 30- and 90-day readmission rates after a traumatic spinal cord injury (SCI).

Methods: A systematic search of MEDLINE and Embase was performed. The period was from inception to June 2022, with no language restrictions. All studies investigating the 30- and/or 90-day readmission rate following traumatic SCI were included. A random-effects model to combine effect sizes in our meta-analysis was applied.

Results: Seven out of 2959 reports met eligibility. The mean age of the patients was 50.2 ± 19.9, with a male-to-female ratio of 2.4:1. The most common traumatic SCI was cervical injury (55.3%). The meta-analysis model revealed a 30-day readmission rate of 14.2% after traumatic SCI, with heterogeneity in the studies. The 90-day readmission rate was 35.7%, with homogeneity in the studies. The meta-regression analysis found significant positive associations between cervical and thoracolumbar injuries and patient age and the 30-day readmission rate, while male sex demonstrated a negative association with the 30-day readmission rate. The 30-day readmission rate following index admission was 13.1% and the 30-day readmission rate after rehabilitation facilities was 15.8%. The study found that the 30-day readmission rate in the USA was 14.0%.

Conclusions: There is no doubt that readmission is an adverse health outcome. The outcome is also complex and multifaceted, which makes it difficult to predict. Injury level is 1 of the predictors that affect readmission, making it essential to consider factors during discharge planning for high-risk people to reduce 30-day readmission rates.