全内窥镜脊柱手术后 90 天急诊室使用率和再入院率:对 821 例患者的多中心回顾性分析。

IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY
Neurosurgery Pub Date : 2025-02-01 Epub Date: 2024-07-18 DOI:10.1227/neu.0000000000003095
Jannik Leyendecker, Tobias Prasse, Christine Park, Malin Köster, Lena Rumswinkel, Tara Shenker, Eliana Bieler, Peer Eysel, Jan Bredow, Mark M Zaki, Varun Kathawate, Edward Harake, Rushikesh S Joshi, Sanjay Konakondla, Osama N Kashlan, Peter Derman, Albert Telfeian, Christoph P Hofstetter
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引用次数: 0

摘要

背景和目标:脊柱手术后的急诊科(ED)使用率和再入院率是衡量医疗质量的常用指标。有关全内窥镜脊柱手术(FESS)后质量指标评估的数据有限。本研究的目的是检测 FESS 术后非计划门诊使用率、原因和风险因素:这项回顾性多中心分析评估了 2014 年 1 月至 2023 年 4 月期间因脊柱退行性病变实施 FESS 后的急诊室使用率和门诊再入院率。结果指标为急诊室使用率、再入院率以及术后 90 天内的翻修手术率:我们的队列中包括 821 名接受 FESS 的患者,平均年龄为 59 岁。大多数手术针对腰椎或骶椎(85.75%),小部分涉及颈椎(10.11%)。最常见的手术是腰椎单侧椎板切除双侧减压术(40.56%)和腰椎经椎间孔椎间盘切除术(25.58%)。术后 90 天内,8.0% 的患者因手术并发症再次前往急诊室就诊。共有2.2%的患者再次入院,其中1.9%的患者需要进行翻修手术。急诊室就诊和再次入院的主要原因是术后疼痛加剧、一过性神经源性膀胱功能障碍和复发性椎间盘突出。我们的多变量回归分析显示,女性患者使用急诊室的可能性明显更高(P = .046;几率比:1.77,95% CI 1.01-3.1 5.69% vs 10.33%)。年龄、美国麻醉医师协会等级、体重指数、合并症和脊柱跨度等因素并不能显著预测术后急诊室的使用率:这项分析表明了 FESS 的安全性,这体现在可接受的急诊室使用率、再入院率和翻修手术率上。未来的研究需要进一步阐明 FESS 与传统脊柱手术相比的安全性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
90-Day Emergency Department Utilization and Readmission Rate After Full-Endoscopic Spine Surgery: A Multicenter, Retrospective Analysis of 821 Patients.

Background and objectives: Emergency department (ED) utilization and readmission rates after spine surgery are common quality of care measures. Limited data exist on the evaluation of quality indicators after full-endoscopic spine surgery (FESS). The objective of this study was to detect rates, causes, and risk factors for unplanned postoperative clinic utilization after FESS.

Methods: This retrospective multicenter analysis assessed ED utilization and clinic readmission rates after FESS performed between 01/2014 and 04/2023 for degenerative spinal pathologies. Outcome measures were ED utilizations, hospital readmissions, and revision surgeries within 90 days postsurgery.

Results: Our cohort includes 821 patients averaging 59 years of age, who underwent FESS. Most procedures targeted the lumbar or sacral spine (85.75%) while a small fraction involved the cervical spine (10.11%). The most common procedures were lumbar unilateral laminotomies for bilateral decompression (40.56%) and lumbar transforaminal discectomies (25.58%). Within 90 days postsurgery, 8.0% of patients revisited the ED for surgical complications. A total of 2.2% of patients were readmitted to a hospital of which 1.9% required revision surgery. Primary reasons for ED visits and clinic readmissions were postoperative pain exacerbation, transient neurogenic bladder dysfunction, and recurrent disk herniations. Our multivariate regression analysis revealed that female patients had a significantly higher likelihood of using the ED ( P = .046; odds ratio: 1.77, 95% CI 1.01-3.1 5.69% vs 10.33%). Factors such as age, American Society of Anesthesiologists class, body mass index, comorbidities, and spanned spinal levels did not significantly predict postoperative ED utilization.

Conclusion: This analysis demonstrates the safety of FESS, as evidenced by acceptable rates of ED utilization, clinic readmission, and revision surgery. Future studies are needed to further elucidate the safety profile of FESS in comparison with traditional spinal procedures.

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来源期刊
Neurosurgery
Neurosurgery 医学-临床神经学
CiteScore
8.20
自引率
6.20%
发文量
898
审稿时长
2-4 weeks
期刊介绍: Neurosurgery, the official journal of the Congress of Neurological Surgeons, publishes research on clinical and experimental neurosurgery covering the very latest developments in science, technology, and medicine. For professionals aware of the rapid pace of developments in the field, this journal is nothing short of indispensable as the most complete window on the contemporary field of neurosurgery. Neurosurgery is the fastest-growing journal in the field, with a worldwide reputation for reliable coverage delivered with a fresh and dynamic outlook.
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