Lingxiao Chen, Jiaming Ding, Zhuo Chen, David B Anderson, Maja R Radojčić, Ruiyuan Zheng, Qingyu Sun, Wenjian Yuan, Jiuxiao Sun, Runhan Fu, Baoyi Shi, Yujie Chen, Lei Qi, Hengxing Zhou, Shiqing Feng
{"title":"腰椎管狭窄术后再入院率、原因和预测因素：一项全国回顾性队列研究","authors":"Lingxiao Chen, Jiaming Ding, Zhuo Chen, David B Anderson, Maja R Radojčić, Ruiyuan Zheng, Qingyu Sun, Wenjian Yuan, Jiuxiao Sun, Runhan Fu, Baoyi Shi, Yujie Chen, Lei Qi, Hengxing Zhou, Shiqing Feng","doi":"10.14245/ns.2449316.658","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the rates, causes, and predictive factors of readmissions at different periods following spine surgery, up to 180 days.</p><p><strong>Methods: </strong>This study utilized data from the 2018 to 2019 Nationwide Readmissions Database and included four postoperative periods: 0 to 7 days, 8 to 30 days, 31 to 90 days, and 91 to 180 days. The causes of readmissions and potential predictive factors were systematically identified. All analyses were performed for each period.</p><p><strong>Results: </strong>For the 180,281 patients (mean age, 65.4 years) included, 2.4% were readmitted between 0 and 7 days, 3.5% between 8 and 30 days, 3.7% between 31 and 90 days, and 4.3% between 91 and 180 days (cumulative rates: 2.4%, 5.9%, 9.3%, and 12.1%, respectively). The causes of readmissions varied across different periods: surgical site-related causes predominated within the first 30 days, whereas nonsurgical site-related causes were more prevalent from 31 to 180 days; other surgical care complication (e.g., infection) was the most prevalent cause between 0 and 7 days (10.7%) and between 8 and 30 days (29.2%), while spondylopathies/spondyloarthropathy (e.g., spinal stenosis) were the leading causes between 31 and 90 days (12.6%) and between 91 and 180 days (17.5%). The predictive factors associated with readmissions also varied across different periods. For example, patients who underwent fusion was associated with a decreased risk of readmissions between 31 and 180 days (e.g., between 91 and 180 days: odds ratio [OR], 0.79; 95% confidence interval [CI], 0.72-0.86; p<0.001), rather than between 0 and 30 days (e.g., between 0 and 7 days: OR, 0.99; 95% CI, 0.90-1.08; p=0.81).</p><p><strong>Conclusion: </strong>About 6% of patients with lumbar spinal stenosis who underwent spine surgery were readmitted within 30 days and 12% by 180 days. The causes of readmissions and predictive factors varied by period, providing valuable insights for quality improvement efforts and the burden of readmission reductions.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 2","pages":"523-539"},"PeriodicalIF":3.6000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242733/pdf/","citationCount":"0","resultStr":"{\"title\":\"Rates, Causes, and Predictive Factors of Hospital Readmissions After Spine Surgery for Lumbar Spinal Stenosis: A Nationwide Retrospective Cohort Study.\",\"authors\":\"Lingxiao Chen, Jiaming Ding, Zhuo Chen, David B Anderson, Maja R Radojčić, Ruiyuan Zheng, Qingyu Sun, Wenjian Yuan, Jiuxiao Sun, Runhan Fu, Baoyi Shi, Yujie Chen, Lei Qi, Hengxing Zhou, Shiqing Feng\",\"doi\":\"10.14245/ns.2449316.658\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aimed to determine the rates, causes, and predictive factors of readmissions at different periods following spine surgery, up to 180 days.</p><p><strong>Methods: </strong>This study utilized data from the 2018 to 2019 Nationwide Readmissions Database and included four postoperative periods: 0 to 7 days, 8 to 30 days, 31 to 90 days, and 91 to 180 days. The causes of readmissions and potential predictive factors were systematically identified. All analyses were performed for each period.</p><p><strong>Results: </strong>For the 180,281 patients (mean age, 65.4 years) included, 2.4% were readmitted between 0 and 7 days, 3.5% between 8 and 30 days, 3.7% between 31 and 90 days, and 4.3% between 91 and 180 days (cumulative rates: 2.4%, 5.9%, 9.3%, and 12.1%, respectively). The causes of readmissions varied across different periods: surgical site-related causes predominated within the first 30 days, whereas nonsurgical site-related causes were more prevalent from 31 to 180 days; other surgical care complication (e.g., infection) was the most prevalent cause between 0 and 7 days (10.7%) and between 8 and 30 days (29.2%), while spondylopathies/spondyloarthropathy (e.g., spinal stenosis) were the leading causes between 31 and 90 days (12.6%) and between 91 and 180 days (17.5%). The predictive factors associated with readmissions also varied across different periods. For example, patients who underwent fusion was associated with a decreased risk of readmissions between 31 and 180 days (e.g., between 91 and 180 days: odds ratio [OR], 0.79; 95% confidence interval [CI], 0.72-0.86; p<0.001), rather than between 0 and 30 days (e.g., between 0 and 7 days: OR, 0.99; 95% CI, 0.90-1.08; p=0.81).</p><p><strong>Conclusion: </strong>About 6% of patients with lumbar spinal stenosis who underwent spine surgery were readmitted within 30 days and 12% by 180 days. The causes of readmissions and predictive factors varied by period, providing valuable insights for quality improvement efforts and the burden of readmission reductions.</p>\",\"PeriodicalId\":19269,\"journal\":{\"name\":\"Neurospine\",\"volume\":\"22 2\",\"pages\":\"523-539\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242733/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neurospine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.14245/ns.2449316.658\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/30 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurospine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.14245/ns.2449316.658","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/30 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Rates, Causes, and Predictive Factors of Hospital Readmissions After Spine Surgery for Lumbar Spinal Stenosis: A Nationwide Retrospective Cohort Study.
Objective: This study aimed to determine the rates, causes, and predictive factors of readmissions at different periods following spine surgery, up to 180 days.
Methods: This study utilized data from the 2018 to 2019 Nationwide Readmissions Database and included four postoperative periods: 0 to 7 days, 8 to 30 days, 31 to 90 days, and 91 to 180 days. The causes of readmissions and potential predictive factors were systematically identified. All analyses were performed for each period.
Results: For the 180,281 patients (mean age, 65.4 years) included, 2.4% were readmitted between 0 and 7 days, 3.5% between 8 and 30 days, 3.7% between 31 and 90 days, and 4.3% between 91 and 180 days (cumulative rates: 2.4%, 5.9%, 9.3%, and 12.1%, respectively). The causes of readmissions varied across different periods: surgical site-related causes predominated within the first 30 days, whereas nonsurgical site-related causes were more prevalent from 31 to 180 days; other surgical care complication (e.g., infection) was the most prevalent cause between 0 and 7 days (10.7%) and between 8 and 30 days (29.2%), while spondylopathies/spondyloarthropathy (e.g., spinal stenosis) were the leading causes between 31 and 90 days (12.6%) and between 91 and 180 days (17.5%). The predictive factors associated with readmissions also varied across different periods. For example, patients who underwent fusion was associated with a decreased risk of readmissions between 31 and 180 days (e.g., between 91 and 180 days: odds ratio [OR], 0.79; 95% confidence interval [CI], 0.72-0.86; p<0.001), rather than between 0 and 30 days (e.g., between 0 and 7 days: OR, 0.99; 95% CI, 0.90-1.08; p=0.81).
Conclusion: About 6% of patients with lumbar spinal stenosis who underwent spine surgery were readmitted within 30 days and 12% by 180 days. The causes of readmissions and predictive factors varied by period, providing valuable insights for quality improvement efforts and the burden of readmission reductions.
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