An Analysis of Causes of Readmission After Spine Surgery

Abstract

Infection, medical complications after surgery, and surgical complications requiring revision of implants are the primary causes of unplanned early readmissions and spine surgery. Further studies are necessary to identify patients and procedures most associated with readmission.

Ninety-day readmissions after degenerative cervical spine surgery: A single-center administrative database study

“…11 McCormack reported 30 day unplanned readmission rates of 4.3% for anterior cervical spine fusion patients and 5.9% for posterior cervical fusion patients from 2007 through 2009. 7 His study is of particular interest because it took place at the same institution as ours, yet it reported higher readmission rates than we observed from 2011 through 2014. These disparate findings can be explained, at least in part, by changes in institution protocol that included application of intrawound vancomycin powder in posterior cervical surgeries, (b) routine nasal swabbing for identification of Staphylococcus carriers in order to optimize antibiotic prophylaxis and (c) standardization of dressing protocol.…”

“…King et al 6 and McCormack et al 7 have reported higher readmission rates after posterior approach surgery when compared to anterior approach. This is consistent with findings in our cohort of patients.…”

“…[2][3][4][5] Data regarding readmission causes and rates in spine surgery have been investigated using large billing administrative databases like the National Inpatient Sample and Medicare. 6,7 However, these databases have inherent limitations such as diagnosis under-reporting, coding errors and lack of clinical detail. Further compounding the issue are the myriad, diverse factors that influence readmission rates and make it especially challenging to standardize an "acceptable" readmission rate.…”

What Are the 30-day Readmission Rates Across Orthopaedic Subspecialties?

“…This is low compared with other orthopaedic studies [9,27]. As we would expect with a low incidence of surgical readmission, our medical 30-day readmission rate of 42% is high when compared with other studies [18,20,23]. The most common cause of surgical readmission is surgical site infection.…”

Readmission from orthopedic surgical site infections: an integrative review

“…In analyzing the variable of interest of this review, meaning the readmission characteristics from orthopedic surgical site infection, it was found that the objectives of included publications varied between characterizing unplanned readmissions within 30 days after discharge (20)(21)(22)(23) , identifying predictors of surgical readmission within 30 days in overall readmission rates (24) , assessing their impact on costs, average stay and overall readmission rates, as well as its causes and risk factors (20)(21)(25)(26) and associated comorbidities (27) . Studies analyzing the impact of seasonality (28) and influence of goals and educational video programs on events that also included readmission (29) were also performed.…”