Factors influencing the length of stay in patients with lumbar pedicle screw fixation

Abstract

Background:Current health care practices aim for cost reduction to achieve maximal benefit. Because of the increasing number of spinal fusions, this area has become a target for both hospitals and payment organizations. Length of stay (LOS) is one potentially modifiable variable to help reduce overall cost. Attempting to predict the LOS in spinal surgery based on patient factors has not revealed a set of variables that are consistently associated with increased stay.Methods:Medical records from all patients who underwent posterior lumbar spinal fusion by a single neurosurgeon at a single facility were retrospectively examined in a blind fashion. Data were obtained including age, gender, body mass index (BMI), American society of Anesthesiologists (ASA) and analyzed to determine a potential relationship with LOS.Results:A total of 1360 patients were identified for analysis. There were significant but small correlations between age, ASA, BMI, and LOS.Conclusions:There is an effect of age, ASA, and BMI on LOS. However, the significance of this effect is small. Future studies aiming to identify additional factors, which could potentially be modifiable, in order to work on decreasing LOS in lumbar spinal fusion patients.

Interspinous Process (ISP) Devices in Comparison to the Use of Traditional Posterior Spinal Instrumentation

“…In one study, Wang et al reported the median LOHS was three days for both the IPD and tubular/percutaneous BPS fixation group, but four days in the open BPS fixation group [ 1 ]. El-Kadi et al reported patients who underwent UPS and/or BPS by one surgeon at one facility, had positive correlations with LOHS, indicating that those with higher age and BMI would be expected to have a longer length of stay [ 25 ]. Segura-Trepichio et al reported LOHS was significantly lower in the discectomy plus ISP when compared to the PLIF group with microdiscectomy, with an average LOHS of two days versus an average LOHS of five days(P < 0.01) [ 26 ].…”