Risk Factors for 30-day Unplanned Readmission following Surgery for Lumbar Degenerative Diseases: A Systematic Review

Abstract

Study design Systematic review. Objectives Surgical procedures for lumbar degenerative diseases (LDD), which have emerged in the 21-century, are commonly practiced worldwide. Regarding financial burdens and health costs, readmissions within 30days following surgery are inconvenient. We performed a systematic review to integrate real-world evidence and report the current risk factors associated with 30-day readmission following surgery for LDD. Methods The Cochrane Library, Embase, and Medline electronic databases were searched from inception to April 2022 to identify relevant studies reporting risk factors for 30-day readmission following surgery for LDD. Results Thirty-six studies were included in the review. Potential risk factors were identified in the included studies that reported multivariate analysis results, including age, race, obesity, higher American Society of Anesthesiologists score, anemia, bleeding disorder, chronic pulmonary disease, heart failure, dependent status, depression, diabetes, frailty, malnutrition, chronic steroid use, surgeries with anterior approach, multilevel spinal surgeries, perioperative transfusion, presence of postoperative complications, prolonged operative time, and prolonged length of stay. Conclusions There are several potential perioperative risk factors associated with unplanned readmission following surgery for LDD. Preoperatively identifying patients that are at increased risk of readmission is critical for achieving the best possible outcomes.

Is there a weekend effect in spine surgery?: A systematic review and meta-analysis of postoperative outcomes

“…[ 11 , 17 ] Regarding postoperative outcomes, readmission following surgery is another event that is of concern to surgeons, as it presents a significant financial burden. [ 4 ] Rosenberg et al [ 16 ] reported that patients who were initially admitted on weekends and who underwent elective thoracolumbar spinal fusion surgery were more likely to experience hospital readmission.…”

“…[1,2] With respect to patient satisfaction, emerging studies have focused on postoperative outcomes, health costs, and re-admission rates. [3][4][5][6] In addition to the impact of different surgical procedures and the general condition of patients, interestingly, some studies have investigated whether there is a weekend effect that will have an impact on postoperative outcomes. [7,8] Lamn first described the concept of a weekend effect and poorer outcomes for patients admitted to hospitals on weekends in 1973.…”

Thirty-Day Unplanned Readmission After Spine Surgery: Analysis of 650 Cases

“…3,4 Several articles in the literature have analyzed large North American databases, 1,2,10,13-29 data from North American single centers, 5-7,9,30-34 and systematic reviews. 3,4,35 Four works from single centers outside the United States were found: one Finnish, 36 one Romanian, 37 one Indian, 38 and one Korean. 8 A Latin American multicenter study was published analyzing readmissions after surgery for adult deformity.…”