Do readmissions and reoperations adversely affect patient-reported outcomes following complex adult spinal deformity surgery at a minimum 2 years postoperative?

Spine Deformity - Tập 9 - Trang 789-801 - 2021
Nathan J. Lee1, Meghan Cerpa1, Eric Leung1, Zeeshan M. Sardar1, Ronald A. Lehman1, Lawrence G. Lenke1
1Department of Orthopaedics, Columbia University Medical Center, The Och Spine Hospital at New York-Presbyterian, New York, USA

Tóm tắt

Unplanned readmissions and reoperations are known to be associated with undesirable costs and potentially inferior outcomes in complex adult spinal deformity (ASD) surgery. A paucity of literature exists on the impact of readmissions/reoperations on patient-reported outcomes (PRO) in this population. Consecutively treated adult patients who underwent complex ASD surgery at a single institution from 2015–2018 and minimum 2-year follow-up were studied. Demographics/comorbidities, operative factors, inpatient complications, and postoperative clinical and patient-reported outcomes (SRS-22r, ODI) were assessed for those with and without readmission/reoperation. 175 patients (72% female, mean age 52.6 ± 16.4) were included. Mean total instrumented/fused levels was 13.3 ± 4.1, range 6–25. The readmission and reoperation rates were 16.6% and 12%, respectively. The two most common causes of reoperation were pseudarthrosis (5.1%) and PJK (4.0%). Predictors for readmission within 2 years following surgery included pulmonary, cardiac, depression and gastrointestinal comorbidities, along with performance of a VCR, and TLIF. At 2 years postoperatively, those who required a readmission/reoperation had significant increases in SRS and reductions in ODI compared to 1-year and preoperative values. Inpatient complications did not negatively impact 2-year PRO’s. The 2-year MCID in PROs was not significantly different between those with and without readmission/reoperation. Complex ASD surgery carries risk, but the vast majority can achieve MCID (SRS-86.4%, ODI-68.2%) in PROs by 2 years. Importantly, even those with inpatient complications and those who required unplanned readmission/reoperation can improve PROs by 2-year follow-up compared to preoperative baseline and 1-year follow-up and achieve similar improvements compared to those who did not require a readmission. III.

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Spine Deformity

Tập 9

789-801

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