Weekend Admission Increases Risk of Readmissions Following Elective Cervical Spinal Fusion.
Complications
Elective cervical spinal fusion
Perioperative characteristics
Postoperative outcomes
Readmission rates
Weekend admission
Journal
Neurospine
ISSN: 2586-6583
Titre abrégé: Neurospine
Pays: Korea (South)
ID NLM: 101724936
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
received:
24
09
2022
accepted:
10
01
2023
medline:
6
4
2023
entrez:
5
4
2023
pubmed:
6
4
2023
Statut:
ppublish
Résumé
The "weekend effect" occurs when patients cared for during weekends versus weekdays experience worse outcomes. But reasons for this effect are unclear, especially amongst patients undergoing elective cervical spinal fusion (ECSF). Our aim was to analyze whether index weekend admission affects 30- and 90-day readmission rates post-ECSF. All ECSF patients > 18 years were retrospectively identified from the 2016-2018 Healthcare Cost and Utilization Project Nationwide Readmissions Database (NRD), using unique patient linkage codes and International Classification of Diseases, Tenth Revision codes. Patient demographics, comorbidities, and outcomes were analyzed. Univariate logistic regression analyzed primary outcomes of 30- and 90-day readmission rates in weekday or weekend groups. Multivariate regression determined the impact of complications on readmission rates. Compared to the weekday group (n = 125,590), the weekend group (n = 1,026) held a higher percentage of Medicare/Medicaid insurance, incurred higher costs, had longer length of stay, and fewer routine home discharge (all p < 0.001). There was no difference in comorbidity burden between weekend versus weekday admissions, as measured by the Elixhauser Comorbidity Index (p = 0.527). Weekend admissions had higher 30-day (4.30% vs. 7.60%, p < 0.001) and 90-day (7.80% vs. 16.10%, p < 0.001) readmission rates, even after adjusting for sex, age, insurance status, and comorbidities. All-cause complication rates were higher for weekend admissions (8.62% vs. 12.7%, p < 0.001), specifically deep vein thrombosis, infection, neurological conditions, and pulmonary embolism. Index weekend admission increases 30- and 90-day readmission rates after ECSF. In patients undergoing ECSF on weekends, postoperative care for patients at risk for specific complications will allow for improved outcomes and health care utilization.
Identifiants
pubmed: 37016876
pii: ns.2244816.408
doi: 10.14245/ns.2244816.408
pmc: PMC10080455
doi:
Types de publication
Journal Article
Langues
eng
Pagination
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