Inpatient admissions predict peri-op risk in lumbar fusion

(HealthDay)—For patients undergoing posterior lumbar fusion, inpatient admissions in the prior year are associated with increased complication rate, length of stay, and total charges, according to a study published in the Dec. 15 issue of Spine.

Ananth Eleswarapu, M.D., from the University of Chicago Medical Center, and colleagues examined risk factors for increased complication rate, length of stay, and hospital charges for patients undergoing posterior lumbar fusion. Data were collected from a quality improvement data set for 462 patients.

The researchers found that the only variable significantly associated with increased complication rate was history of more than one admission in the prior year (odds ratio, 10.56; P < 0.0001). Increased length of stay correlated with history of more than one admission in the prior year (P < 0.0001), operative duration of more than five hours (P = 0.008), and American Society of Anesthesiologists physical status classification of 3 or greater (P = 0.01). Increased total charges were seen in association with history of more than one admission in the prior year, fusion of four or more levels, and operative duration of more than five hours (all P < 0.0001).

"The number of inpatient admissions in the prior year was found to be a more powerful predictor of perioperative risk after lumbar fusion than metrics evaluated in prior studies, such as age, body mass index, and comorbidities," the authors write.

Relevant financial activities outside the submitted work were disclosed: board membership, consultancy, royalties, stocks, grants, employment.