How do teaching hospitals compare to non-teaching hospitals for inpatient morbidity and mortality after adult spinal deformity surgery?
A new study published in the Journal of Neurosurgery: Spine examines the Nationwide Inpatient Sample to compare the two. There were 2,603 patients identified for the study who underwent surgery between 2002 and 2011. Most — 61.2 percent — were performed in teaching hospitals; the remainder underwent surgery at non-teaching hospitals.
The researchers found:
1. There were more patients undergoing revision surgery at the teaching hospitals; 5.2 percent of the patients at teaching hospitals were undergoing a revision procedure compared to 3.9 percent at non-teaching hospitals.
2. Spinal fusions at eight segments or more and/or osteotomy procedures were more common at the teaching hospitals — 27 percent, versus 21.7 percent at non-teaching hospitals.
3. The overall complication rate at teaching hospitals was 47.9 percent while the overall complication rate at non-teaching hospitals was 49.8 percent. However, after controlling for the patient characteristics, complexity and revision states patients at the teaching hospitals were significantly less likely to develop complications.
4. The mortality rate at teaching hospitals was 0.4 percent; the mortality rate was lower in non-teaching hospitals.
5. The researchers concluded patients at teaching hospitals have lower odds of complications when compared with non-teaching hospitals.