5 key notes on risk factors for unplanned hospital readmission after pediatric scoliosis surgery

Spine

The Spine Journal published a study examining the risk factors associated with unplanned hospital readmissions after pediatric spinal deformity surgery.

The study authors examined the inpatient database for 30-day and 90-day readmissions in New York, Utah, Nebraska, Florida, North Carolina and California. The study included patients with spinal deformity as the primary diagnosis and underwent a three-plus level lumbar and/or thoracic fusion.

 

There were 13,287 patients included in the study with an average age of 14 years old. The researchers found:

 

1. The 30-day readmission rate was 4.7 percent and the 90-day readmission rate was 6.1 percent.

 

2. Infections were the most common reason for readmissions, accounting for 38 percent of the 30-day readmissions and 33 percent of the 90-day readmissions. Wound-dehiscence accounted for 19 percent of the 30-day readmissions and 17 percent of the 90-day readmissions.

 

3. Pulmonary complications accounted for 12 percent of 30-day readmissions and 13 percent of 90-day readmissions.

 

4. Predictors of 30-day readmissions include:

 

• Male sex
• Neuromuscular or congenital scoliosis
• Scheuermann kyphosis
• Medicaid
• Length of stay less than three days or longer than six days
• Surgery at a teaching hospital

 

5. When the hospital performed more than 80 procedures per year, there was a 34 percent reduced risk of 30-day readmissions when compared with hospitals that performed fewer than 20 operations per year.

 

The study authors concluded, "The short-term readmission rate for pediatric spine deformity is driven by patient-related factors as well as several risk factors that may be modified to reduce this rate."

 

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