242. A national analysis on complications and readmissions for adult cerebral palsy patients undergoing primary spinal fusion surgery

Abstract

BACKGROUND CONTEXT Prevention of early hospital readmission following surgery is imperative for improved patient outcomes and high quality, cost-effective care. The readmission risk profile for adult cerebral palsy (CP) patients after spine surgery has yet to be defined on a national level. Prior single-surgeon data suggests the unplanned 90-day readmission rate for pediatric patients with cerebral palsy to be 16.1%. The National Readmission Database (NRD) was used to determine the national estimates for readmission, costs and other outcomes associated with adult CP patients undergoing primary spinal fusion surgery. PURPOSE To examine the 90-day costs, outcomes, and readmissions for adult CP patients undergoing spinal fusion surgery. STUDY DESIGN/SETTING Retrospective cohort of a national database. PATIENT SAMPLE Adult CP patients who underwent spinal fusion surgery. OUTCOME MEASURES Ninety-day readmissions, complications and hospital costs. METHODS NRD2012-2015 was queried for pediatric patients(age>18) diagnosed with CP and underwent spinal fusion surgery. Patient, hospital, and cost data were compared using Chi-squared and t-tests. Independent risk factors for readmissions were identified using the multivariate logistic regression. RESULTS A total of 1,487 adult patients with CP (42.3% female) underwent spinal fusion surgery between 2012 and 2015. Of these, 190 (12.8%) were readmitted within 90 days following the primary surgery. The mean hospital cost associated with the primary admission was $135,603 (no readmission) and $196,794 (readmission)(p-value: CONCLUSIONS The 90-day readmission rates are high for adult CP patients undergoing spine fusion. Complications may stem from the complex nature of CP where there is frequent use of urinary catheters, aspiration events and nutritional concerns. The spasticity associated with CP may also contribute to wound and implant related complications/readmissions. Nevertheless, readmissions are costly and appear to be associated with a number of patient and hospital factors. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.