Unplanned hospital readmission after surgical treatment for thoracic spinal stenosis: incidence and causative factors

Hui Wang,Shuai Jiang,Longjie Wang,Weishi Li,Zhuoran Sun

doi:10.1186/s12891-021-03975-6

Abstract

BackgroundTo assess the incidence and causative factors of unplanned hospital readmission within 90 days after surgical treatment of thoracic spinal stenosis (TSS).MethodsHospital administrative database was queried to identify patients who underwent surgical treatment of TSS from July 2010 through December 2017. All unplanned readmissions within 90 days of discharge were reviewed for causes and the rate of unplanned readmissions was calculated. Patients of unplanned readmission were matched 1:3 to a control cohort without readmission.ResultsTwenty-one patients (incidence of 1.7 % in 1239 patients) presented unplanned hospital readmission within a 90-day period and enrolled as the study group, 63 non-readmission patients (a proportion of 1: 3) were randomly selected as the control group. Causes of readmission include pseudomeningocele (8 patients; 38 %), CSF leakage combined with poor incision healing (6 patients; 29 %), wound dehiscence (2 patient; 9 %), surgical site infection (2 patients; 9 %), spinal epidural hematoma (1 patient; 5 %), inadequate original surgical decompression (2 patients; 9 %). Mean duration from re-admission to the first surgery was 39.6 ± 28.2 days, most of the patients readmitted at the first 40 days (66.7 %, 14/21 patients). When compared to the non-readmitted patients, diagnosis of OPLL + OFL, circumferential decompression, dural injury, long hospital stay were more to be seen in readmitted patients.ConclusionsThe incidence of 90-day unplanned readmission after surgical treatment for TSS is 1.7 %, CSF leakage and pseudomeningocele were the most common causes of readmission, the peak period of readmission occurred from 10 to 40 days after surgery, patients should be closely followed up within this period.

Highlights

To assess the incidence and causative factors of unplanned hospital readmission within 90 days after surgical treatment of thoracic spinal stenosis (TSS)
Twenty-one patients presented unplanned hospital readmission within a 90-day period and enrolled as the study group. 63 non-readmission patients were randomly selected as the control group
There was no significant difference in age, gender, body mass index (BMI), number of levels involved, comorbidity between study group and control group, except diagnosis. (Table 1) Diagnosis of Ossification of posterior longitudinal ligament (OPLL) + OFL was more to be seen in study group than that in control group (42.9 % vs. 14.3 %)

Summary

Introduction

To assess the incidence and causative factors of unplanned hospital readmission within 90 days after surgical treatment of thoracic spinal stenosis (TSS). Unplanned hospital readmission following surgical procedures are undesirable outcomes for patients and medical providers, represent a heavy financial burden upon healthcare systems, and have been a target for improving care and reducing costs [1,2,3]. Myelopathy caused by thoracic spinal stenosis (TSS) is much less common than in the cervical and lumbar spine, since the thoracic spine is relatively stable [11]. Whether and which of these complications may increase the rate of unplanned readmission followed thoracic decompression surgery is unknown, because there has been no study on the rate of unplanned readmission after surgical treatment for TSS due to the low prevalence of the condition

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