Wednesday, September 26, 2018 3:35 PM – 5:05 PM How to Avoid Complications: 98. Hospital-acquired conditions occur more frequently in elective spine surgery than for other common elective surgical procedures

Abstract

BACKGROUND CONTEXT Hospital-acquired conditions (HACs) have significant deleterious effects on patients and providers. These events have been the focus of recent policy initiatives by the Centers for Medicare and Medicaid Services in an effort to improve patient safety and outcomes. PURPOSE To determine the rates of the three most common HACs that occur within 30-days postoperatively for spine surgeries and compare them to other common surgical procedures. STUDY DESIGN/SETTING Retrospective review of prospectively collected data. PATIENT SAMPLE A total of 647,878 patients from a national database undergoing common surgical procedures. OUTCOME MEASURES Rates of the three most common HACs: superficial or deep surgical site infection (SSI), venous thromboembolism (VTE), and urinary tract infection (UTI). These rates were compared between patients undergoing spine surgery versus other surgical procedures. METHODS Patients over 18 years who underwent elective spine surgery were identified in the American College of Surgeons’ National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005 to 2013. These patients were stratified by whether they experienced at least one HAC and then compared to those undergoing other common procedures including bariatric surgery, hip and knee arthroplasty (THA and TKA, respectively). RESULTS A total of 90,551 elective spine surgery patients were identified in the NSQIP database, of which 3021 (3.3%) developed at least one HAC. SSI was the most common HAC (1.4%), followed by UTI (1.3%) and VTE (0.8%). Stratified by surgery type, fusion procedures were associated with higher rates of overall HACs compared to decompression-only procedures (1.0% vs. 0.5%, p CONCLUSIONS Spine surgery patients experienced an overall HAC rate of 3.3%, with surgical site infections occurring most frequently. When compared to other surgery types, spine procedures were associated with higher HACs than bariatric surgery patients and knee and hip arthroplasties overall but lower HAC rates than patients undergoing cardiothoracic surgery. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.