Predictors of extended length of stay, discharge to inpatient rehab, and hospital readmission following elective lumbar spine surgery: introduction of the Carolina-Semmes Grading Scale

Journal of Neurosurgery. Spine
Matthew J McGirtAnthony L Asher

Abstract

OBJECTIVE Extended hospital length of stay (LOS), unplanned hospital readmission, and need for inpatient rehabilitation after elective spine surgery contribute significantly to the variation in surgical health care costs. As novel payment models shift the risk of cost overruns from payers to providers, understanding patient-level risk of LOS, readmission, and inpatient rehabilitation is critical. The authors set out to develop a grading scale that effectively stratifies risk of these costly events after elective surgery for degenerative lumbar pathologies. METHODS The Quality and Outcomes Database (QOD) registry prospectively enrolls patients undergoing surgery for degenerative lumbar spine disease. This registry was queried for patients who had undergone elective 1- to 3-level lumbar surgery for degenerative spine pathology. The association between preoperative patient variables and extended postoperative hospital LOS (LOS ≥ 7 days), discharge status (inpatient facility vs home), and 90-day hospital readmission was assessed using stepwise multivariate logistic regression. The Carolina-Semmes grading scale was constructed using the independent predictors for LOS (0-12 points), discharge to inpatient facility (0-18 points), and ...Continue Reading

References

Jan 1, 1985·Rheumatology International·G B Langley, H Sheppeard
Jul 1, 1995·American Journal of Physical Medicine & Rehabilitation·M C MuninH E Rubash
Mar 1, 1995·Health Care for Women International·D B Preston
May 1, 1997·Health Affairs·B K Atchinson, D M Fox
May 1, 1997·Health Affairs·C S Weisman
Oct 18, 2000·The Cochrane Database of Systematic Reviews·J Parkes, S Shepperd
Nov 14, 2000·Spine·J C Fairbank, P B Pynsent
Feb 15, 2001·Archives of Internal Medicine·C A JonesM E Suarez-Almazor
Sep 29, 2004·Health Affairs·Stephen HefflerChristopher Truffer
Dec 14, 2004·Arthritis and Rheumatism·Paola de PabloJeffrey N Katz
May 30, 2007·Archives of Physical Medicine and Rehabilitation·Tuan-Anh NguyenPeter Henke
Feb 11, 2009·Archives of Internal Medicine·Drahomir AujeskySaid A Ibrahim
Apr 8, 2010·JAMA : the Journal of the American Medical Association·Richard A DeyoJeffrey G Jarvik
Apr 19, 2011·PM & R : the Journal of Injury, Function, and Rehabilitation·Timothy R DillinghamLiliana E Pezzin
Oct 27, 2012·The Spine Journal : Official Journal of the North American Spine Society·Marjorie C WangAnn B Nattinger
Jan 5, 2013·Journal of the American Board of Family Medicine : JABFM·Gregory M GarrisonBradley Bohn
Feb 21, 2013·The Spine Journal : Official Journal of the North American Spine Society·Owoicho AdogwaMatthew J McGirt
May 24, 2013·Spine·William W SchairerSigurd H Berven
Oct 9, 2013·Health Affairs·Kathleen RowanLynn A Blewett
Nov 5, 2013·The Spine Journal : Official Journal of the North American Spine Society·Jordan A GruskayJonathan N Grauer
Nov 12, 2013·The Spine Journal : Official Journal of the North American Spine Society·Kimon BekelisSymeon Missios
Feb 25, 2014·World Neurosurgery·Sasha VaziriWilliam A Friedman
Dec 20, 2014·Spine·Rafael De la Garza-RamosTimothy F Witham
Dec 2, 2015·Neurosurgical Focus·Kimon BekelisAnthony L Asher

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Citations

Sep 18, 2018·Clinical Spine Surgery : a Spine Publication·Benjamin KhechenKern Singh
May 26, 2018·Journal of Neurosurgery. Spine·Elyne N KahnAndrew M Ryan
Mar 11, 2019·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Deeptee JainSigurd H Berven
Mar 29, 2019·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Paul T OginkJoseph H Schwab
Mar 3, 2018·International Journal of Geriatric Psychiatry·Stephanie PettyTom Dening
Jan 21, 2019·Spine Deformity·Rajiv K SethiMichael Vitale
Oct 1, 2019·Quality Management in Health Care·Rolando A Berríos
Sep 3, 2020·Global Spine Journal·David S JevotovskyThemistocles S Protopsaltis
Apr 4, 2019·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Paul T OginkJoseph H Schwab
Jan 15, 2020·Global Spine Journal·Fan JiangMichael G Fehlings
Sep 19, 2020·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·A F MannionD Haschtmann
Dec 19, 2020·Physiotherapy Research International : the Journal for Researchers and Clinicians in Physical Therapy·Saddam F KanaanNeena K Sharma
Sep 16, 2019·World Neurosurgery·Aditya V KarhadeJoseph H Schwab
Jan 26, 2020·Spine Deformity·Rajiv K SethiMichael Vitale
Nov 14, 2020·The Journal of Bone and Joint Surgery. American Volume·Michael L MartiniJohn M Caridi
Nov 11, 2021·Journal of the American Medical Informatics Association : JAMIA·Erin E KennedySubhash Aryal
Aug 23, 2019·Journal of Clinical Anesthesia·Shubham AgrawalRodney A Gabriel
Jan 4, 2022·The Journal of the American Academy of Orthopaedic Surgeons·Madhav R PatelKern Singh

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REDCap [ Research Electronic Data Capture
SPSS

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