Length of stay, readmission, and mortality after primary surgery for pediatric spinal deformities: a 10-year nationwide cohort study

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

Standard

Length of stay, readmission, and mortality after primary surgery for pediatric spinal deformities : a 10-year nationwide cohort study. / Fruergaard, Sidsel; Ohrt-Nissen, Søren; Pitter, Frederik Taylor; Høy, Kristian; Lindberg-Larsen, Martin; Eiskjær, Søren; Dahl, Benny; Gehrchen, Martin.

I: The Spine Journal, Bind 21, Nr. 4, 04.2021, s. 653-663.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

Harvard

Fruergaard, S, Ohrt-Nissen, S, Pitter, FT, Høy, K, Lindberg-Larsen, M, Eiskjær, S, Dahl, B & Gehrchen, M 2021, 'Length of stay, readmission, and mortality after primary surgery for pediatric spinal deformities: a 10-year nationwide cohort study', The Spine Journal, bind 21, nr. 4, s. 653-663. https://doi.org/10.1016/j.spinee.2021.01.004

APA

Fruergaard, S., Ohrt-Nissen, S., Pitter, F. T., Høy, K., Lindberg-Larsen, M., Eiskjær, S., Dahl, B., & Gehrchen, M. (2021). Length of stay, readmission, and mortality after primary surgery for pediatric spinal deformities: a 10-year nationwide cohort study. The Spine Journal, 21(4), 653-663. https://doi.org/10.1016/j.spinee.2021.01.004

CBE

Fruergaard S, Ohrt-Nissen S, Pitter FT, Høy K, Lindberg-Larsen M, Eiskjær S, Dahl B, Gehrchen M. 2021. Length of stay, readmission, and mortality after primary surgery for pediatric spinal deformities: a 10-year nationwide cohort study. The Spine Journal. 21(4):653-663. https://doi.org/10.1016/j.spinee.2021.01.004

MLA

Vancouver

Author

Fruergaard, Sidsel ; Ohrt-Nissen, Søren ; Pitter, Frederik Taylor ; Høy, Kristian ; Lindberg-Larsen, Martin ; Eiskjær, Søren ; Dahl, Benny ; Gehrchen, Martin. / Length of stay, readmission, and mortality after primary surgery for pediatric spinal deformities : a 10-year nationwide cohort study. I: The Spine Journal. 2021 ; Bind 21, Nr. 4. s. 653-663.

Bibtex

@article{6d83833ceef94bad8b97bdb4690988bd,
title = "Length of stay, readmission, and mortality after primary surgery for pediatric spinal deformities: a 10-year nationwide cohort study",
abstract = "BACKGROUND CONTEXT: Extended length of stay (extLOS) and unplanned readmissions after first time pediatric spinal deformity surgery are a considerable challenge to both the patient and the health-care system. To our knowledge, only a limited number of nationwide studies reporting short-term comorbidity with complete follow-up exist.PURPOSE: The purpose of this study was to identify the postoperative complications leading to extLOS, readmissions, and mortality within 90 days after surgery. Furthermore, to identify risk factors for readmission.DESIGN: Retrospective national cohort study.PATIENT SAMPLE: A nationwide registry study including all pediatric spinal deformity patients (OUTCOME MEASURES: Reasons for extLOS and 90-day readmissions as well as mortality risk.METHODS: Patients were identified by procedure and diagnosis codes in the Danish National Patient Registry (DNPR). Data on length of stay (LOS), readmissions, and mortality within 90 days were retrieved from the DNPR. Patients were categorized in six groups according to etiology. Reasons for extLOS and readmission were collected from medical records and discharge summaries.RESULTS: For the 1,310 patients, the median LOS was 8 days (interquartile range 7-9). Etiologies were idiopathic deformity (53%), neuromuscular deformity (23%), congenital/structural deformity (9%), spondylolisthesis (7%), Scheuermann kyphosis (5%), and syndromic deformity (3%). A total of 274 (21%) patients had extLOS and the most common reason was pain/mobilization issues but with considerable variation between etiologies; Scheuermann kyphosis (91%), idiopathic (59%), syndromic (44%), spondylolisthesis (38%), and congenital (30%). Pulmonary complications were the primary reason for extLOS in the neuromuscular group (22%). The 90-day readmission rate was 6%; 67% of readmissions were medical, mainly infections unrelated to the surgical site (23%); 33% of readmissions were surgical and 14% of patients required revision surgery. Neuromuscular deformity, spondylolisthesis, Scheuermann kyphosis, and LOS > 9 days were independent risk factors for readmission; odds ratio (OR) 4.4 (95% confidence interval: 2.2-9.1, pCONCLUSIONS: In this nationwide cohort, pain/mobilization issues are the most common reason for extLOS. The most common reason for readmission is infection unrelated to the surgical site. Readmission after pediatric spinal surgery is related to the etiology and increased focus on patients operated for neuromuscular deformity, spondylolisthesis and Scheuermann kyphosis is warranted. (C) 2021 Elsevier Inc. All rights reserved.",
keywords = "Complication, Congenital scoliosis, Idiopathic scoliosis, Kyphosis, Mortality, Neuromuscular scoliosis, Pediatric spinal deformity, Readmission, Scheuermann kyphosis, Scoliosis",
author = "Sidsel Fruergaard and S{\o}ren Ohrt-Nissen and Pitter, {Frederik Taylor} and Kristian H{\o}y and Martin Lindberg-Larsen and S{\o}ren Eiskj{\ae}r and Benny Dahl and Martin Gehrchen",
note = "Copyright {\textcopyright} 2021. Published by Elsevier Inc.",
year = "2021",
month = apr,
doi = "10.1016/j.spinee.2021.01.004",
language = "English",
volume = "21",
pages = "653--663",
journal = "Spine Journal",
issn = "1529-9430",
publisher = "Elsevier BV",
number = "4",

}

RIS

TY - JOUR

T1 - Length of stay, readmission, and mortality after primary surgery for pediatric spinal deformities

T2 - a 10-year nationwide cohort study

AU - Fruergaard, Sidsel

AU - Ohrt-Nissen, Søren

AU - Pitter, Frederik Taylor

AU - Høy, Kristian

AU - Lindberg-Larsen, Martin

AU - Eiskjær, Søren

AU - Dahl, Benny

AU - Gehrchen, Martin

N1 - Copyright © 2021. Published by Elsevier Inc.

PY - 2021/4

Y1 - 2021/4

N2 - BACKGROUND CONTEXT: Extended length of stay (extLOS) and unplanned readmissions after first time pediatric spinal deformity surgery are a considerable challenge to both the patient and the health-care system. To our knowledge, only a limited number of nationwide studies reporting short-term comorbidity with complete follow-up exist.PURPOSE: The purpose of this study was to identify the postoperative complications leading to extLOS, readmissions, and mortality within 90 days after surgery. Furthermore, to identify risk factors for readmission.DESIGN: Retrospective national cohort study.PATIENT SAMPLE: A nationwide registry study including all pediatric spinal deformity patients (OUTCOME MEASURES: Reasons for extLOS and 90-day readmissions as well as mortality risk.METHODS: Patients were identified by procedure and diagnosis codes in the Danish National Patient Registry (DNPR). Data on length of stay (LOS), readmissions, and mortality within 90 days were retrieved from the DNPR. Patients were categorized in six groups according to etiology. Reasons for extLOS and readmission were collected from medical records and discharge summaries.RESULTS: For the 1,310 patients, the median LOS was 8 days (interquartile range 7-9). Etiologies were idiopathic deformity (53%), neuromuscular deformity (23%), congenital/structural deformity (9%), spondylolisthesis (7%), Scheuermann kyphosis (5%), and syndromic deformity (3%). A total of 274 (21%) patients had extLOS and the most common reason was pain/mobilization issues but with considerable variation between etiologies; Scheuermann kyphosis (91%), idiopathic (59%), syndromic (44%), spondylolisthesis (38%), and congenital (30%). Pulmonary complications were the primary reason for extLOS in the neuromuscular group (22%). The 90-day readmission rate was 6%; 67% of readmissions were medical, mainly infections unrelated to the surgical site (23%); 33% of readmissions were surgical and 14% of patients required revision surgery. Neuromuscular deformity, spondylolisthesis, Scheuermann kyphosis, and LOS > 9 days were independent risk factors for readmission; odds ratio (OR) 4.4 (95% confidence interval: 2.2-9.1, pCONCLUSIONS: In this nationwide cohort, pain/mobilization issues are the most common reason for extLOS. The most common reason for readmission is infection unrelated to the surgical site. Readmission after pediatric spinal surgery is related to the etiology and increased focus on patients operated for neuromuscular deformity, spondylolisthesis and Scheuermann kyphosis is warranted. (C) 2021 Elsevier Inc. All rights reserved.

AB - BACKGROUND CONTEXT: Extended length of stay (extLOS) and unplanned readmissions after first time pediatric spinal deformity surgery are a considerable challenge to both the patient and the health-care system. To our knowledge, only a limited number of nationwide studies reporting short-term comorbidity with complete follow-up exist.PURPOSE: The purpose of this study was to identify the postoperative complications leading to extLOS, readmissions, and mortality within 90 days after surgery. Furthermore, to identify risk factors for readmission.DESIGN: Retrospective national cohort study.PATIENT SAMPLE: A nationwide registry study including all pediatric spinal deformity patients (OUTCOME MEASURES: Reasons for extLOS and 90-day readmissions as well as mortality risk.METHODS: Patients were identified by procedure and diagnosis codes in the Danish National Patient Registry (DNPR). Data on length of stay (LOS), readmissions, and mortality within 90 days were retrieved from the DNPR. Patients were categorized in six groups according to etiology. Reasons for extLOS and readmission were collected from medical records and discharge summaries.RESULTS: For the 1,310 patients, the median LOS was 8 days (interquartile range 7-9). Etiologies were idiopathic deformity (53%), neuromuscular deformity (23%), congenital/structural deformity (9%), spondylolisthesis (7%), Scheuermann kyphosis (5%), and syndromic deformity (3%). A total of 274 (21%) patients had extLOS and the most common reason was pain/mobilization issues but with considerable variation between etiologies; Scheuermann kyphosis (91%), idiopathic (59%), syndromic (44%), spondylolisthesis (38%), and congenital (30%). Pulmonary complications were the primary reason for extLOS in the neuromuscular group (22%). The 90-day readmission rate was 6%; 67% of readmissions were medical, mainly infections unrelated to the surgical site (23%); 33% of readmissions were surgical and 14% of patients required revision surgery. Neuromuscular deformity, spondylolisthesis, Scheuermann kyphosis, and LOS > 9 days were independent risk factors for readmission; odds ratio (OR) 4.4 (95% confidence interval: 2.2-9.1, pCONCLUSIONS: In this nationwide cohort, pain/mobilization issues are the most common reason for extLOS. The most common reason for readmission is infection unrelated to the surgical site. Readmission after pediatric spinal surgery is related to the etiology and increased focus on patients operated for neuromuscular deformity, spondylolisthesis and Scheuermann kyphosis is warranted. (C) 2021 Elsevier Inc. All rights reserved.

KW - Complication

KW - Congenital scoliosis

KW - Idiopathic scoliosis

KW - Kyphosis

KW - Mortality

KW - Neuromuscular scoliosis

KW - Pediatric spinal deformity

KW - Readmission

KW - Scheuermann kyphosis

KW - Scoliosis

UR - http://www.scopus.com/inward/record.url?scp=85099815051&partnerID=8YFLogxK

U2 - 10.1016/j.spinee.2021.01.004

DO - 10.1016/j.spinee.2021.01.004

M3 - Journal article

C2 - 33429087

VL - 21

SP - 653

EP - 663

JO - Spine Journal

JF - Spine Journal

SN - 1529-9430

IS - 4

ER -