Introduction: Posterior cervical fusions are common spinal operations for a variety of spinal disorders including cervical myelopathy, unstable fractures, cervical deformity, and tumors. Data elaborating on risk factors for 30-day readmission are limited.
Methods: Data were collected from the 2006 to 2013 American
College of Surgeons National Surgical Quality Improvement Program database. Predictors of 30-day readmission comprising patient demographics, comorbidities, operative features, and postoperative complications were identified through logistic multivariable regression.
Results: A total of 3401 patients met study criteria. Rate of 30- day readmission was 6.20%. Multilevel fusion was performed in 69.16% of patients. Postoperative infection was the most reason, accounting for 17.06% of all readmissions. Age older than 70
years (odds ratio [OR]-1.61, P-0.012), renal failure requiring dialysis (OR-3.69, P-0.011), anemia (OR-1.57, P-0.006), multilevel fusion (OR-1.61, P-0.012), surgical site infections (OR -20.4, P <0.001), wound dehiscence (OR -19.08,
P<0.001), postoperative pneumonia (OR-2.75, P-0.01), pulmonary embolism (OR-15.39, P<0.001), and progressing
renal insufficiency (OR-10.13, P-0.061) were significant predictors of hospital readmission.
Conclusions: The identified predictors of readmission after PCF
can improve patient counseling, identification of high-risk patients, and guide changes in healthcare delivery pathways. Patients with modifiable risk factors such as anemia and kidney failure may benefit from preoperative optimization. In addition, postoperative complications represent a key target for intervention.
Patient Care: Identifying modifiable predictors for 30 day hospital readmission is key in lowering those rates by optimization of those medical risk factors.
Learning Objectives: 1- The 30-day readmission rate following posterior cervical fusions is 6.2 %
2- Anemia, and progressive renal insufficiency are independent modifiable predictors of 30 day hospital readmission following PCF.