Baaj AA, et al. - Ninety-day readmission, as well as risk factors associated with readmission, were examined following lumbar fusion in New York State. Researchers reported that major risk factors for 90-day readmission included age, sex, race, insurance, procedure, number of operated spinal levels, health service area ([HSA], and comorbidities. For preventing early readmission, improving quality of care, and reducing health care expenditures through prior surgery identification of high-risk patients, the findings of this study are significant.

Methods

• Researchers performed a retrospective cohort study, for which they utilized the New York Statewide Planning and Research Cooperative System (SPARCS) to capture patients undergoing lumbar fusion from 2005 to 2014.
• They used Cochran-Armitage test to assess temporal trend of 90-day readmission.
• Furthermore, they used logistic regression to assess predictors associated with 90-day readmission.

Results

• This cohort study included a total of 86,869 patients.
• The overall 90-day readmission rate was 24.8%.
• On a multivariable analysis model, the following factors were shown to be significantly associated with 90-day readmission: age (odds ratio [OR] comparing ≥75 versus <35 years: 1.24, 95% confidence interval [CI]: 1.13–1.35), sex (OR female to male: 1.19, 95% CI: 1.15–1.23), race (OR African-American to white: 1.60, 95% CI: 1.52–1.69), insurance (OR Medicaid to Medicare: 1.42, 95% CI: 1.33–1.53), procedure (OR comparing thoracolumbar fusion, combined [International Classification of Disease, Ninth Revision, ICD-9: 81.04] to posterior lumbar interbody fusion/transforaminal lumbar spinal fusion [ICD-9: 81.08]: 2.10, 95% CI: 1.49–2.97), number of operated spinal levels (OR comparing 4 to 8 vertebrae to 2 to 3 vertebrae: 2.39, 95% CI: 2.07–2.77), health service area ([HSA]; OR comparing Finger Lakes to New York-Pennsylvania border: 0.67, 95% CI: 0.61-0.73), and comorbidity, i.e., coronary artery disease (OR: 1.26, 95% CI: 1.19–1.33).
• In addition, researchers noted that directions of the odds ratios for these factors were consistent after stratification by procedure type.