Hijji Fady Y, Narain Ankur S, Haws Brittany E, Khechen Benjamin, Kudaravalli Krishna T, Yom Kelly H, Singh Kern
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.
Clin Spine Surg. 2018 Jun;31(5):E291-E295. doi: 10.1097/BSD.0000000000000640.
Retrospective Cohort.
To determine if an association exists between surgery day and length of stay or hospital costs after minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).
Length of inpatient stay after orthopedic procedures has been identified as a primary cost driver, and previous research has focused on determining risk factors for prolonged length of stay. In the arthroplasty literature, surgery performed later in the week has been identified as a predictor of increased length of stay. However, no such investigation has been performed for MIS TLIF.
A surgical registry of patients undergoing MIS TLIF between 2008 and 2016 was retrospectively reviewed. Patients were grouped based on day of surgery, with groups including early surgery and late surgery. Day of surgery group was tested for an association with demographics and perioperative variables using the student t test or χ analysis. Day of surgery group was then tested for an association with direct hospital costs using multivariate linear regression.
In total, 438 patients were analyzed. In total, 51.8% were in the early surgery group, and 48.2% were in the late surgery group. There were no differences in demographics between groups. There were no differences between groups with regard to operative time, intraoperative blood loss, length of stay, or discharge day. Finally, there were no differences in total hospital charges between early and late surgery groups (P=0.247).
The specific day on which a MIS TLIF procedure occurs is not associated with differences in length of inpatient stay or total hospital costs. This suggests that the postoperative course after MIS TLIF procedures is not affected by the differences in hospital staffing that occurs on the weekend compared with weekdays.
回顾性队列研究。
确定在微创经椎间孔腰椎椎体间融合术（MIS TLIF）后，手术日期与住院时间或住院费用之间是否存在关联。
骨科手术后的住院时间已被确定为主要的成本驱动因素，以往的研究主要集中在确定住院时间延长的风险因素。在关节置换文献中，一周内较晚进行的手术已被确定为住院时间延长的一个预测因素。然而，尚未对MIS TLIF进行此类研究。
对2008年至2016年间接受MIS TLIF手术的患者手术登记资料进行回顾性分析。根据手术日期对患者进行分组，包括早期手术组和晚期手术组。使用学生t检验或χ分析来检验手术日期组与人口统计学和围手术期变量之间的关联。然后使用多元线性回归检验手术日期组与直接住院费用之间的关联。
总共分析了438例患者。早期手术组占51.8%，晚期手术组占48.2%。两组在人口统计学方面无差异。在手术时间、术中失血量、住院时间或出院日期方面，两组之间也无差异。最后，早期和晚期手术组之间的总住院费用无差异（P = 0.247）。
MIS TLIF手术的具体日期与住院时间或总住院费用的差异无关。这表明，与工作日相比，周末医院人员配备的差异并未影响MIS TLIF手术后的病程。
