Camacho Jael E, Kung Justin E, Thomson Alexandra E, Ye Ivan B, Gonzalez Nicolas, Usmani M F, Sokolow Michael J, Bruckner Jacob J, Cavanaugh Daniel L, Buraimoh Kendall, Koh Eugene Y, Gelb Daniel E, Ludwig Steven C
Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA.
University of Maryland School of Medicine, Baltimore, MD, USA.
Global Spine J. 2023 Jul;13(6):1558-1565. doi: 10.1177/21925682211041045. Epub 2021 Sep 25.
Retrospective Case Series.
This study aims to evaluate readmission rates, risk factors, and reason for unplanned 30-day readmissions after thoracolumbar spine trauma surgery.
A retrospective chart review was conducted for patients undergoing operative treatment for thoracic or lumbar trauma with open or minimally invasive surgical approach at a Level 1 urban trauma center. Patients were divided into two groups based on 30-day readmission status. Reason for readmission, reoperation rates, injury type, trauma severity, and incidence of polytrauma were compared between the two groups.
A total of 312 patients, 69.9% male with an average age of 47 ± 19 years were included. The readmitted group included 16 patients (5.1%) of which 9 (56%) were readmitted for medical complications and 7 for surgical complications. Wound complications (31.3% of readmissions) were the most common cause of readmission, followed by non-wound related sepsis (18.9% of readmissions). A total of 6 patients (37.5%) required reoperation; 2 instrumentation failures underwent revision surgery, and 4 wound complications underwent irrigation and debridement. Patients with higher Injury Severity Scale (ISS) were more likely to be readmitted (27.8% vs 22.1%, = .045). Concomitant lower limb surgery increased odds of readmission (OR, 4.40; 95% CI, 1.10-17.83; = .037).
Spine trauma 30-day readmission rate was 5.1%, comparable to those reported in the elective spine surgery literature. Readmitted patients were more likely to sustain concomitant operative lower limb trauma. Wound complications were the most common cause of readmission, and almost half of the patients were readmitted due to surgery-related complications.
回顾性病例系列研究。
本研究旨在评估胸腰椎脊柱创伤手术后30天再入院率、风险因素及非计划再入院原因。
对一家一级城市创伤中心采用开放或微创外科手术方法接受胸腰椎创伤手术治疗的患者进行回顾性病历审查。根据30天再入院状态将患者分为两组。比较两组之间的再入院原因、再次手术率、损伤类型、创伤严重程度及多发伤发生率。
共纳入312例患者,男性占69.9%,平均年龄47±19岁。再入院组包括16例患者(5.1%),其中9例(56%)因医疗并发症再入院,7例因手术并发症再入院。伤口并发症(占再入院患者的31.3%)是最常见的再入院原因,其次是与伤口无关的脓毒症(占再入院患者的18.9%)。共有6例患者(37.5%)需要再次手术;2例内固定失败患者接受了翻修手术,4例伤口并发症患者接受了冲洗和清创术。损伤严重程度评分(ISS)较高的患者更有可能再入院(27.8%对22.1%,P = .045)。同时进行下肢手术增加了再入院几率(比值比[OR],4.40;95%置信区间[CI]为1.10 - 17.83;P = .037)。
脊柱创伤30天再入院率为5.1%,与择期脊柱手术文献报道的比率相当。再入院患者更有可能同时发生下肢手术创伤。伤口并发症是最常见的再入院原因,近一半患者因手术相关并发症再入院。