Graham Benjamin C, Lucasti Christopher, Scott Maxwell M, Baker Seth C, Vallee Emily K, Patel Dil V, Hamill Christopher L
Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
UBMD Orthopaedics and Sports Medicine Doctors of Buffalo, University at Buffalo, Buffalo, NY, USA.
Global Spine J. 2025 Mar;15(2):1136-1142. doi: 10.1177/21925682241226821. Epub 2024 Jan 10.
Retrospective Cohort Analysis.
Extended hospital length of stay (LOS) poses a significant cost burden to patients undergoing adult spinal deformity (ASD) surgery. The purpose of this study is to investigate the relationship between late-week surgery and LOS in patients undergoing ASD surgery.
256 patients who underwent ASD surgery between January 2018 and December 2021 by a single fellowship-trained orthopedic spine surgeon comprised the patient sample. Demographics, intraoperative, and perioperative data were collected for the 256 patients who underwent ASD surgery. Patients were divided into two groups based on surgical day of the week: (1) Early-week (Monday/Tuesday) n = 126 and (2) Late-week (Thursday/Friday) n = 130. Descriptive statistics, T-tests, and linear and logistic regression models were used to analyze the data.
Surgical details and sociodemographic characteristics did not differ between the groups. When controlling for TLIF/DLIF status and PSO status there was no difference in mean length of stay between the groups. The late-week group was associated with a greater risk of 30-day readmission, but there was no difference in complications, infections, or intraoperative complications.
We found no difference in mean length of stay between surgeries performed early in the week vs late in the week. Although late-week surgeries had higher 30-day readmission risk, all other outcomes, including complication rates, showed no significant differences. When adequate weekend post-operative care is available, we do not advise restricting ASD surgeries to specific weekdays.
回顾性队列分析。
延长住院时间（LOS）给接受成人脊柱畸形（ASD）手术的患者带来了巨大的成本负担。本研究的目的是调查在接受ASD手术的患者中，周后期手术与住院时间之间的关系。
2018年1月至2021年12月期间，由一位接受过 fellowship 培训的骨科脊柱外科医生为256例患者实施了ASD手术，这些患者构成了研究样本。收集了这256例接受ASD手术患者的人口统计学、术中及围手术期数据。根据手术的星期几将患者分为两组：（1）周前期（周一/周二）n = 126例，（2）周后期（周四/周五）n = 130例。使用描述性统计、t检验以及线性和逻辑回归模型对数据进行分析。
两组之间的手术细节和社会人口统计学特征没有差异。在控制经椎间孔腰椎体间融合术（TLIF）/直接外侧腰椎椎间融合术（DLIF）状态和全脊椎切除术（PSO）状态时，两组之间的平均住院时间没有差异。周后期组30天再入院风险更高，但在并发症、感染或术中并发症方面没有差异。
我们发现，在一周早期进行的手术与在一周后期进行的手术之间，平均住院时间没有差异。尽管周后期手术的30天再入院风险较高，但所有其他结果，包括并发症发生率，均无显著差异。当有足够的周末术后护理时，我们不建议将ASD手术限制在特定的工作日进行。
