Liu Wangmi, Zhang Feng, Tao Yiqing, Li Hao, Chen Qixin, Li Fangcai
Department of Orthopedic Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Orthop Surg. 2025 May;17(5):1389-1396. doi: 10.1111/os.70022. Epub 2025 Mar 16.
Understanding the risk factors associated with unscheduled readmission following lateral lumbar interbody fusion (LLIF) is crucial for mitigating the occurrence of these costly events. This study aims to ascertain the incidence and factors of unscheduled hospital readmission subsequent to LLIF.
A retrospective analysis was conducted on patients who underwent LLIF at our institution from March 2016 to February 2023. Instances of unscheduled hospital readmission after LLIF were meticulously recorded, including baseline demographics, characteristics of spine pathology, surgical interventions, duration between two hospitalizations, and hospitalization costs and duration. Reasons for readmission were categorized based on their etiology. A case-control methodology was employed to compare unscheduled hospital readmission patients against planned readmission patients due to staged surgery. Parametric data were analyzed with a two-tailed T-test, nonparametric data with the Wilcoxon rank-sum test, and categorical data with the χ test.
A total of 1521 patients who received LLIF at our institution were included in the study. A total of 59 patients (3.88%) were unscheduled readmitted due to adjacent segment disease (ASD), cage subsidence, the original surgical segments remaining narrow, spondylodiscitis, and pain. 51 patients (3.35%) experienced reoperation, predominantly attributable to ASD. Compared to planned readmission patients, unscheduled readmission patients tended to be younger, had a lower likelihood of having scoliosis, and were more likely to have short-segment surgery and higher initial hospitalization costs. Among unscheduled readmission patients, patients receiving short-segment surgery, as well as those who paid less during the initial hospitalization, demonstrated a higher likelihood of a 90-day readmission rate.
Our findings indicated the heightened risks of unscheduled hospital readmission after LLIF. Taking targeted measures against these risk factors is expected to reduce the healthcare burden caused by unplanned readmissions in the future.
了解与腰椎侧方椎间融合术（LLIF）后计划外再入院相关的风险因素对于减少这些代价高昂的事件的发生至关重要。本研究旨在确定LLIF术后计划外医院再入院的发生率及相关因素。
对2016年3月至2023年2月在本机构接受LLIF手术的患者进行回顾性分析。详细记录LLIF术后计划外医院再入院的情况，包括基线人口统计学资料、脊柱病理特征、手术干预措施、两次住院之间的间隔时间、住院费用和住院时长。根据再入院病因进行分类。采用病例对照方法，将计划外医院再入院患者与因分期手术导致的计划内再入院患者进行比较。参数数据采用双尾t检验分析，非参数数据采用Wilcoxon秩和检验分析，分类数据采用χ检验分析。
本研究共纳入1521例在本机构接受LLIF手术的患者。共有59例患者（3.88%）因相邻节段疾病（ASD）、椎间融合器下沉、原手术节段仍狭窄、椎体骨髓炎和疼痛等原因计划外再入院。51例患者（3.35%）接受了再次手术，主要原因是ASD。与计划内再入院患者相比，计划外再入院患者往往更年轻，患脊柱侧凸的可能性更低，更有可能接受短节段手术，且初始住院费用更高。在计划外再入院患者中，接受短节段手术的患者以及初始住院期间费用较低的患者90天再入院率更高。
我们的研究结果表明LLIF术后计划外医院再入院风险增加。针对这些风险因素采取有针对性的措施有望在未来减轻因计划外再入院造成的医疗负担。
