Factors associated with a 30-day unplanned readmission after elective spine surgery: a retrospective cohort study

Abstract

Purpose The aim of this study was to identify factors that are independently associated with the 30-day unplanned readmission rate of patients who underwent elective spine surgery. Methods This study was a retrospective cohort study conducted in a single tertiary academic hospital. The study analyzed the electronic health records of adult patients aged 18 years or older who underwent inpatient elective spine surgery under general anesthesia between January 2010 and March 2018. The primary endpoint was an unplanned readmission within 30 days. The study used uni- and multivariable logistic regression analyses. Result A total of 7,025 patients were included in the analysis. Among the patients included in the analysis, 215 patients (3.1%) had unplanned readmission within 30 days after being discharged following elective spine surgery. In the complete-case analysis in the multivariable model, the factors associated with a 30-day unplanned readmission were found to be preoperative ASA physical status of >= 3 (vs 1) (OR: 2.21, 95% CI: 1.27, 3.84;P = 0.005), cancer (OR: 4.60, 95% CI: 2.72, 7.77;P < 0.001), and pRBC transfusion (OR: 1.81, 95% CI: 1.20, 2.71;P = 0.004). Conclusion The present study showed that preoperative ASA physical status of >= 3, diagnosis of cancer, and transfusion of pRBC were associated with an increased 30-day unplanned readmission rate after elective spine surgery.