Octogenarians Are Independently Associated With Extended LOS and Non-Routine Discharge After Elective ACDF for CSM
Study Design: Retrospective cohort study. Objective: The aim of this study was to determine the impact age has on LOS and discharge disposition following elective ACDF for cervical spondylotic myelopathy (CSM). Methods: A retrospective cohort study was performed using the National Inpatient Sample (...
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Published in | Global spine journal Vol. 12; no. 8; pp. 1792 - 1803 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Los Angeles, CA
SAGE Publications
01.10.2022
Sage Publications Ltd |
Subjects | |
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Abstract | Study Design:
Retrospective cohort study.
Objective:
The aim of this study was to determine the impact age has on LOS and discharge disposition following elective ACDF for cervical spondylotic myelopathy (CSM).
Methods:
A retrospective cohort study was performed using the National Inpatient Sample (NIS) database from 2016 and 2017. All adult patients >50 years old undergoing ACDF for CSM were identified using the ICD-10-CM diagnosis and procedural coding system. Patients were then stratified by age: 50 to 64 years-old, 65 to 79 years-old, and greater than or equal to 80 years-old. Weighted patient demographics, comorbidities, perioperative complications, LOS, discharge disposition, and total cost of admission were assessed.
Results:
A total of 14 865 patients were identified. Compared to the 50-64 and 65-79 year-old cohorts, the 80+ years cohort had a significantly higher rate of postoperative complication (50-64 yo:10.2% vs. 65-79 yo:12.6% vs. 80+ yo:18.9%, P = 0.048). The 80+ years cohort experienced significantly longer hospital stays (50-64 yo: 2.0 ± 2.4 days vs. 65-79 yo: 2.2 ± 2.8 days vs. 80+ yo: 2.3 ± 2.1 days, P = 0.028), higher proportion of patients with extended LOS (50-64 yo:18.3% vs. 65-79 yo:21.9% vs. 80+ yo:28.4%, P = 0.009), and increased rates of non-routine discharges (50-64 yo:15.1% vs. 65-79 yo:23.0% vs. 80+ yo:35.8%, P < 0.001). On multivariate analysis, age 80+ years was found to be a significant independent predictor of extended LOS [OR:1.97, 95% CI:(1.10,3.55), P = 0.023] and non-routine discharge [OR:2.46, 95% CI:(1.44,4.21), P = 0.001].
Conclusions:
Our study demonstrates that octogenarian age status is a significant independent risk factor for extended LOS and non-routine discharge after elective ACDF for CSM. |
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AbstractList | STUDY DESIGNRetrospective cohort study. OBJECTIVEThe aim of this study was to determine the impact age has on LOS and discharge disposition following elective ACDF for cervical spondylotic myelopathy (CSM). METHODSA retrospective cohort study was performed using the National Inpatient Sample (NIS) database from 2016 and 2017. All adult patients >50 years old undergoing ACDF for CSM were identified using the ICD-10-CM diagnosis and procedural coding system. Patients were then stratified by age: 50 to 64 years-old, 65 to 79 years-old, and greater than or equal to 80 years-old. Weighted patient demographics, comorbidities, perioperative complications, LOS, discharge disposition, and total cost of admission were assessed. RESULTSA total of 14 865 patients were identified. Compared to the 50-64 and 65-79 year-old cohorts, the 80+ years cohort had a significantly higher rate of postoperative complication (50-64 yo:10.2% vs. 65-79 yo:12.6% vs. 80+ yo:18.9%, P = 0.048). The 80+ years cohort experienced significantly longer hospital stays (50-64 yo: 2.0 ± 2.4 days vs. 65-79 yo: 2.2 ± 2.8 days vs. 80+ yo: 2.3 ± 2.1 days, P = 0.028), higher proportion of patients with extended LOS (50-64 yo:18.3% vs. 65-79 yo:21.9% vs. 80+ yo:28.4%, P = 0.009), and increased rates of non-routine discharges (50-64 yo:15.1% vs. 65-79 yo:23.0% vs. 80+ yo:35.8%, P < 0.001). On multivariate analysis, age 80+ years was found to be a significant independent predictor of extended LOS [OR:1.97, 95% CI:(1.10,3.55), P = 0.023] and non-routine discharge [OR:2.46, 95% CI:(1.44,4.21), P = 0.001]. CONCLUSIONSOur study demonstrates that octogenarian age status is a significant independent risk factor for extended LOS and non-routine discharge after elective ACDF for CSM. Study Design: Retrospective cohort study. Objective: The aim of this study was to determine the impact age has on LOS and discharge disposition following elective ACDF for cervical spondylotic myelopathy (CSM). Methods: A retrospective cohort study was performed using the National Inpatient Sample (NIS) database from 2016 and 2017. All adult patients >50 years old undergoing ACDF for CSM were identified using the ICD-10-CM diagnosis and procedural coding system. Patients were then stratified by age: 50 to 64 years-old, 65 to 79 years-old, and greater than or equal to 80 years-old. Weighted patient demographics, comorbidities, perioperative complications, LOS, discharge disposition, and total cost of admission were assessed. Results: A total of 14 865 patients were identified. Compared to the 50-64 and 65-79 year-old cohorts, the 80+ years cohort had a significantly higher rate of postoperative complication (50-64 yo:10.2% vs. 65-79 yo:12.6% vs. 80+ yo:18.9%, P = 0.048). The 80+ years cohort experienced significantly longer hospital stays (50-64 yo: 2.0 ± 2.4 days vs. 65-79 yo: 2.2 ± 2.8 days vs. 80+ yo: 2.3 ± 2.1 days, P = 0.028), higher proportion of patients with extended LOS (50-64 yo:18.3% vs. 65-79 yo:21.9% vs. 80+ yo:28.4%, P = 0.009), and increased rates of non-routine discharges (50-64 yo:15.1% vs. 65-79 yo:23.0% vs. 80+ yo:35.8%, P < 0.001). On multivariate analysis, age 80+ years was found to be a significant independent predictor of extended LOS [OR:1.97, 95% CI:(1.10,3.55), P = 0.023] and non-routine discharge [OR:2.46, 95% CI:(1.44,4.21), P = 0.001]. Conclusions: Our study demonstrates that octogenarian age status is a significant independent risk factor for extended LOS and non-routine discharge after elective ACDF for CSM. Retrospective cohort study. The aim of this study was to determine the impact age has on LOS and discharge disposition following elective ACDF for cervical spondylotic myelopathy (CSM). A retrospective cohort study was performed using the National Inpatient Sample (NIS) database from 2016 and 2017. All adult patients >50 years old undergoing ACDF for CSM were identified using the ICD-10-CM diagnosis and procedural coding system. Patients were then stratified by age: 50 to 64 years-old, 65 to 79 years-old, and greater than or equal to 80 years-old. Weighted patient demographics, comorbidities, perioperative complications, LOS, discharge disposition, and total cost of admission were assessed. A total of 14 865 patients were identified. Compared to the 50-64 and 65-79 year-old cohorts, the 80+ years cohort had a significantly higher rate of postoperative complication (50-64 yo:10.2% vs. 65-79 yo:12.6% vs. 80+ yo:18.9%, = 0.048). The 80+ years cohort experienced significantly longer hospital stays (50-64 yo: 2.0 ± 2.4 days vs. 65-79 yo: 2.2 ± 2.8 days vs. 80+ yo: 2.3 ± 2.1 days, = 0.028), higher proportion of patients with extended LOS (50-64 yo:18.3% vs. 65-79 yo:21.9% vs. 80+ yo:28.4%, = 0.009), and increased rates of non-routine discharges (50-64 yo:15.1% vs. 65-79 yo:23.0% vs. 80+ yo:35.8%, < 0.001). On multivariate analysis, age 80+ years was found to be a significant independent predictor of extended LOS [OR:1.97, 95% CI:(1.10,3.55), = 0.023] and non-routine discharge [OR:2.46, 95% CI:(1.44,4.21), = 0.001]. Our study demonstrates that octogenarian age status is a significant independent risk factor for extended LOS and non-routine discharge after elective ACDF for CSM. Study Design: Retrospective cohort study. Objective: The aim of this study was to determine the impact age has on LOS and discharge disposition following elective ACDF for cervical spondylotic myelopathy (CSM). Methods: A retrospective cohort study was performed using the National Inpatient Sample (NIS) database from 2016 and 2017. All adult patients >50 years old undergoing ACDF for CSM were identified using the ICD-10-CM diagnosis and procedural coding system. Patients were then stratified by age: 50 to 64 years-old, 65 to 79 years-old, and greater than or equal to 80 years-old. Weighted patient demographics, comorbidities, perioperative complications, LOS, discharge disposition, and total cost of admission were assessed. Results: A total of 14 865 patients were identified. Compared to the 50-64 and 65-79 year-old cohorts, the 80+ years cohort had a significantly higher rate of postoperative complication (50-64 yo:10.2% vs. 65-79 yo:12.6% vs. 80+ yo:18.9%, P = 0.048). The 80+ years cohort experienced significantly longer hospital stays (50-64 yo: 2.0 ± 2.4 days vs. 65-79 yo: 2.2 ± 2.8 days vs. 80+ yo: 2.3 ± 2.1 days, P = 0.028), higher proportion of patients with extended LOS (50-64 yo:18.3% vs. 65-79 yo:21.9% vs. 80+ yo:28.4%, P = 0.009), and increased rates of non-routine discharges (50-64 yo:15.1% vs. 65-79 yo:23.0% vs. 80+ yo:35.8%, P < 0.001). On multivariate analysis, age 80+ years was found to be a significant independent predictor of extended LOS [OR:1.97, 95% CI:(1.10,3.55), P = 0.023] and non-routine discharge [OR:2.46, 95% CI:(1.44,4.21), P = 0.001]. Conclusions: Our study demonstrates that octogenarian age status is a significant independent risk factor for extended LOS and non-routine discharge after elective ACDF for CSM. |
Author | Laurans, Maxwell Pennington, Zach Freedman, Isaac G. Sciubba, Daniel M. Ehresman, Jeff David, Wyatt B. Elsamadicy, Aladine A. Koo, Andrew B. Reeves, Benjamin C. Kolb, Luis |
AuthorAffiliation | 1 Department of Neurosurgery, 12228 Yale University School of Medicine , New Haven, CT, USA 2 Department of Neurosurgery, 1500 John Hopkins School of Medicine , Baltimore, MD, USA |
AuthorAffiliation_xml | – name: 1 Department of Neurosurgery, 12228 Yale University School of Medicine , New Haven, CT, USA – name: 2 Department of Neurosurgery, 1500 John Hopkins School of Medicine , Baltimore, MD, USA |
Author_xml | – sequence: 1 givenname: Aladine A. orcidid: 0000-0002-7658-6461 surname: Elsamadicy fullname: Elsamadicy, Aladine A. email: aladine.elsamadicy@yale.edu – sequence: 2 givenname: Andrew B. surname: Koo fullname: Koo, Andrew B. – sequence: 3 givenname: Benjamin C. surname: Reeves fullname: Reeves, Benjamin C. – sequence: 4 givenname: Isaac G. orcidid: 0000-0003-2603-4201 surname: Freedman fullname: Freedman, Isaac G. – sequence: 5 givenname: Wyatt B. surname: David fullname: David, Wyatt B. – sequence: 6 givenname: Jeff surname: Ehresman fullname: Ehresman, Jeff – sequence: 7 givenname: Zach orcidid: 0000-0001-8012-860X surname: Pennington fullname: Pennington, Zach – sequence: 8 givenname: Maxwell surname: Laurans fullname: Laurans, Maxwell – sequence: 9 givenname: Luis surname: Kolb fullname: Kolb, Luis – sequence: 10 givenname: Daniel M. orcidid: 0000-0001-7604-434X surname: Sciubba fullname: Sciubba, Daniel M. |
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CitedBy_id | crossref_primary_10_1177_21925682231202579 crossref_primary_10_1016_j_jocn_2024_05_032 crossref_primary_10_1007_s11357_024_01083_6 crossref_primary_10_22603_ssrr_2022_0030 crossref_primary_10_1016_j_bas_2023_102683 |
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Keywords | anterior cervical discectomy and fusion extended LOS cervical spondylotic myelopathy non-routine discharge octogenarian |
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Retrospective cohort study.
Objective:
The aim of this study was to determine the impact age has on LOS and discharge disposition following... Retrospective cohort study. The aim of this study was to determine the impact age has on LOS and discharge disposition following elective ACDF for cervical... Study Design: Retrospective cohort study. Objective: The aim of this study was to determine the impact age has on LOS and discharge disposition following... STUDY DESIGNRetrospective cohort study. OBJECTIVEThe aim of this study was to determine the impact age has on LOS and discharge disposition following elective... |
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Title | Octogenarians Are Independently Associated With Extended LOS and Non-Routine Discharge After Elective ACDF for CSM |
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