Analysis Of Cause And Related Factors Of 30-day Readmission And Reoperation After Spinal Surgery

Objective1.To analyze the causes and related factors of 30-day unplanned readmission of spinal surgery patients,explore the clinical strategies to reduce unplanned readmission rate of spinal surgery patients.2.To analyze the causes and related factors of 30-day unplanned reoperation of spinal surgery patients,explore the clinical strategies to reduce unplanned reoperation rate of spinal surgery patients.Methods1.A total of 14,770 cases of patients admitted to our hospital for the department of spine from July 2001 to July 2017 were retrospectively collected,92 cases were 30-day unplanned readmission,the patients were divided into readmission group and non-readmission group.Hospital number,name,age,gender,main diagnosis,complications,the initial surgical site,the initial surgical procedure,initial hospitalization days and expenses,reoperation after readmssion,hospitalization days and expense of readmission.The cause and related factors of readmission were analysied.2.A total of 14,770 cases of patients admitted to our hospital for the department of spine from July 2001 to July 2017 were retrospectively collected,109 cases were 30-day unplanned reoperation,the patients were divided into the reoperation group and the non-reoperation group.Hospital number,name,age,gender,first main diagnosis before surgery,complications situation,the initial surgical site,initial operation method,the time interval between two operations,reoperation method,hospitalization days and hospitalization expenses.The cause and related factors of reoperation were analysied.Result1.92 patients were 30-day unplanned readmission,with an unplanned readmission rate of 0.62%.Cause for readmission included neurological deficits(50.0%,46/92),surgical site infection(32.8%,32/92),cerebrospinal fluid leakage(6.5%,6/92),hematoma(5.4%,5/92),implant displacement(2.2%,2/92),and bone cement leakage(1.1%,1/92).See readmission in patients with more men than women(P<0.05)?the readmission rate of patients with diabetes is higher than the patients without(P<0.05),the readmission rate of patients with infectious disease is higher than patients with degenerative disease(P<0.05).6 cases reoperation were performed after readmission because of cerebrospinal fluid leakage(100·0%),reoperation rate after readmission was 35.9%(33/92)as a whole.The hospitalization expenses of the readmission group is higher than non-readmission group,the difference was statistically significant(P<0.05).2.In this study,a total of 14,770 patients underwent spine surgery and 109 patients were 30-day unplanned reoperation,with an unplanned reoperation rate of 0.74%.There was no significant difference between the two groups in age,surgical site(P>0.05).See reoperation in patients with more men than women(P<0.03),the reoperation rate of patients with hypoproteinemia is higher than patients without(P<0.05),the reoperation rate of patients with infectious disease is higher than patients with deformity disease(P<0.05).Cause for reoperation included incision complication(37.6%,41/109),neurological deficits(31.2%,34/109),hematoma(11.9%,13/109),implant displacement(9.2%,10/109),cerebrospinal fluid leakage(5.5%,6/109),drainage tube residual(4.6%,5/109).In addition,the hospitalization days and expenses of the reoperation group is higher than non-reoperation group,the difference was statistically significant(P<0.05).Conclusionl.The rate of 30-day readmission in spinal surgey patients was 0.62%(92/14770),the most common reason for readmission is neurological deficits,Male,patients with diabetes,patients with infectious spinal diseases were more common among readmission patients.2.The rate of 30-day reoperation in spinal surgey patients was 0.74%(109/14770),the most common reason for reoperation is incision complication,Male,patients with hypoproteinemia,patients with infectious spinal diseases,patients with implants were more common among reoperation patients.