Non-medical factors significantly influence the length of hospital stay after surgery for degenerative spine disorders.

Mai, Domenique; Brand, C; Haschtmann, D; Pirvu, T; Fekete, T F; Mannion, A F (2020). Non-medical factors significantly influence the length of hospital stay after surgery for degenerative spine disorders. European spine journal, 29(2), pp. 203-212. Springer 10.1007/s00586-019-06209-5

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BACKGROUND

Unnecessarily long hospital stays are costly and inefficient. Studies have shown that the length of hospital stay (LOS) for spine surgical procedures is influenced by various disease-related or medical factors, but few have examined the role of socio-demographic/socio-economic (SDE) factors.

METHODS

This was a retrospective analysis of data from 10,770 patients (5056 men, 5714 women; 62 ± 15 years) with degenerative spinal disorders, collected prospectively in an in-house database within the framework of EUROSPINE's Spine Tango Registry. Surgeons completed the Tango surgery form (clinical history, demographics, surgical measures, complications), and patients, a baseline Core Outcome Measures Index. Stepwise linear regression analyses examined SDE predictors of LOS, controlling for potential medical/biological factors.

RESULTS

The mean LOS was 7.9 ± 5.2 days. The final model accounted for 42% of variance in LOS, with SDE variables explaining 13% variance and medical/surgical predictors, 29%. In the final model, the SDE factors age and being female were significant independent predictors of LOS, whereas others were either non-significant (insurance status, being of Swiss nationality, being a smoker) or reached only borderline significance (p < 0.1) (BMI). Controlling for all other SDE and medical/surgical confounders, being female was associated with 1.11-day longer LOS (95% CI 0.96-1.27; p < 0.0001).

CONCLUSIONS

Patients of advanced age and female gender are at increased risk of longer hospital stay after surgery for degenerative spinal disorders. Further studies should seek to understand the reasoning behind the gender disparity, in order to minimise potentially unnecessary costs of prolonged LOS. Targeted preoperative discharge planning may improve the utilisation of hospital resources. These slides can be retrieved under Electronic Supplementary Material.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Mai, Domenique, Brand, Christian Michael Georg

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0940-6719

Publisher:

Springer

Language:

English

Submitter:

Beatrice Minder Wyssmann

Date Deposited:

18 Nov 2019 14:25

Last Modified:

05 Dec 2022 15:32

Publisher DOI:

10.1007/s00586-019-06209-5

PubMed ID:

31734806

Uncontrolled Keywords:

Degenerative disorders of the cervical and thoracic/lumbar spine Length of stay Non-medical predictors Spine surgery

BORIS DOI:

10.7892/boris.135222

URI:

https://boris.unibe.ch/id/eprint/135222

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