Factors contributing to a longer length of stay in adults admitted to a quaternary spinal care center

Background Longer hospital length of stay (LOS) has been associated with worse outcomes and increased resource utilization. However, diagnostic and patient-level factors associated with LOS have not been well studied on a large scale. The goal was to identify patient, surgical and organizational fac...

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Bibliographic Details
Published in:European spine journal 2023-03, Vol.32 (3), p.824-830
Main Authors: Hindi, Mathew N., Dandurand, Charlotte, Ailon, Tamir, Boyd, Michael, Charest-Morin, Raphaele, Dea, Nicolas, Dvorak, Marcel F., Fisher, Charles, Kwon, Brian K., Paquette, Scott, Street, John
Format: Article
Language:English
Subjects:
Adult
Adverse events
Delirium
Dysphagia
Humans
Length of Stay
Medicine
Medicine & Public Health
Neuralgia
Neurosurgery
Original
Original Article
Patients
Pneumonia
Resource allocation
Resource utilization
Retrospective Studies
Spine - surgery
Surgical Orthopedics
Surgical site infections
Surgical Wound Infection
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Summary:Background Longer hospital length of stay (LOS) has been associated with worse outcomes and increased resource utilization. However, diagnostic and patient-level factors associated with LOS have not been well studied on a large scale. The goal was to identify patient, surgical and organizational factors associated with longer patient LOS for adult patients at a high-volume quaternary spinal care center. Methods We performed a retrospective analysis of 13,493 admissions from January 2006 to December 2019. Factors analyzed included age, sex, admission status (emergent vs scheduled), ASIA grade, operative vs non-operative management, mean blood loss, operative time, and adverse events. Specific adverse events included surgical site infection (SSI), other infection (systemic or UTI), neuropathic pain, delirium, dural tear, pneumonia, and dysphagia. Diagnostic categories included trauma, oncology, deformity, degenerative, and “other”. A multivariable linear regression model was fit to log-transformed LOS to determine independent factors associated with patient LOS, with effects expressed as multipliers on mean LOS. Results Mean LOS for the population (SD) was 15.8 (34.0) days. Factors significantly ( p  
ISSN:0940-6719
1432-0932
DOI:10.1007/s00586-023-07547-1