Clinical spine surgery · 2024
Impact of Weekday on Short-term Surgical Outcomes After Lumbar Fusion Surgery.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Heard Jeremy C, Ezeonu Teeto, Lee Yunsoo, Narayanan Rajkishen, Issa Tariq, McCall Cordero, Dulitzki Yoni, Resnick Dylan, Zucker Jeffrey, Shaer Alexander, Kurd Mark, Hilibrand Alan S, Vaccaro Alexander R, Kepler Christopher K, Schroeder Gregory D, Canseco Jose A
Аннотация
STUDY DESIGN: Retrospective cohort study.
OBJECTIVE: The purpose of this study is to investigate whether weekday lumbar spine fusion surgery has an impact on surgical and inpatient physical therapy (PT) outcomes.
SUMMARY OF BACKGROUND DATA: Timing of surgery has been implicated as a factor that may impact outcomes after spine surgery. Previous literature suggests that there may be an adverse effect to having surgery on the weekend.
METHODS: All patients ≥18 years who underwent primary lumbar spinal fusion from 2014 to 2020 were retrospectively identified. Patients were subdivided into an early subgroup (surgery between Monday and Wednesday) and a late subgroup (surgery between Thursday and Friday). Surgical outcome variables included inpatient complications, 90-day readmissions, and 1-year revisions. PT data from the first inpatient PT session included hours to PT session, AM-PAC Daily Activity or Basic Mobility scores, and total gait trial distance achieved.
RESULTS: Of the 1239 patients identified, 839 had surgery between Monday and Wednesday and 400 had surgery between Thursday and Friday. Patients in the later surgery subgroup were more likely to experience a nonsurgical neurologic complication (3.08% vs. 0.86%, P =0.008); however, there was no difference in total complications. Patients in the early surgery subgroup had their first inpatient PT session earlier than patients in the late subgroup (15.7 vs. 18.9 h, P <0.001). However, patients in the late subgroup achieved a farther total gait distance (98.2 vs. 75.4, P =0.011). Late surgery was a significant predictor of more hours of PT (est.=0.256, P =0.016) and longer length of stay (est.=2.277, P =0.001). There were no significant differences in readmission and revision rates.
CONCLUSIONS: Patients who undergo surgery later in the week may experience more nonsurgical neurologic complications, longer wait times for inpatient PT appointments, and longer lengths of stay. This analysis showed no adverse effect of later weekday surgery as it relates to total complications, readmissions, and reoperations.
LEVEL OF EVIDENCE: Level III.
OBJECTIVE: The purpose of this study is to investigate whether weekday lumbar spine fusion surgery has an impact on surgical and inpatient physical therapy (PT) outcomes.
SUMMARY OF BACKGROUND DATA: Timing of surgery has been implicated as a factor that may impact outcomes after spine surgery. Previous literature suggests that there may be an adverse effect to having surgery on the weekend.
METHODS: All patients ≥18 years who underwent primary lumbar spinal fusion from 2014 to 2020 were retrospectively identified. Patients were subdivided into an early subgroup (surgery between Monday and Wednesday) and a late subgroup (surgery between Thursday and Friday). Surgical outcome variables included inpatient complications, 90-day readmissions, and 1-year revisions. PT data from the first inpatient PT session included hours to PT session, AM-PAC Daily Activity or Basic Mobility scores, and total gait trial distance achieved.
RESULTS: Of the 1239 patients identified, 839 had surgery between Monday and Wednesday and 400 had surgery between Thursday and Friday. Patients in the later surgery subgroup were more likely to experience a nonsurgical neurologic complication (3.08% vs. 0.86%, P =0.008); however, there was no difference in total complications. Patients in the early surgery subgroup had their first inpatient PT session earlier than patients in the late subgroup (15.7 vs. 18.9 h, P <0.001). However, patients in the late subgroup achieved a farther total gait distance (98.2 vs. 75.4, P =0.011). Late surgery was a significant predictor of more hours of PT (est.=0.256, P =0.016) and longer length of stay (est.=2.277, P =0.001). There were no significant differences in readmission and revision rates.
CONCLUSIONS: Patients who undergo surgery later in the week may experience more nonsurgical neurologic complications, longer wait times for inpatient PT appointments, and longer lengths of stay. This analysis showed no adverse effect of later weekday surgery as it relates to total complications, readmissions, and reoperations.
LEVEL OF EVIDENCE: Level III.