Predictors of prolonged length of hospital stay and 30-Day readmission following surgical resection of spinal Chordomas: A retrospective national cancer database analysis.

BACKGROUND

Surgery for spinal chordomas is often extensive and carry a risk for complications. This study seeks to analyze factors contributing to prolonged length of stay (LOS) and 30-day readmission following spinal chordoma resection, utilizing data from the National Cancer Database (NCDB).

METHODS

A retrospective cohort of patients diagnosed with spinal chordoma from 2004 to 2017 was extracted from the NCDB. Patients were categorized based on whether they experienced prolonged LOS (defined as the 75th percentile, ≥12 days) or 30-day readmission. Various demographic, clinical, and treatment variables were examined using logistic regression to identify independent predictors of prolonged LOS and 30-day readmission.

RESULTS

Among 1015 patients analyzed for LOS, 26.0 % experienced a prolonged hospital stay. Independent predictors of prolonged LOS included larger tumor volume (OR = 1.01, 95 % CI = 1.006 - 1.015, p < 0.001) and longer time from diagnosis to surgery (OR = 1.01, 95 % CI = 1.002 - 1.013, p = 0.007). Sacral tumor location and preoperative radiation were associated with prolonged LOS, but did not reach significance in the multivariable model. In the 1204-patient cohort assessed for readmission, 8.8 % were readmitted within 30 days. A Deyo-Charleson Comorbidity Index ≥ 2 (OR = 3.03, 95 % CI = 1.522 - 6.036, p = 0.002) and extended diagnosis-to-surgery duration (OR = 1.01, 95 % CI = 1.002 - 1.013, p = 0.002) emerged as independent predictors of 30-day readmission.

CONCLUSIONS

Both prolonged LOS and 30-day readmission following spinal chordoma resection are influenced by factors such as tumor size, preoperative treatments, and surgical timing. Identifying these predictors can inform surgical planning and post-operative care strategies to improve patient outcomes and reduce healthcare burdens.