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Comparison of Inpatient and Outpatient Preoperative Factors and Postoperative Outcomes in 2-Level Cervical Disc Arthroplasty
OBJECTIVE: The purpose of this study was to evaluate factors associated with inpatient admission following 2-level cervical disc arthroplasty (CDA). A secondary aim was to compare outcomes between those treated on an inpatient versus outpatient basis. METHODS: Using data from the American College of...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Korean Spinal Neurosurgery Society
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6347354/ https://www.ncbi.nlm.nih.gov/pubmed/30531659 http://dx.doi.org/10.14245/ns.1836102.051 |
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author | Hill, Patrick Vaishnav, Avani Kushwaha, Blake McAnany, Steven Albert, Todd Gang, Catherine Himo Qureshi, Sheeraz |
author_facet | Hill, Patrick Vaishnav, Avani Kushwaha, Blake McAnany, Steven Albert, Todd Gang, Catherine Himo Qureshi, Sheeraz |
author_sort | Hill, Patrick |
collection | PubMed |
description | OBJECTIVE: The purpose of this study was to evaluate factors associated with inpatient admission following 2-level cervical disc arthroplasty (CDA). A secondary aim was to compare outcomes between those treated on an inpatient versus outpatient basis. METHODS: Using data from the American College of Surgeons National Surgical Quality Improvement Program database, multivariate logistic regression analysis was used to assess the independent effect of each variable on inpatient or outpatient selection for surgery. Statistical significance was defined by p-values <0.05. The factors considered were age, sex, body mass index (BMI), smoking status, American Society of Anesthesiologists physical status classification, and comorbidities including hypertension, diabetes, history of dyspnea or chronic obstructive pulmonary disease, previous cardiac intervention or surgery, steroid usage, and history of bleeding. In addition, whether the operation was performed by an orthopedic or neurosurgical specialist was analyzed. RESULTS: The number of 2-level CDA procedures increased from 6 cases reported in 2014 to 142 in 2016, although a statistically significant increase in the number of outpatient cases performed was not seen (p=0.2). The factors found to be significantly associated with inpatient status following surgery were BMI (p=0.019) and diabetes mellitus requiring insulin (p=0.043). There were no significant differences in complication and readmission rates between the inpatient and outpatient groups. CONCLUSION: Patients undergoing inpatient 2-level CDA had significantly higher rates of obesity and diabetes requiring insulin than did patients undergoing the same procedure in the outpatient setting. With no difference in complication or readmission rates, 2-level CDA may be considered safe in the outpatient setting in appropriately selected patients. |
format | Online Article Text |
id | pubmed-6347354 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Korean Spinal Neurosurgery Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-63473542019-02-14 Comparison of Inpatient and Outpatient Preoperative Factors and Postoperative Outcomes in 2-Level Cervical Disc Arthroplasty Hill, Patrick Vaishnav, Avani Kushwaha, Blake McAnany, Steven Albert, Todd Gang, Catherine Himo Qureshi, Sheeraz Neurospine Original Article OBJECTIVE: The purpose of this study was to evaluate factors associated with inpatient admission following 2-level cervical disc arthroplasty (CDA). A secondary aim was to compare outcomes between those treated on an inpatient versus outpatient basis. METHODS: Using data from the American College of Surgeons National Surgical Quality Improvement Program database, multivariate logistic regression analysis was used to assess the independent effect of each variable on inpatient or outpatient selection for surgery. Statistical significance was defined by p-values <0.05. The factors considered were age, sex, body mass index (BMI), smoking status, American Society of Anesthesiologists physical status classification, and comorbidities including hypertension, diabetes, history of dyspnea or chronic obstructive pulmonary disease, previous cardiac intervention or surgery, steroid usage, and history of bleeding. In addition, whether the operation was performed by an orthopedic or neurosurgical specialist was analyzed. RESULTS: The number of 2-level CDA procedures increased from 6 cases reported in 2014 to 142 in 2016, although a statistically significant increase in the number of outpatient cases performed was not seen (p=0.2). The factors found to be significantly associated with inpatient status following surgery were BMI (p=0.019) and diabetes mellitus requiring insulin (p=0.043). There were no significant differences in complication and readmission rates between the inpatient and outpatient groups. CONCLUSION: Patients undergoing inpatient 2-level CDA had significantly higher rates of obesity and diabetes requiring insulin than did patients undergoing the same procedure in the outpatient setting. With no difference in complication or readmission rates, 2-level CDA may be considered safe in the outpatient setting in appropriately selected patients. Korean Spinal Neurosurgery Society 2018-12 2018-09-09 /pmc/articles/PMC6347354/ /pubmed/30531659 http://dx.doi.org/10.14245/ns.1836102.051 Text en Copyright © 2018 by the Korean Spinal Neurosurgery Society This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Hill, Patrick Vaishnav, Avani Kushwaha, Blake McAnany, Steven Albert, Todd Gang, Catherine Himo Qureshi, Sheeraz Comparison of Inpatient and Outpatient Preoperative Factors and Postoperative Outcomes in 2-Level Cervical Disc Arthroplasty |
title | Comparison of Inpatient and Outpatient Preoperative Factors and Postoperative Outcomes in 2-Level Cervical Disc Arthroplasty |
title_full | Comparison of Inpatient and Outpatient Preoperative Factors and Postoperative Outcomes in 2-Level Cervical Disc Arthroplasty |
title_fullStr | Comparison of Inpatient and Outpatient Preoperative Factors and Postoperative Outcomes in 2-Level Cervical Disc Arthroplasty |
title_full_unstemmed | Comparison of Inpatient and Outpatient Preoperative Factors and Postoperative Outcomes in 2-Level Cervical Disc Arthroplasty |
title_short | Comparison of Inpatient and Outpatient Preoperative Factors and Postoperative Outcomes in 2-Level Cervical Disc Arthroplasty |
title_sort | comparison of inpatient and outpatient preoperative factors and postoperative outcomes in 2-level cervical disc arthroplasty |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6347354/ https://www.ncbi.nlm.nih.gov/pubmed/30531659 http://dx.doi.org/10.14245/ns.1836102.051 |
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