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Post-operative delirium is an independent predictor of 30-day hospital readmission after spine surgery in the elderly (≥65years old): A study of 453 consecutive elderly spine surgery patients.
J Clin Neurosci. 2017 Jul; 41:128-131.JC

Abstract

In the last decade, costs of U.S. healthcare expenditures have been soaring, with billions of dollars spent on hospital readmissions. Identifying causes and risk factors can reduce soaring readmission rates and help lower healthcare costs. The aim of this is to determine if post-operative delirium in the elderly is an independent risk factor for 30-day hospital readmission after spine surgery. The medical records of 453 consecutive elderly (≥65years old) patients undergoing spine surgery at Duke University Medical Center from 2008 to 2010 were reviewed. We identified 17 (3.75%) patients who experienced post-operative delirium according to DSM-V criteria. Patient demographics, comorbidities, and post-operative complication rates were collected for each patient. Elderly patients experiencing post-operative delirium had an increased length of hospital stay (10.47days vs. 5.70days, p=0.009). Complication rates were similar between the cohorts with the post-operative delirium patients having increased UTI and superficial surgical site infections. In total, 12.14% of patients were re-admitted within 30-days of discharge, with post-operative delirium patients experiencing approximately a 4-fold increase in 30-day readmission rates (Delirium: 41.18% vs. No Delirium: 11.01%, p=0.002). In a multivariate logistic regression analysis, post-operative delirium is an independent predictor of 30-day readmission after spine surgery in the elderly (p=0.03). Elderly patients experiencing post-operative delirium after spine surgery is an independent risk factor for unplanned readmission within 30-days of discharge. Preventable measures and early awareness of post-operative delirium in the elderly may help reduce readmission rates.

Authors+Show Affiliations

Department of Neurosurgery, Duke University Medical Center, Durham, NC, United States.Department of Neurosurgery, Duke University Medical Center, Durham, NC, United States.Department of Neurosurgery, Duke University Medical Center, Durham, NC, United States.Department of Neurosurgery, Duke University Medical Center, Durham, NC, United States.Department of Neurosurgery, Duke University Medical Center, Durham, NC, United States.Department of Neurosurgery, Duke University Medical Center, Durham, NC, United States.Department of Neurosurgery, Duke University Medical Center, Durham, NC, United States. Electronic address: oren.gottfried@duke.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28262398

Citation

Elsamadicy, Aladine A., et al. "Post-operative Delirium Is an Independent Predictor of 30-day Hospital Readmission After Spine Surgery in the Elderly (≥65years Old): a Study of 453 Consecutive Elderly Spine Surgery Patients." Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, vol. 41, 2017, pp. 128-131.
Elsamadicy AA, Wang TY, Back AG, et al. Post-operative delirium is an independent predictor of 30-day hospital readmission after spine surgery in the elderly (≥65years old): A study of 453 consecutive elderly spine surgery patients. J Clin Neurosci. 2017;41:128-131.
Elsamadicy, A. A., Wang, T. Y., Back, A. G., Lydon, E., Reddy, G. B., Karikari, I. O., & Gottfried, O. N. (2017). Post-operative delirium is an independent predictor of 30-day hospital readmission after spine surgery in the elderly (≥65years old): A study of 453 consecutive elderly spine surgery patients. Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, 41, 128-131. https://doi.org/10.1016/j.jocn.2017.02.040
Elsamadicy AA, et al. Post-operative Delirium Is an Independent Predictor of 30-day Hospital Readmission After Spine Surgery in the Elderly (≥65years Old): a Study of 453 Consecutive Elderly Spine Surgery Patients. J Clin Neurosci. 2017;41:128-131. PubMed PMID: 28262398.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Post-operative delirium is an independent predictor of 30-day hospital readmission after spine surgery in the elderly (≥65years old): A study of 453 consecutive elderly spine surgery patients. AU - Elsamadicy,Aladine A, AU - Wang,Timothy Y, AU - Back,Adam G, AU - Lydon,Emily, AU - Reddy,Gireesh B, AU - Karikari,Isaac O, AU - Gottfried,Oren N, Y1 - 2017/03/02/ PY - 2016/11/30/received PY - 2017/02/12/accepted PY - 2017/3/7/pubmed PY - 2018/1/18/medline PY - 2017/3/7/entrez KW - 30-Day readmission KW - Delirium KW - Spine surgery SP - 128 EP - 131 JF - Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia JO - J Clin Neurosci VL - 41 N2 - In the last decade, costs of U.S. healthcare expenditures have been soaring, with billions of dollars spent on hospital readmissions. Identifying causes and risk factors can reduce soaring readmission rates and help lower healthcare costs. The aim of this is to determine if post-operative delirium in the elderly is an independent risk factor for 30-day hospital readmission after spine surgery. The medical records of 453 consecutive elderly (≥65years old) patients undergoing spine surgery at Duke University Medical Center from 2008 to 2010 were reviewed. We identified 17 (3.75%) patients who experienced post-operative delirium according to DSM-V criteria. Patient demographics, comorbidities, and post-operative complication rates were collected for each patient. Elderly patients experiencing post-operative delirium had an increased length of hospital stay (10.47days vs. 5.70days, p=0.009). Complication rates were similar between the cohorts with the post-operative delirium patients having increased UTI and superficial surgical site infections. In total, 12.14% of patients were re-admitted within 30-days of discharge, with post-operative delirium patients experiencing approximately a 4-fold increase in 30-day readmission rates (Delirium: 41.18% vs. No Delirium: 11.01%, p=0.002). In a multivariate logistic regression analysis, post-operative delirium is an independent predictor of 30-day readmission after spine surgery in the elderly (p=0.03). Elderly patients experiencing post-operative delirium after spine surgery is an independent risk factor for unplanned readmission within 30-days of discharge. Preventable measures and early awareness of post-operative delirium in the elderly may help reduce readmission rates. SN - 1532-2653 UR - https://www.unboundmedicine.com/medline/citation/28262398/Post_operative_delirium_is_an_independent_predictor_of_30_day_hospital_readmission_after_spine_surgery_in_the_elderly__≥65years_old_:_A_study_of_453_consecutive_elderly_spine_surgery_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0967-5868(16)31330-3 DB - PRIME DP - Unbound Medicine ER -