Critical care in patients undergoing lumbar spine fusion: a population-based study
Department of Anesthesiology
Medical Subject Headings
Blood Component Transfusion; Comorbidity; *Critical Care; Demography; Female; Hospital Charges; Humans; Length of Stay; Lumbar Vertebrae; Male; Middle Aged; Patient Discharge; Prevalence; Respiration, Artificial; *Spinal Fusion; Treatment Outcome; United States
Anesthesiology | Clinical Epidemiology | Critical Care | Orthopedics | Surgery
BACKGROUND: Data on the utilization of critical care services (CCSs) among patients who underwent spine fusion are rare. Given the increasing popularity of this procedure, information regarding demographics and risk factors for the use of these advanced services is needed in order to appropriately allocate resources, educate clinical staff, and identify targets for future research.
METHODS: We analyzed hospital discharge data of patients who underwent lumbar spine fusion in approximately 400 US hospitals between 2006 and 2010. Patient, procedure, and health care system-related demographics for those requiring CCS were compared to those who did not. Outcomes such as mortality, complications, disposition status, and hospital charges were compared among groups and risk factors for the utilization of CCS identified.
RESULTS: A total of 95 434 entries of patients who underwent posterior lumbar spine fusion surgery between 2006 and 2010 were identified. Approximately 10% of the patients required CCS. On average, patients requiring CCS were older and had a higher comorbidity burden, developed more complications, had longer hospital stays and higher costs, and were less likely to be discharged home compared to non-CCS patients. Risk factors with increased odds for requiring CCS included advanced age, increasing comorbidity burden, increasing surgical invasiveness, and presence of postoperative complications, especially pulmonary.
CONCLUSIONS: Approximately, 10% of the patients undergoing lumbar spine surgery require CCS. Utilizing the present data, critical care physicians and administrators can identify patients at risk, educate clinical staff, identify targets for intervention, and allocate resources to meet the needs of this particular patient population.
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Citation: J Intensive Care Med. 2014 Sep-Oct;29(5):275-84. doi: 10.1177/0885066613491924. Epub 2013 Jun 10. Link to article on publisher's site
Memtsoudis, Stavros G.; Stundner, Ottokar; Sun, Xuming; Chiu, Ya-Lin; Ma, Yan; Fleischut, Peter; Kerr, Gregory E.; Girardi, Federico P.; and Walz, J. Matthias, "Critical care in patients undergoing lumbar spine fusion: a population-based study" (2014). Anesthesiology and Perioperative Medicine Publications. 177.