Racial Disparities in 30-Day Readmission Rates After Elective Spine Surgery: A Single Institutional Experience.

Published

Journal Article

STUDY DESIGN: Retrospective cohort review. OBJECTIVE: The aim of this study is to investigate whether patient race is an independent predictor of unplanned 30-day hospital readmission after elective spine surgery. SUMMARY OF BACKGROUND DATA: Racial disparities are known to exist for many aspects of surgical care. However, it is unknown if disparities exist in 30-day readmissions after elective spine surgery, an area that is becoming a prime focus for clinical leaders and policymakers. METHODS: Records of 600 patients undergoing elective spine surgery at a major academic medical center were reviewed. We identified all unplanned readmissions within 30 days of discharge. Unplanned readmissions were defined to have occurred as a result of either a surgical or a nonsurgical complication. Patient's records were reviewed to determine the cause of readmission and the length of hospital stay. The main outcome measure was risk-adjusted odds of all-cause 30-day readmission. We used multivariate logistic regression to determine if Black patients had an increased likelihood of 30-day readmission compared with White patients. RESULTS: Baseline characteristics were similar between both groups. Black patients had higher readmission rates than White patients (10.56% vs. 7.86%, Pā€Š=ā€Š0.04). In a univariate analysis, race, body mass index, sex, patient age, smoking, diabetes, and fusion levels were associated with increased 30-day readmission rates. However, in a multivariate logistic regression model, race was an independent predictor of 30-day readmission after elective spine surgery. In addition, no significant differences in baseline, 1-year and 2-year patient reported outcomes measures were observed between both groups. CONCLUSION: This study suggests that Black patients are more likely to be readmitted within 30-days of discharge after elective spine surgery. Efforts at reducing disparities should focus not only on race-based measures but also effective post discharge care. LEVEL OF EVIDENCE: 3.

Full Text

Duke Authors

Cited Authors

  • Adogwa, O; Elsamadicy, AA; Mehta, AI; Cheng, J; Bagley, CA; Karikari, IO

Published Date

  • November 1, 2016

Published In

Volume / Issue

  • 41 / 21

Start / End Page

  • 1677 - 1682

PubMed ID

  • 27054453

Pubmed Central ID

  • 27054453

Electronic International Standard Serial Number (EISSN)

  • 1528-1159

Digital Object Identifier (DOI)

  • 10.1097/BRS.0000000000001616

Language

  • eng

Conference Location

  • United States