315 Race as a Predictor of Postoperative Hospital Readmission After Spine Surgery.

INTRODUCTION: Hospital readmission after surgery results in a substantial economic burden, and several recent studies have investigated the impact of race and ethnicity on hospital readmission rates, with the goal to identify hospitals and patients with high readmission risk. METHODS: This single-institution, retrospective cohort study assesses the impact of race, along with preoperative and intraoperative risk factors, on 30-day readmission rates following spinal surgery. A total of 1346 consecutive adult patients who underwent anterior and/or posterior spinal surgery from 2008 to 2010 for degenerative and deformity causes, as well as for higher-risk causes, including traumatic and neoplastic etiologies, were included in the study. Clinical variables included age, demographics, surgical etiology, intraoperative technique, and other comorbidities known to be associated with postoperative complication. RESULTS: A total of 1346 patients (654 male, 692 female) were included in the study. With the use of multivariate logistic regression, black patients were found to have over twice the odds of readmission (odds ratio [OR], 2.20; 95% confidence interval [CI],: 1.04-4.64), and patients with total length of stay of 7 or more days had nearly 5 times the odds of readmission (OR, 4.73; 95% CI, 1.72-12.98). Conversely, patients who underwent cervical surgery were found to have lower odds of readmission (OR, 0.27; 95% CI, 0.08-0.91). CONCLUSION: Within the context of the ongoing national goal of reducing hospital readmission, our study demonstrated that race and length of hospital stay influence the incidence of 30-day readmission rates after spinal surgery. Studies such as ours will aid in identifying patients with postoperative readmission risk and help elucidate the underlying factors that may be contributing to disparities in readmission after surgery.

Duke Scholars

Author Oren N Gottfried Neurosurgery

Author Maragatha Kuchibhatla Biostatistics & Bioinformatics, Division of Biostatistics