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Predictive Modeling of Length of Hospital Stay Following Adult Spinal Deformity Correction: Analysis of 653 Patients with an Accuracy of 75% within 2 Days.

Publication ,  Journal Article
Safaee, MM; Scheer, JK; Ailon, T; Smith, JS; Hart, RA; Burton, DC; Bess, S; Neuman, BJ; Passias, PG; Miller, E; Shaffrey, CI; Schwab, F ...
Published in: World Neurosurg
July 2018

BACKGROUND: Length of stay (LOS) after surgery for adult spinal deformity (ASD) is a critical period that allows for optimal recovery. Predictive models that estimate LOS allow for stratification of high-risk patients. METHODS: A prospectively acquired multicenter database of patients with ASD was used. Patients with staged surgery or LOS >30 days were excluded. Univariable predictor importance ≥0.90, redundancy, and collinearity testing were used to identify variables for model building. A generalized linear model was constructed using a training dataset developed from a bootstrap sample; patients not randomly selected for the bootstrap sample were selected to the training dataset. LOS predictions were compared with actual LOS to calculate an accuracy percentage. RESULTS: Inclusion criteria were met by 653 patients. The mean LOS was 7.9 ± 4.1 days (median 7 days; range, 1-28 days). Following bootstrapping, 893 patients were modeled (653 in the training model and 240 in the testing model). Linear correlations for the training and testing datasets were 0.632 and 0.507, respectively. The prediction accuracy within 2 days of actual LOS was 75.4%. CONCLUSIONS: Our model successfully predicted LOS after ASD surgery with an accuracy of 75% within 2 days. Factors relating to actual LOS, such as rehabilitation bed availability and social support resources, are not captured in large prospective datasets. Predictive analytics will play an increasing role in the future of ASD surgery, and future models will seek to improve the accuracy of these tools.

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Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

July 2018

Volume

115

Start / End Page

e422 / e427

Location

United States

Related Subject Headings

  • Young Adult
  • Spinal Cord
  • Retrospective Studies
  • Prospective Studies
  • Predictive Value of Tests
  • Neurosurgical Procedures
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
 

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Safaee, M. M., Scheer, J. K., Ailon, T., Smith, J. S., Hart, R. A., Burton, D. C., … International Spine Study Group, . (2018). Predictive Modeling of Length of Hospital Stay Following Adult Spinal Deformity Correction: Analysis of 653 Patients with an Accuracy of 75% within 2 Days. World Neurosurg, 115, e422–e427. https://doi.org/10.1016/j.wneu.2018.04.064
Safaee, Michael M., Justin K. Scheer, Tamir Ailon, Justin S. Smith, Robert A. Hart, Douglas C. Burton, Shay Bess, et al. “Predictive Modeling of Length of Hospital Stay Following Adult Spinal Deformity Correction: Analysis of 653 Patients with an Accuracy of 75% within 2 Days.World Neurosurg 115 (July 2018): e422–27. https://doi.org/10.1016/j.wneu.2018.04.064.
Safaee MM, Scheer JK, Ailon T, Smith JS, Hart RA, Burton DC, et al. Predictive Modeling of Length of Hospital Stay Following Adult Spinal Deformity Correction: Analysis of 653 Patients with an Accuracy of 75% within 2 Days. World Neurosurg. 2018 Jul;115:e422–7.
Safaee, Michael M., et al. “Predictive Modeling of Length of Hospital Stay Following Adult Spinal Deformity Correction: Analysis of 653 Patients with an Accuracy of 75% within 2 Days.World Neurosurg, vol. 115, July 2018, pp. e422–27. Pubmed, doi:10.1016/j.wneu.2018.04.064.
Safaee MM, Scheer JK, Ailon T, Smith JS, Hart RA, Burton DC, Bess S, Neuman BJ, Passias PG, Miller E, Shaffrey CI, Schwab F, Lafage V, Klineberg EO, Ames CP, International Spine Study Group. Predictive Modeling of Length of Hospital Stay Following Adult Spinal Deformity Correction: Analysis of 653 Patients with an Accuracy of 75% within 2 Days. World Neurosurg. 2018 Jul;115:e422–e427.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

July 2018

Volume

115

Start / End Page

e422 / e427

Location

United States

Related Subject Headings

  • Young Adult
  • Spinal Cord
  • Retrospective Studies
  • Prospective Studies
  • Predictive Value of Tests
  • Neurosurgical Procedures
  • Middle Aged
  • Male
  • Length of Stay
  • Humans