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Readmissions After Surgical Resection of Metastatic Tumors of the Spine at a Single Institution.

Publication ,  Journal Article
Abu-Bonsrah, N; Goodwin, CR; De la Garza-Ramos, R; Sankey, EW; Liu, A; Kosztowski, T; Elder, BD; Bettegowda, C; Bydon, A; Witham, TF ...
Published in: World Neurosurg
May 2017

BACKGROUND: Surgical management of spinal metastasis is complex and can be associated with significant postoperative morbidity. Analyzing readmission rates may serve as a proxy for postoperative morbidity and functional decline, allowing patients and physicians to make informed decisions about treatment. METHODS: Retrospective analysis was performed of patients with metastatic spine disease surgically treated at a tertiary center from 2003 to 2012. Patients with primary lung cancer, breast cancer, kidney cancer, bone marrow cancer, prostate cancer, gynecologic cancer, and melanoma were analyzed. Primary and secondary outcome variables were readmissions and overall survival. Multivariate Cox proportional hazards model was used to identify independent factors associated with readmissions. RESULTS: There were 159 patients analyzed. Lung, breast, and kidney represented the most common primary cancer sites, accounting for 22%, 19.5%, and 16.4%. Of patients, 56.6% had at least 1 readmission, with a 30-day readmission rate of 13.8% and 1-year readmission rate of 47.2%. Readmissions were for surgical complications (26.7%), oncologic disease progression (33.7%), and other medical reasons (36.7%). Patients with colorectal cancer had the highest number of readmissions. Patients with melanoma had more readmissions over the course of their limited postoperative survival. Overall mortality was 59.1%, with a median survival of 15.1 months. Multivariate analysis revealed age >60 years and previous radiation of the spine increased the likelihood of readmission. CONCLUSIONS: Readmissions provide an important window into understanding postoperative morbidity among patients with metastatic disease of the spine. This study offers an important starting point for understanding the nuances of patients' postoperative outcomes.

Duke Scholars

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

May 2017

Volume

101

Start / End Page

695 / 701.e1

Location

United States

Related Subject Headings

  • Tertiary Care Centers
  • Spinal Neoplasms
  • Retrospective Studies
  • Patient Readmission
  • Mortality
  • Middle Aged
  • Male
  • Humans
  • Female
  • Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Abu-Bonsrah, N., Goodwin, C. R., De la Garza-Ramos, R., Sankey, E. W., Liu, A., Kosztowski, T., … Sciubba, D. M. (2017). Readmissions After Surgical Resection of Metastatic Tumors of the Spine at a Single Institution. World Neurosurg, 101, 695-701.e1. https://doi.org/10.1016/j.wneu.2017.02.065
Abu-Bonsrah, Nancy, C Rory Goodwin, Rafael De la Garza-Ramos, Eric W. Sankey, Ann Liu, Thomas Kosztowski, Benjamin D. Elder, et al. “Readmissions After Surgical Resection of Metastatic Tumors of the Spine at a Single Institution.World Neurosurg 101 (May 2017): 695-701.e1. https://doi.org/10.1016/j.wneu.2017.02.065.
Abu-Bonsrah N, Goodwin CR, De la Garza-Ramos R, Sankey EW, Liu A, Kosztowski T, et al. Readmissions After Surgical Resection of Metastatic Tumors of the Spine at a Single Institution. World Neurosurg. 2017 May;101:695-701.e1.
Abu-Bonsrah, Nancy, et al. “Readmissions After Surgical Resection of Metastatic Tumors of the Spine at a Single Institution.World Neurosurg, vol. 101, May 2017, pp. 695-701.e1. Pubmed, doi:10.1016/j.wneu.2017.02.065.
Abu-Bonsrah N, Goodwin CR, De la Garza-Ramos R, Sankey EW, Liu A, Kosztowski T, Elder BD, Bettegowda C, Bydon A, Witham TF, Wolinsky J-P, Gokaslan ZL, Sciubba DM. Readmissions After Surgical Resection of Metastatic Tumors of the Spine at a Single Institution. World Neurosurg. 2017 May;101:695-701.e1.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

May 2017

Volume

101

Start / End Page

695 / 701.e1

Location

United States

Related Subject Headings

  • Tertiary Care Centers
  • Spinal Neoplasms
  • Retrospective Studies
  • Patient Readmission
  • Mortality
  • Middle Aged
  • Male
  • Humans
  • Female
  • Aged