Heyl, Johannes;
Hardy, Flavien;
Gray, William K;
Tucker, Katie;
Marchã, Maria JM;
Yates, Jeremy;
Briggs, Tim WR;
(2024)
Factors associated with poorer outcomes for posterior lumbar decompression and or/or discectomy: an exploratory analysis of administrative data.
Archives of Orthopaedic and Trauma Surgery
, 144
pp. 1129-1137.
10.1007/s00402-023-05182-5.
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Abstract
Purpose: This study aimed to identify factors associated with poorer patient outcomes for lumbar decompression and/or discectomy (PLDD).// Methods: We extracted data from the Hospital Episodes Statistics database for the 5 years from 1st April 2014 to 31st March 2019. Patients undergoing an elective one- or two-level PLDD aged ≥ 17 years and without evidence of revision surgery during the index stay were included. The primary patient outcome measure was readmission within 90 days post-discharge.// Results: Data for 93,813 PLDDs across 111 hospital trusts were analysed. For the primary outcome, greater age [< 40 years vs 70–79 years odds ratio (OR) 1.28 (95% confidence interval (CI) 1.14 to 1.42), < 40 years vs ≥ 80 years OR 2.01 (95% CI 1.76–2.30)], female sex [OR 1.09 (95% CI 1.02–1.16)], surgery over two spinal levels [OR 1.16 (95% CI 1.06–1.26)] and the comorbidities chronic pulmonary disease, connective tissue disease, liver disease, diabetes, hemi/paraplegia, renal disease and cancer were all associated with emergency readmission within 90 days. Other outcomes studied had a similar pattern of associations.// Conclusions: A high-throughput PLDD pathway will not be suitable for all patients. Extra care should be taken for patients aged ≥ 70 years, females, patients undergoing surgery over two spinal levels and those with specific comorbidities or generalised frailty.
| Type: | Article |
|---|---|
| Title: | Factors associated with poorer outcomes for posterior lumbar decompression and or/or discectomy: an exploratory analysis of administrative data |
| Location: | Germany |
| DOI: | 10.1007/s00402-023-05182-5 |
| Publisher version: | https://doi.org/10.1007/s00402-023-05182-5 |
| Language: | English |
| Additional information: | This version is the author-accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Posterior lumbar decompression, Discectomy, Spinal surgery |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Computer Science |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10188327 |
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