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Late-Week Spinal Surgeries Tied to Longer Hospital Stays

Lengths of stay even longer with discharge to a skilled nursing facility or rehabilitation center

WEDNESDAY, April 21, 2021 (HealthDay News) — Late-week spinal surgeries are associated with a prolonged length of stay (LOS) in the hospital, according to a study published online April 6 in the Journal of Neurosurgery: Spine.

Sebastian Salas-Vega, Ph.D., from the London School of Economics and Political Science, and colleagues examined clinical and nonclinical drivers of patient LOS in the hospital following elective lumbar laminectomy. The analysis included 1,359 patients undergoing laminectomy surgery for degenerative lumbar spinal stenosis within a single health system between March 1, 2016, and Feb. 1, 2019.

The researchers found that the mean LOS ranged from 2.01 to 2.47 days for Monday and Friday cases, respectively, and was also notably longer for patients ultimately discharged to a skilled nursing facility or rehabilitation center. Longer LOS for procedures occurring later in the week was not associated with greater underlying health risks yet resulted in greater costs of care, with the average total surgical costs for lumbar laminectomy being 20 percent greater for Friday cases versus Monday cases. Comorbidity burden, surgery at a tertiary care center versus a community hospital, and the incidence of any postoperative complication were associated with significantly longer LOS. Significant nonclinical predictors of LOS prolongation included discharge to home health care, skilled nursing facilities, or rehabilitation centers and late-week surgery, even after adjusting for underlying patient health risks and insurance.

“Interventions to optimize surgical scheduling and perioperative care coordination could help reduce prolonged LOSs, lower costs, and, ultimately, give service line management personnel greater flexibility over how to use existing resources as they remain ahead of health care reforms,” the authors write.

Several authors disclosed financial ties to medical technology and publishing companies.

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