Patient Body Mass Index is an Independent Predictor of 30-Day Hospital Readmission After Elective Spine Surgery

Aladine A. Elsamadicy, Owoicho Adogwa, Victoria D. Vuong, Ankit I. Mehta, Raul A. Vasquez, Joseph Cheng, Isaac O. Karikari, Carlos A. Bagley

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background Hospital readmission within 30 days of index surgery is receiving increased scrutiny as an indicator of poor quality of care. Reducing readmissions achieves the dual benefit of improving quality and reducing costs. With the growing prevalence of obesity, understanding its impact on 30-day unplanned readmissions and patients' perception of health status is important for appropriate risk stratification of patients. The aim of this study was to determine if obesity is an independent risk factor for unplanned 30-day readmissions after elective spine surgery. Methods The medical records of 500 patients (nonobese, n = 281; obese, n = 219) undergoing elective spine surgery at a major academic medical center were reviewed. Preoperative body mass index (BMI) was measured on all patients. BMI that was ≥30 kg/m2 was classified as obese. Patient demographics, comorbidities, and postoperative complication rates were collected. The primary outcome investigated was unplanned all-cause 30-day hospital readmission. The association between preoperative obesity and 30-day readmission rate was assessed via multivariate logistic regression analysis. Results Baseline characteristics and operative variables and complication profiles were similar between both cohorts. Overall, 8.6% of patients were readmitted within 30 days of discharge; obese patients experienced a 2-fold increase in 30-day readmission rates (obese 12.33% vs. nonobese 5.69%, P = 0.01). In a multivariate logistic regression analysis, preoperative obesity (BMI ≥30 kg/m2) was found to be an independent predictor of 30-day readmission after elective spine surgery (P = 0.001). Conclusions Preoperative obesity is an independent risk factor for readmission within 30 days of discharge after elective spine surgery. In a cost-conscious health care climate, preoperative BMI can identify patients at risk for early unplanned hospital readmission.

Original languageEnglish (US)
Pages (from-to)148-151
Number of pages4
JournalWorld Neurosurgery
Volume96
DOIs
StatePublished - Dec 1 2016

Fingerprint

Patient Readmission
Spine
Body Mass Index
Obesity
Logistic Models
Regression Analysis
Quality of Health Care
Climate
Ambulatory Surgical Procedures
Health Care Costs
Health Status
Medical Records
Comorbidity
Demography
Costs and Cost Analysis

Keywords

  • 30-Day readmission
  • BMI
  • Body mass index
  • Obesity
  • Spine
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Patient Body Mass Index is an Independent Predictor of 30-Day Hospital Readmission After Elective Spine Surgery. / Elsamadicy, Aladine A.; Adogwa, Owoicho; Vuong, Victoria D.; Mehta, Ankit I.; Vasquez, Raul A.; Cheng, Joseph; Karikari, Isaac O.; Bagley, Carlos A.

In: World Neurosurgery, Vol. 96, 01.12.2016, p. 148-151.

Research output: Contribution to journalArticle

Elsamadicy, Aladine A. ; Adogwa, Owoicho ; Vuong, Victoria D. ; Mehta, Ankit I. ; Vasquez, Raul A. ; Cheng, Joseph ; Karikari, Isaac O. ; Bagley, Carlos A. / Patient Body Mass Index is an Independent Predictor of 30-Day Hospital Readmission After Elective Spine Surgery. In: World Neurosurgery. 2016 ; Vol. 96. pp. 148-151.
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abstract = "Background Hospital readmission within 30 days of index surgery is receiving increased scrutiny as an indicator of poor quality of care. Reducing readmissions achieves the dual benefit of improving quality and reducing costs. With the growing prevalence of obesity, understanding its impact on 30-day unplanned readmissions and patients' perception of health status is important for appropriate risk stratification of patients. The aim of this study was to determine if obesity is an independent risk factor for unplanned 30-day readmissions after elective spine surgery. Methods The medical records of 500 patients (nonobese, n = 281; obese, n = 219) undergoing elective spine surgery at a major academic medical center were reviewed. Preoperative body mass index (BMI) was measured on all patients. BMI that was ≥30 kg/m2 was classified as obese. Patient demographics, comorbidities, and postoperative complication rates were collected. The primary outcome investigated was unplanned all-cause 30-day hospital readmission. The association between preoperative obesity and 30-day readmission rate was assessed via multivariate logistic regression analysis. Results Baseline characteristics and operative variables and complication profiles were similar between both cohorts. Overall, 8.6{\%} of patients were readmitted within 30 days of discharge; obese patients experienced a 2-fold increase in 30-day readmission rates (obese 12.33{\%} vs. nonobese 5.69{\%}, P = 0.01). In a multivariate logistic regression analysis, preoperative obesity (BMI ≥30 kg/m2) was found to be an independent predictor of 30-day readmission after elective spine surgery (P = 0.001). Conclusions Preoperative obesity is an independent risk factor for readmission within 30 days of discharge after elective spine surgery. In a cost-conscious health care climate, preoperative BMI can identify patients at risk for early unplanned hospital readmission.",
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AU - Elsamadicy, Aladine A.

AU - Adogwa, Owoicho

AU - Vuong, Victoria D.

AU - Mehta, Ankit I.

AU - Vasquez, Raul A.

AU - Cheng, Joseph

AU - Karikari, Isaac O.

AU - Bagley, Carlos A.

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N2 - Background Hospital readmission within 30 days of index surgery is receiving increased scrutiny as an indicator of poor quality of care. Reducing readmissions achieves the dual benefit of improving quality and reducing costs. With the growing prevalence of obesity, understanding its impact on 30-day unplanned readmissions and patients' perception of health status is important for appropriate risk stratification of patients. The aim of this study was to determine if obesity is an independent risk factor for unplanned 30-day readmissions after elective spine surgery. Methods The medical records of 500 patients (nonobese, n = 281; obese, n = 219) undergoing elective spine surgery at a major academic medical center were reviewed. Preoperative body mass index (BMI) was measured on all patients. BMI that was ≥30 kg/m2 was classified as obese. Patient demographics, comorbidities, and postoperative complication rates were collected. The primary outcome investigated was unplanned all-cause 30-day hospital readmission. The association between preoperative obesity and 30-day readmission rate was assessed via multivariate logistic regression analysis. Results Baseline characteristics and operative variables and complication profiles were similar between both cohorts. Overall, 8.6% of patients were readmitted within 30 days of discharge; obese patients experienced a 2-fold increase in 30-day readmission rates (obese 12.33% vs. nonobese 5.69%, P = 0.01). In a multivariate logistic regression analysis, preoperative obesity (BMI ≥30 kg/m2) was found to be an independent predictor of 30-day readmission after elective spine surgery (P = 0.001). Conclusions Preoperative obesity is an independent risk factor for readmission within 30 days of discharge after elective spine surgery. In a cost-conscious health care climate, preoperative BMI can identify patients at risk for early unplanned hospital readmission.

AB - Background Hospital readmission within 30 days of index surgery is receiving increased scrutiny as an indicator of poor quality of care. Reducing readmissions achieves the dual benefit of improving quality and reducing costs. With the growing prevalence of obesity, understanding its impact on 30-day unplanned readmissions and patients' perception of health status is important for appropriate risk stratification of patients. The aim of this study was to determine if obesity is an independent risk factor for unplanned 30-day readmissions after elective spine surgery. Methods The medical records of 500 patients (nonobese, n = 281; obese, n = 219) undergoing elective spine surgery at a major academic medical center were reviewed. Preoperative body mass index (BMI) was measured on all patients. BMI that was ≥30 kg/m2 was classified as obese. Patient demographics, comorbidities, and postoperative complication rates were collected. The primary outcome investigated was unplanned all-cause 30-day hospital readmission. The association between preoperative obesity and 30-day readmission rate was assessed via multivariate logistic regression analysis. Results Baseline characteristics and operative variables and complication profiles were similar between both cohorts. Overall, 8.6% of patients were readmitted within 30 days of discharge; obese patients experienced a 2-fold increase in 30-day readmission rates (obese 12.33% vs. nonobese 5.69%, P = 0.01). In a multivariate logistic regression analysis, preoperative obesity (BMI ≥30 kg/m2) was found to be an independent predictor of 30-day readmission after elective spine surgery (P = 0.001). Conclusions Preoperative obesity is an independent risk factor for readmission within 30 days of discharge after elective spine surgery. In a cost-conscious health care climate, preoperative BMI can identify patients at risk for early unplanned hospital readmission.

KW - 30-Day readmission

KW - BMI

KW - Body mass index

KW - Obesity

KW - Spine

KW - Surgery

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