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Research ArticleArticles

The effect of July admission on inpatient morbidity and mortality after adult spinal deformity surgery

Rafael De la Garza-Ramos, Peter G. Passias, Frank J. Schwab, Virginie Lafage and Daniel M. Sciubba
International Journal of Spine Surgery January 2016, 10 3; DOI: https://doi.org/10.14444/3003
Rafael De la Garza-Ramos
1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
MD
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Peter G. Passias
2Division of Spinal Surgery, NYU Medical Center-Hospital for Joint Diseases, New York City, New York
MD
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Frank J. Schwab
3Spine Surgery, Hospital for Special Surgery, New York City, New York
MD
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Virginie Lafage
3Spine Surgery, Hospital for Special Surgery, New York City, New York
Ph.D
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Daniel M. Sciubba
1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
MD
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  • Fig. 1
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    Fig. 1

    Patient inclusion/exclusion criteria. Following identification of the final cohort, discharge weights were applied, which roughly correspond to a 5-fold multiplication (given that the NIS is a 20% sample database).

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    Fig. 2

    Bar graphs showing rates of overall complications (Top) and major complications (Bottom) stratified by month of admission. These rates were not statistically different between groups.

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    Table 1

    Characteristics of patients who underwent adult spinal deformity surgery in July and other months between 2002 and 2011.

    VariableJulyOther monthsp-value
    Total2,02325,771
    Age (average years)56 ± 1658 ± 150.040
    Age > 65 (%)30.435.00.057
    Female gender (%)76.374.70.468
    Race
    Caucasian (%)91.491.30.933
    African American (%)3.83.5
    Hispanic (%)1.72.2
    Other (%)3.13.0
    Primary payer
    Medicare (%)38.541.70.183
    Medicaid (%)7.24.5
    Private insurance (%)50.250.1
    Other (%)4.13.7
    Elixhauser comorbidity score (average)1.8 ± 1.71.8 ± 1.60.644
    Fusion of 8 or more segments (%)25.420.90.031
    Osteotomy (%)6.77.10.768
    Revision procedures (%)5.04.90.933
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    Table 2

    Outcomes of patients who underwent adult spinal deformity surgery in July and other months between 2002 and 2011.

    VariableJulyOther monthsp-value
    Total2,02325,771
    Length of stay (average days)7.2 ± 5.47.3 ± 7.10.641
    Overall complications (%)43.144.90.468
    Major complications (%)12.912.40.764
    Mortality (%)*0.40.807
    • ↵* NIS does not allow publication of values equal to or less than 10.

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International Journal of Spine Surgery
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1 Jan 2016
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The effect of July admission on inpatient morbidity and mortality after adult spinal deformity surgery
Rafael De la Garza-Ramos, Peter G. Passias, Frank J. Schwab, Virginie Lafage, Daniel M. Sciubba
International Journal of Spine Surgery Jan 2016, 10 3; DOI: 10.14444/3003

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The effect of July admission on inpatient morbidity and mortality after adult spinal deformity surgery
Rafael De la Garza-Ramos, Peter G. Passias, Frank J. Schwab, Virginie Lafage, Daniel M. Sciubba
International Journal of Spine Surgery Jan 2016, 10 3; DOI: 10.14444/3003
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Keywords

  • july effect
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  • mortality
  • Nationwide Inpatient Sample

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