Increasing Patient Complexity Is Associated With Longer In-Hospital Lengths of Stay and Higher Rates of Medical Complications Following Primary 1- to 2-Level Lumbar Fusion

Geoffrey W. Cloud; Shreya Jain; Adam M. Gordon; Aaron W. Lam; Andrew R. Horn; Ahmed Saleh; Afshin E. Razi

doi:10.14444/8364

Article Figures & Data

Tables

View popup

Table 1

Demographics of patients undergoing primary 1- to 2-level lumbar fusion with an Elixhauser Comorbidity Index score of 1 to 5 within the Medicare database.

Demographics	n (%)
Age, y
<64	23,040 (21.91%)
65–69	44,660 (42.48%)
70–74	21,160 (20.12%)
75–79	10,760 (10.23%)
80–84	3952 (3.75%)
>85	876 (0.83%)
Unknown	672 (0.63%)
Sex
Women	56,216 (53.47%)
Men	48,232 (45.88%)
Unknown	672 (0.63%)

View popup

Table 2

Comparison of in-hospital length of stay among patients with an ECI score of 1 to 5 undergoing primary 1- to 2-level lumbar fusion within the Medicare database.

Comparison	Mean ± SD		P Value
Comparison	Control Group	Study Group	P Value
ECI 1 vs ECI 2	4.28 ± 4.36	6.00 ± 4.51	<0.001
ECI 1 vs ECI 3	4.28 ± 4.36	6.22 ± 4.67	<0.001
ECI 1 vs ECI 4	4.28 ± 4.36	7.35 ± 5.05	<0.001
ECI 1 vs ECI 5	4.28 ± 4.36	8.99 ± 5.67	<0.001

Abbreviation: ECI, Elixhauser Comorbidity Index.

View popup

Table 3

Comparison of 90-d medical complications of patients with an ECI score of 1 to 5 undergoing primary 1- to 2-level lumbar fusion in the Medicare database.

Comparison	Control Group, %	Study Group, %	OR	95% CI	P Value
ECI 1 vs ECI 2	2.45%	2.85%	1.17	1.05–1.30	0.003
ECI 1 vs ECI 3	2.45%	2.98%	1.22	1.10–1.36	<0.001
ECI 1 vs ECI 4	2.45%	3.10%	1.26	1.13–1.40	<0.001
ECI 1 vs ECI 5	2.45%	2.89%	1.18	1.06–1.31	0.001
Total	9.80%	11.82%	1.22	1.16–1.30	<0.001

Abbreviation: ECI, Elixhauser Comorbidity Index.

View popup

Table 4

Incidence trends of most common medical complication among patients with an ECI score of 1 to 5 undergoing primary 1- to 2-level primary lumbar fusion within the Medicare database.

Medical Complication	Incidence of Medical Complications Based on ECI Score, %					P Value
Medical Complication	ECI 1	ECI 2	ECI 3	ECI 4	ECI 5	P Value
Pneumoniae	0.13%	0.25%	0.24%	0.31%	0.22%	<0.0001
Deep vein thromboses	0.05%	0.06%	0.06%	0.06%	0.11%	<0.0001
Cerebrovascular accidents	0.28%	0.33%	0.40%	0.46%	0.40%	<0.0001
Myocardial infarctions	0.19%	0.24%	0.27%	0.30%	0.32%	<0.0001
Total	0.65%	0.88%	0.97%	1.13%	1.05%	<0.0001