The Impact of Weekend Hospital Admission on the Timing of Intervention and Outcomes After Surgery for Spinal Metastases

被引:26
作者
Dasenbrock, Hormuzdiyar H. [2 ]
Pradilla, Gustavo [1 ,2 ,3 ]
Witham, Timothy F. [1 ,2 ,3 ]
Gokaslan, Ziya L. [1 ,2 ,3 ]
Bydon, Ali [1 ,2 ,3 ]
机构
[1] Johns Hopkins Univ, Dept Neurosurg, Baltimore, MD 21287 USA
[2] Johns Hopkins Univ, Sch Med, Baltimore, MD 21287 USA
[3] Johns Hopkins Univ, Spinal Column Biomech & Surg Outcomes Lab, Baltimore, MD 21287 USA
关键词
Early intervention; Nationwide Inpatient Sample; Spinal metastases; Spine surgery; Timing of surgery; Weekend admission; QUALITY-OF-LIFE; NATIONAL INPATIENT COMPLICATIONS; ELEVATION MYOCARDIAL-INFARCTION; CORD COMPRESSION; WEEKDAY ADMISSION; CLINICAL ARTICLE; SURGICAL-TREATMENT; STEREOTACTIC RADIOSURGERY; EPIDURAL COMPRESSION; THORACOLUMBAR SPINE;
D O I
10.1227/NEU.0b013e318232d1ee
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND: Many studies have found that patients admitted on the weekend have inferior outcomes compared with those admitted on a weekday, which may be due partially to decreased availability of procedures. OBJECTIVE: To evaluate the impact of weekend admission on the timing of intervention and outcomes after surgery for metastatic spine disease. METHODS: Data from the Nationwide Inpatient Sample (2005-2008) were retrospectively extracted. Patients were included if they had metastatic disease and underwent spine surgery; elective hospital admissions were excluded. Multivariate logistic regression analyses were conducted to calculate the odds of undergoing early surgery, in-hospital death, and the development of a complication for patients admitted on the weekend compared with those admitted on a weekday. All analyses were adjusted for differences in age, sex, comorbid disease, primary tumor histology, myelopathy, visceral metastases, and expected primary payer, as well as hospital volume, bed size, and teaching status. RESULTS: We evaluated 2714 admissions. Weekend admission was associated with a significantly lower adjusted odds of receiving surgery within 1 day (odds ratio, 0.66, 95% confidence interval, 0.54-0.81; P < .001) and within 2 days (odds ratio, 0.68; 95% confidence interval, 0.56-0.83; P < .001) of admission. The adjusted odds of in-hospital death and developing a postoperative complication were not significantly different for those admitted on the weekend. CONCLUSION: In this nationwide study examining patients with spinal metastases, those admitted on the weekend were significantly less likely to receive early intervention. Future studies are needed to delineate the reasons for differences in the timing of surgery.
引用
收藏
页码:586 / 593
页数:8
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