Evidence map›Paper›PMID 31734806›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2020

Non-medical factors significantly influence the length of hospital stay after surgery for degenerative spine disorders.

D Mai, C Brand, D Haschtmann, T Pirvu, T F Fekete, A F Mannion

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Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
  6. Can the Charlson Comorbidity Index be used to predict the ASA grade in patients undergoing spine surgery?European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

D MaiSpine Center, Schulthess Clinic, Lengghalde 2, 8008, Zurich, Switzerland.
C BrandSwissRDL, Institute of Social and Preventive Medicine (ISPM), University of Berne, Mittelstrasse 43, 3012, Bern, Switzerland.
D HaschtmannSpine Center, Schulthess Clinic, Lengghalde 2, 8008, Zurich, Switzerland.
T PirvuSpine Center, Schulthess Clinic, Lengghalde 2, 8008, Zurich, Switzerland.
T F FeketeSpine Center, Schulthess Clinic, Lengghalde 2, 8008, Zurich, Switzerland.
A F MannionSpine Center, Schulthess Clinic, Lengghalde 2, 8008, Zurich, Switzerland. anne@annefmannion.com.ORCID 0000-0002-1203-1096

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUnnecessarily long hospital stays are costly and inefficient. Studies have shown that the length of hospital stay (LOS) for spine surgical procedures is influenced by various disease-related or medical factors, but few have examined the role of socio-demographic/socio-economic (SDE) factors.

methodsThis was a retrospective analysis of data from 10,770 patients (5056 men, 5714 women; 62 ± 15 years) with degenerative spinal disorders, collected prospectively in an in-house database within the framework of EUROSPINE's Spine Tango Registry. Surgeons completed the Tango surgery form (clinical history, demographics, surgical measures, complications), and patients, a baseline Core Outcome Measures Index. Stepwise linear regression analyses examined SDE predictors of LOS, controlling for potential medical/biological factors.

resultsThe mean LOS was 7.9 ± 5.2 days. The final model accounted for 42% of variance in LOS, with SDE variables explaining 13% variance and medical/surgical predictors, 29%. In the final model, the SDE factors age and being female were significant independent predictors of LOS, whereas others were either non-significant (insurance status, being of Swiss nationality, being a smoker) or reached only borderline significance (p < 0.1) (BMI). Controlling for all other SDE and medical/surgical confounders, being female was associated with 1.11-day longer LOS (95% CI 0.96-1.27; p < 0.0001).

conclusionsPatients of advanced age and female gender are at increased risk of longer hospital stay after surgery for degenerative spinal disorders. Further studies should seek to understand the reasoning behind the gender disparity, in order to minimise potentially unnecessary costs of prolonged LOS. Targeted preoperative discharge planning may improve the utilisation of hospital resources. These slides can be retrieved under Electronic Supplementary Material.

Indexed as

Spinal DiseasesAgedFemaleHumansLength of StayMaleMiddle AgedPatient DischargePostoperative ComplicationsRetrospective StudiesRisk FactorsSpineDegenerative disorders of the cervical and thoracic/lumbar spineLength of stayNon-medical predictorsSpine surgery

Identifiers

PMID31734806

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.