ArticleJournal of spine surgery (Hong Kong)2019
Risk factors for delay in surgery for patients undergoing elective anterior cervical discectomy and fusion.
Article in Journal of spine surgery (Hong Kong), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Clinical Outcomes Following Cervical Fusion in Patients with Dialysis-Related Spondyloarthropathy: A Systematic Review.Spine surgery and related research · 2026Review
- Dual cutoffs of estrogen receptor positivity define prognostic and predictive subgroups in breast cancer.iScience · 2026Article
- Safety and efficacy of day anterior cervical discectomy and fusion procedure for degenerative cervical spondylosis: a retrospective analysis.BMC musculoskeletal disorders · 2024Article
- Article
- Development of a Machine Learning-Based Prognostic Model for Hormone Receptor-Positive Breast Cancer Using Nine-Gene Expression Signature.World journal of oncology · 2023Article
- Incidence, etiology and time course of delays to adult spinal deformity surgery: a single-center experience.Spine deformity · 2023Article
- Extended length of stay in diabetic octogenarians following revision total hip arthroplasty.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Article
- COVID-19: Moral and Ethical Implications for Orthopaedic Spine Surgeons.Case reports in orthopedics · 2021Article
- Impact of surgical delay on 30-day reoperation rates and length of stay after anterior fixation of odontoid fractures.Journal of craniovertebral junction & spineArticle
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3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAnterior cervical discectomy and fusion (ACDF) is well-tolerated by most patients and commonly necessitates only a short hospital admission. Surgical delay after hospital admission, however, may result in longer hospital stays, consequently increasing hospital resource utilization. The current study evaluates risk factors for surgical delay in patients undergoing elective ACDF.
methodsA retrospective analysis of ACS-NSQIP data from 2006-2015 was performed. Patients undergoing elective ACDF were selected using current procedural terminology (CPT) codes (22251, 22252, 22554). A surgical delay was defined as surgery that occurred one day or later after initial hospital admission. Differences in outcomes between the non-delayed and delayed cohorts were evaluated with univariate analysis. Multivariate logistic regression was performed to identify risk factors for surgical delay.
resultsThere were a total of 771 (2.0%) surgical delays out of 39,371 patients undergoing elective ACDF from 2006-2015. Multivariate analysis found partially dependent functional status (OR 5.88; 95% CI: 4.48-7.71; P<0.001), totally dependent functional status (OR 18.22; 95% CI: 9.60-34.59; P<0.001), ASA class 4 (OR 2.73; 95% CI: 1.70-4.38; P<0.001), bleeding disorders (OR 1.75; 95% CI: 1.08-2.85; P=0.024), male sex (OR 1.19; 95% CI: 1.03-1.38; P=0.019), and chronic steroid use (OR 1.76; 95% CI: 1.30-2.37; P<0.001) as independent predictors of delay. Univariate analysis found surgical delay was associated with a higher rate of post-operative major adverse events (4.8%
conclusionsImpaired pre-operative functional status, a higher comorbidity burden, and chronic steroid use are risk factors for surgical delay, increased complications, and length of stay in patients undergoing elective ACDF. This is helpful information to consider given a rising incidence of cervical fusions in the Medicare population, a wide variation in costs, and increasing popularity of bundled-payment models. LEVEL OF EVIDENCE: 3.
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