Evidence map›Paper›PMID 36708396›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 Society2023

Factors contributing to a longer length of stay in adults admitted to a quaternary spinal care center.

Mathew N Hindi, Charlotte Dandurand, Tamir Ailon, Michael Boyd, Raphaele Charest-Morin, Nicolas Dea, Marcel F Dvorak, Charles Fisher, Brian K Kwon, Scott Paquette and 1 more

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In one paragraph

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, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. 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

11 authors.

Mathew N HindiCombined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, Canada.ORCID 0000-0002-7590-3277
Charlotte DandurandCombined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, Canada.
Tamir AilonCombined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, Canada.
Michael BoydCombined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, Canada.
Raphaele Charest-MorinCombined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, Canada.
Nicolas DeaCombined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, Canada.
Marcel F DvorakCombined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, Canada.
Charles FisherCombined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, Canada.
Brian K KwonCombined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, Canada.
Scott PaquetteCombined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, Canada.
John StreetCombined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, Canada. john.street@vch.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLonger hospital length of stay (LOS) has been associated with worse outcomes and increased resource utilization. However, diagnostic and patient-level factors associated with LOS have not been well studied on a large scale. The goal was to identify patient, surgical and organizational factors associated with longer patient LOS for adult patients at a high-volume quaternary spinal care center.

methodsWe performed a retrospective analysis of 13,493 admissions from January 2006 to December 2019. Factors analyzed included age, sex, admission status (emergent vs scheduled), ASIA grade, operative vs non-operative management, mean blood loss, operative time, and adverse events. Specific adverse events included surgical site infection (SSI), other infection (systemic or UTI), neuropathic pain, delirium, dural tear, pneumonia, and dysphagia. Diagnostic categories included trauma, oncology, deformity, degenerative, and "other". A multivariable linear regression model was fit to log-transformed LOS to determine independent factors associated with patient LOS, with effects expressed as multipliers on mean LOS.

resultsMean LOS for the population (SD) was 15.8 (34.0) days. Factors significantly (p < 0.05) associated with longer LOS were advanced patient age [multiplier on mean LOS 1.011/year (95% CI: 1.007-1.015)], emergency admission [multiplier on mean LOS 1.615 (95% CI: 1.337-1.951)], ASIA grade [multiplier on mean LOS 1.125/grade (95% CI: 1.051-1.205)], operative management [multiplier on mean LOS 1.211 (95% CI: 1.006-1.459)], and the occurrence of one or more AEs [multiplier on mean LOS 2.613 (95% CI: 2.188-3.121)]. Significant AEs included postoperative SSI [multiplier on mean LOS 1.749 (95% CI: 1.250-2.449)], other infections (systemic infections and UTI combined) [multiplier on mean LOS 1.650 (95% CI: 1.359-2.004)], delirium [multiplier on mean LOS 1.404 (95% CI: 1.103-1.787)], and pneumonia [multiplier on mean LOS 1.883 (95% CI: 1.447-2.451)]. Among the diagnostic categories explored, degenerative patients experienced significantly shorter LOS [multiplier on mean LOS 0.672 (95%CI: 0.535-0.844), p < 0.001] compared to non-degenerative categories.

conclusionThis large-scale study taking into account diagnostic categories identified several factors associated with patient LOS. Future interventions should target modifiable factors to minimize LOS and guide hospital resource allocation thereby improving patient outcomes and quality of care and decreasing healthcare-associated costs.

Indexed as

DeliriumSpineAdultHumansLength of StayRetrospective StudiesSurgical Wound InfectionAdverse eventsDiagnosesFactorsLength of stayQuality of careSpine surgery

Identifiers

PMID36708396
PMCPMC9883608

What OpenQuestion holds

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Registered trials

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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.