Evidence map›Paper›PMID 38206447›Full record

ArticleArchives of orthopaedic and trauma surgery2024

Factors associated with poorer outcomes for posterior lumbar decompression and or/or discectomy: an exploratory analysis of administrative data.

Johannes Heyl, Flavien Hardy, William K Gray, Katie Tucker, Maria J M Marchã, Jeremy Yates, Tim W R Briggs, Mike Hutton

Abstract read
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Article in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

8 authors.

Johannes HeylDepartment of Physics and Astronomy, University College London, London, UK.
Flavien HardyGetting It Right First Time Programme, NHS England, London, UK.
William K GrayGetting It Right First Time Programme, NHS England, London, UK. William.gray5@nhs.net.ORCID http://orcid.org/0000-0002-9597-5446
Katie TuckerInnovation and Intelligent Automation Unit, Royal Free London NHS Foundation Trust, London, UK.
Maria J M MarchãScience and Technology Facilities Council Distributed Research Utilising Advanced Computing (DiRAC) High Performance Computing Facility, London, UK.
Jeremy YatesScience and Technology Facilities Council Distributed Research Utilising Advanced Computing (DiRAC) High Performance Computing Facility, London, UK.
Tim W R BriggsGetting It Right First Time Programme, NHS England, London, UK.
Mike HuttonGetting It Right First Time Programme, NHS England, London, UK.

Funding

Science and Technology Facilities Council ST/S003916/1Science and Technology Facilities Council ST/W002760/1
6 · The paper itself

Abstract

purposeThis study aimed to identify factors associated with poorer patient outcomes for lumbar decompression and/or discectomy (PLDD).

methodsWe extracted data from the Hospital Episodes Statistics database for the 5 years from 1st April 2014 to 31st March 2019. Patients undergoing an elective one- or two-level PLDD aged ≥ 17 years and without evidence of revision surgery during the index stay were included. The primary patient outcome measure was readmission within 90 days post-discharge.

resultsData for 93,813 PLDDs across 111 hospital trusts were analysed. For the primary outcome, greater age [< 40 years vs 70-79 years odds ratio (OR) 1.28 (95% confidence interval (CI) 1.14 to 1.42), < 40 years vs ≥ 80 years OR 2.01 (95% CI 1.76-2.30)], female sex [OR 1.09 (95% CI 1.02-1.16)], surgery over two spinal levels [OR 1.16 (95% CI 1.06-1.26)] and the comorbidities chronic pulmonary disease, connective tissue disease, liver disease, diabetes, hemi/paraplegia, renal disease and cancer were all associated with emergency readmission within 90 days. Other outcomes studied had a similar pattern of associations.

conclusionsA high-throughput PLDD pathway will not be suitable for all patients. Extra care should be taken for patients aged ≥ 70 years, females, patients undergoing surgery over two spinal levels and those with specific comorbidities or generalised frailty.

Indexed as

AftercarePatient DischargeDecompression, SurgicalDiskectomyFemaleHumansLumbar VertebraeRetrospective StudiesSpineDiscectomyPosterior lumbar decompressionSpinal surgery

Identifiers

PMID38206447

What OpenQuestion holds

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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.