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- Title
Safety of Same-Day Discharge Posterior Lumbar Decompression and/or Discectomy: An Observational Study Using Administrative Data From England.
- Authors
Gray, William K.; Day, Jamie; Briggs, Tim W. R.; Hutton, Mike
- Abstract
Study design: Retrospective cohort study. Objectives: Same-day discharge is widely used in many surgical specialities. If carefully planned, it can improve patient outcomes whilst using resources efficiently. We aimed to investigate the safety of same-day discharge following a posterior lumbar decompression and/or discectomy (PLDD). Methods: This was a retrospective analysis of administrative data. We 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 19-54 years during the index stay were included. The primary exposure variable was same-day discharge or post-surgery overnight stay and the primary outcome was emergency hospital readmission within 90 days post-discharge. Results: Data were available for 45,814 PLDD performed across 103 hospital trusts of which 7914 (17.3%) were performed as same-day discharge. Same-day discharge rates varied from 87.7% to 0% across the 90 hospital trusts that operated on more than 50 patients during the study period. Fourteen (15.6%) trusts had same-day discharge rates above 30% and 57 (63.3%) trusts had same-day discharge rates below 10%. The odds of emergency hospital readmission within 90 days were lower for same-day discharge patients (odds ratio.72 (95% confidence interval.61 to.85). There was no difference in outcomes for patients seen at trusts with a same-day discharge rate of ≥30% compared to trusts with a same-day discharge rate of ≤10%. Conclusions: Same-day discharge low-complexity elective PLDD is safe in adult patients below the age of 55 years. There is potential for many providers to substantially increase their rates of same-day discharge.
- Subjects
ENGLAND; DISCECTOMY; PATIENT readmissions; NUMERIC databases; SCIENTIFIC observation; HOSPITAL emergency services; HOSPITAL statistics
- Publication
Global Spine Journal, 2024, Vol 14, Issue 3, p978
- ISSN
2192-5682
- Publication type
Article
- DOI
10.1177/21925682221131764