Emergency Department Visits After Elective Spine Surgery

Area of Science:

• Orthopedic Surgery
• Health Services Research
• Patient Outcomes

Background:

• Emergency department (ED) overuse is a significant, often overlooked, post-discharge cost after spine surgery.
• Investigating the reasons for ED visits is crucial for enhancing care value in spine patients.

Purpose of the Study:

• Determine the prevalence, causes, and timing of ED visits after elective spine surgery.
• Identify risk factors associated with post-discharge ED utilization.

Main Methods:

• Prospective longitudinal registry of patients undergoing elective spine surgery for degenerative disease.
• Collection of patient/surgery characteristics, patient-reported outcomes, and self-reported 90-day ED visits.
• Multivariable regression analysis to identify independent risk factors for ED visits; chart review for ED visit reasons and timing.

Main Results:

• A 9.4% 90-day ED visit rate was observed in 2762 patients.
• Pain (70%) and medical concerns (70%) were primary drivers for ED visits within 9 and 7 days post-discharge, respectively.
• Younger age, preoperative opioid use, COPD, and increased vertebral levels involved were independent risk factors for ED visits.

Conclusions:

• Approximately 10% of elective spine surgery patients experience 90-day ED visits without readmission.
• Pain and medical issues within 10 days of discharge constitute 70% of ED visits at the study center.
• Findings offer clinical details and a timeline to guide interventions aimed at preventing unnecessary ED visits post-spine surgery.