Emergency Department Use Within 90 Days After Single-Level Posterior Cervical Foraminotomy

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Health Services Research

Background:

• Emergency department (ED) visits after posterior cervical foraminotomy (PCF) are common but understudied.
• Understanding the incidence, timing, predictors, and causes of these visits is crucial for improving patient outcomes.

Purpose of the Study:

• To characterize the incidence, timing, predictive factors, and reasons for ED visits within 90 days following single-level PCF.
• To identify patient characteristics associated with increased risk of ED utilization post-PCF.

Main Methods:

• Analysis of the 2010-2022 M161 PearlDiver database for elective single-level PCFs.
• Exclusion of multilevel procedures, fusions, trauma, infection, or neoplasm indications.
• Multivariate analysis of patient demographics, Elixhauser Comorbidity Index (ECI), insurance, and region to predict ED use.

Main Results:

• 9.09% of 10,588 PCF patients had an ED visit within 90 days, predominantly in the first 4 weeks.
• Predictors of ED visits included younger age, female sex, higher ECI, specific geographic regions, and Medicaid coverage.
• Surgical site-related diagnoses accounted for 69.9% of ED visits in the first 4 weeks, decreasing to 27.1% thereafter.

Conclusions:

• A significant proportion of PCF patients require ED visits post-surgery, highlighting a need for targeted interventions.
• Patient-specific factors and the timing of the visit influence the reasons for ED presentation.
• Proactive healthcare strategies informed by risk factors and visit causes can potentially improve outcomes and reduce healthcare costs.