title: Preoperative predictors of increased hospital costs in elective anterior cervical fusions: a single-institution analysis of 1,082 patients.
abstract: BACKGROUND
  The frequency of anterior cervical fusion (ACF) surgery and total hospital costs in spine surgery have substantially increased in the last several years.
  
  
  OBJECTIVE
  To determine which patient comorbidities are associated with increased total hospital costs after elective one- or two-level ACFs.
  
  
  METHODS
  Retrospective cohort analysis.
  
  
  METHODS
  Individuals who have undergone elective one- or two-level ACFs at our single institution. The total number of patients amounted to 1,082.
  
  
  METHODS
  Total hospital costs during single admission.
  
  
  METHODS
  Multivariate linear regression models were used to analyze independent effects of preoperative patient characteristics on total hospital costs. Univariate analysis was used to examine association of these characteristics on operative time, length of hospital stay (LOS), and complications.
  
  
  RESULTS
  Age, obesity, and diabetes were independently associated with increased average hospital costs of $1,404 (95% confidence interval [CI], $857-$1,951; p<.001), $681 (95% CI, $285-$1,076; p=.001), and $1,877 (95% CI, $726-$3,072; p=.001), respectively. Age was associated with increased LOS (p<.001) and complications (p<.001) but not operative time (p=.431). Diabetes was associated with increased LOS (p<.001) and complications (p=.042) but not operative time (p=.234). Obesity was not associated with increased LOS (p=.164), complications (p=.890), or operative time (p=.067).
  
  
  CONCLUSIONS
  This study highlights the patient comorbidities associated with increased hospital costs after one- or two-level ACFs and the potential drivers of these costs.
authors.affiliation: Department of Orthopaedic Surgery, Northwestern University, Feinberg School of Medicine, 676 North Saint Clair St, NMH/Arkes Family Pavilion Suite 1350, Chicago, IL 60611, USA.
authors.forename: Shobhit V
authors.initials: SV
authors.lastname: Minhas
authors.affiliation: Department of Orthopaedic Surgery, Northwestern University, Feinberg School of Medicine, 676 North Saint Clair St, NMH/Arkes Family Pavilion Suite 1350, Chicago, IL 60611, USA.
authors.forename: Ian
authors.initials: I
authors.lastname: Chow
authors.affiliation: Department of Orthopaedic Surgery, Northwestern University, Feinberg School of Medicine, 676 North Saint Clair St, NMH/Arkes Family Pavilion Suite 1350, Chicago, IL 60611, USA.
authors.forename: Tyler J
authors.initials: TJ
authors.lastname: Jenkins
authors.affiliation: Department of Orthopaedic Surgery, Northwestern University, Feinberg School of Medicine, 676 North Saint Clair St, NMH/Arkes Family Pavilion Suite 1350, Chicago, IL 60611, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Dhingra
authors.affiliation: Department of Orthopaedic Surgery, Northwestern University, Feinberg School of Medicine, 676 North Saint Clair St, NMH/Arkes Family Pavilion Suite 1350, Chicago, IL 60611, USA. Electronic address: alpesh.patel@nmff.org.
authors.forename: Alpesh A
authors.initials: AA
authors.lastname: Patel
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000191:economics*; D005260:Female; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D013123:Spinal Fusion / Q000009:adverse effects / Q000191:economics*
keywords: ACF; Cervical spine; Comorbidities; Complications; Hospital costs; Length of stay; Operation time