title: Unplanned hospital readmission after surgical treatment of common lumbar pathologies: rates and causes.
abstract: METHODS
  Retrospective cohort study.
  
  
  OBJECTIVE
  To assess the rate and causes of unplanned readmissions after surgical treatment of common degenerative lumbar pathologies within 90 days.
  
  
  BACKGROUND
  With pay-for performance and bundled payment compensation models being implemented; there is a growing emphasis to decrease the number of unplanned readmissions after surgery. Reports on degenerative lumbar spine pathology readmission rates are often obtained from national databases that lack clinical detail. Less published are the results from single-center institutions.
  
  
  METHODS
  Hospital administrative database from a single-tertiary institution was queried to identify patients who underwent surgery for 6 common lumbar pathologies during a period from 2011 to 2013. All readmissions within 90 days of discharge were reviewed for cause and rate of unplanned readmissions was calculated.
  
  
  RESULTS
  A total of 1306 patients were identified who underwent surgery for various lumbar pathologies during a 2-year time period. There were a total of 70 readmissions captured in the database that included 14 planned, 43 unplanned readmissions, and 13 coding errors. The unplanned readmission rate varied between 2.1% and 7.1% depending on pathology, with an overall rate of 3.3% within 90 days of discharge. Index length of stay, discharge disposition, severity of illness scores, and surgical approach were associated with readmission. The addition of fusion to decompression procedures did not seem to increase readmission rates. Surgical site infections and wound complications were the 2 most common reasons for readmissions accounting for 72% of all readmissions during the 90-day postdischarge period.
  
  
  CONCLUSIONS
  The rate of readmission after surgery for common lumbar degenerative pathologies is relatively low. Surgical site infections and wound complications were the most common cause of readmission in this patient cohort.
  
  
  METHODS
  4.
authors.affiliation: From the Division of Spine Surgery, Hospital for Joint Diseases, New York Langone Medical Center, New York, NY.
authors.forename: Chibuikem
authors.initials: C
authors.lastname: Akamnonu
authors.forename: Thomas
authors.initials: T
authors.lastname: Cheriyan
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Goldstein
authors.forename: Virginie
authors.initials: V
authors.lastname: Lafage
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Errico
authors.forename: John A
authors.initials: JA
authors.lastname: Bendo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects / Q000706:statistics & numerical data; D008159:Lumbar Vertebrae / Q000601:surgery*; D008161:Lumbosacral Region / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects / Q000706:statistics & numerical data; D013530:Surgical Wound Infection / Q000209:etiology