Predictors of complications and readmission following spinal stereotactic radiosurgery. (July 2017)

• Record Type: Journal Article
• Authors: Lubelski, Daniel; Tanenbaum, Joseph E; Purvis, Taylor E; Bomberger, Thomas T; Goodwin, Courtney Rory; Laufer, Ilya; Sciubba, Daniel M
• Is Part Of: CNS oncology. Volume 6:Number 3(2017)
• Page Start: 221
• Page End: 230
• Publication Date: 2017-07
• Subjects: 30 day readmission -- American College of Surgeons National Quality Improvement Program -- major morbidity and mortality -- predictors -- spinal stereotactic radiosurgery -- spinal tumors; Central nervous system -- Tumors -- Periodicals; 616.99481
• DOI: 10.2217/cns-2016-0048
• Languages: English
• ISSNs: 2045-0907

Abstract

Aim: to identify preoperative factors associated with morbidity/mortality, hospital length of stay (LOS), 30-day readmission and operation rates following spinal stereotactic radiosurgery (SRS) for spinal tumors.Methods: The American College of Surgeons National Quality Improvement Program was queried from 2012 to 2014 to identify patients undergoing SRS for spinal tumors. Logistic regression was performed to identify predictors.Results: 2714 patients were identified; 6.8% had major morbidity or mortality, 6.9% were readmitted within 30 days and 4.3% had a subsequent operation within 30 days. Age, BMI and American Society of Anesthesiologist (ASA) class were predictive of LOS. Major morbidity was predicted by age >80, BMI >35, high ASA, pretreatment functional dependence and baseline comorbidities. Predictors of operation within 30 days included preoperative steroid use, renal failure, BMI >35 and if the treatment was nonelective.Discussion: 4–7% of patients undergoing SRS for spinal tumors have morbidity following the procedure. Factors predictive of morbidity, LOS, and subsequent operation included age, BMI, baseline comorbidities and functional status.Conclusion: Identification of preoperative patient-specific factors that are predictive of post-treatment outcome will aid in patient selection and patient counseling leading to greater patient satisfaction and hospital efficiency.