Universität zu Köln

Abboud, Tammam ORCID: 0000-0003-4379-6961, Melich, Patrick, Scheithauer, Simone, Rohde, Veit and Schatlo, Bawarjan ORCID: 0000-0002-9221-0843 (2023). Complications, Length of Hospital Stay, and Cost of Care after Surgery for Pyogenic Spondylodiscitis. J. Neurol. Surg. Part A, 84 (1). S. 52 - 58. NEW YORK: THIEME MEDICAL PUBL INC. ISSN 2193-6323

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Abstract

Background Infectious Spondylodiscitis is a heterogeneous disease usually affecting a fragile patient population with multiple comorbidities. Therefore, surgical and medical complications are important considerations before initiating treatment. Methods This retrospective analysis included data of 218 patients who underwent surgical treatment for pyogenic Spondylodiscitis between 2008 and 2016. Groups were divided into length of hospital stay (LOS) (group I <= 21 days and group II>21 days). Analysis included patient age, gender, Charlson comorbidity index, smoking, obesity, osteoporosis, colonization with multidrug-resistant bacteria, preoperative neurologic deficit, pre- and postoperative inflammation markers (CRP and WBC), duration of surgery, number of operated segments, vertebrectomy, and postoperative medical and surgical complications. The case value for each patient expressed in Euro was retrieved from hospital records and included in the analysis. Results Duration of stay after surgical treatment of Spondylodiscitis was <= 21 days (range: 4-21 days; mean: 16 days) in 41% of patients and >21 days (range: 22-162 days; mean: 41 days) in 59% of the patients. Multivariate analysis showed that both medical complications (odds ratio [OR]: 2.62; 95% confidence interval [CI]: 1.24-5.56; p =0.012) and surgical site infection (OR: 6.04; 95% CI: 2.35-15.51; p <0.001) were independently associated with a long hospital stay. Case values averaged at euro21,667 +/- 1,579 (minimum: euro2,888; maximum: euro203,802) and correlated significantly with the length of hospital stay (Pearson's correlation coefficient: 0.681; p <0.05). The occurrence of a postoperative complication increased the cost of care significantly from euro17,790 to 24,527 on average ( p =0.025). Conclusions This study provides benchmark data for patients treated surgically for Spondylodiscitis. Surgical site infection and medical complications are the main drivers of prolonged hospital stays and cost of care.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Abboud, Tammam UNSPECIFIED orcid.org/0000-0003-4379-6961 UNSPECIFIED Melich, Patrick UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheithauer, Simone UNSPECIFIED UNSPECIFIED UNSPECIFIED Rohde, Veit UNSPECIFIED UNSPECIFIED UNSPECIFIED Schatlo, Bawarjan UNSPECIFIED orcid.org/0000-0002-9221-0843 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-667089
DOI:	10.1055/a-1811-7633
Journal or Publication Title:	J. Neurol. Surg. Part A
Volume:	84
Number:	1
Page Range:	S. 52 - 58
Date:	2023
Publisher:	THIEME MEDICAL PUBL INC
Place of Publication:	NEW YORK
ISSN:	2193-6323
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language VERTEBRAL OSTEOMYELITIS; PEDICLE SCREWS; MANAGEMENT; PLACEMENT; OUTCOMES; SCORE Multiple languages Clinical Neurology; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66708