Trends in Hospital Readmission Among CSM Patients Undergoing PCDF

Introduction: Patients with cervical spondylotic myelopathy (CSM) who experience pain or neurological deficit undergo posterior cervical decompression and fusion (PCDF). Unfortunately, many may require readmission after initial hospitalization due to either individual factors or hospital events. The aim of this study was to assess the patient- and hospital-level factors that contribute to 7-, 30-, and 90-day readmissions after treatment of CSM.

Methods: A retrospective cohort study was performed using the 2016–2019 Nationwide Readmissions Database (NRD). All adult patients undergoing PCDF for CSM were identified via ICD-10 coding. Patients were stratified into 3 cohorts: no readmission, readmission within 7 days, within 8-30 days, or within 31-90 days. Patient demographic information, comorbidities, and adverse events were collected.

Results: Of the 9053 patients included, 333 were readmitted within 7 days, 321 within 30, 340 within 90, and 8059 who were not readmitted. The patients readmitted within 7 days were significantly older than the rest of the patients (p < 0.001), while patients readmitted within 7 or 90 days had the highest number of comorbidities compared to those in the 30-day or no readmission cohorts (p < 0.001). The 30-day readmission cohort had the longest mean LOS (p < 0.001), followed by 90-day, 7-day, and no readmit cohorts. Sepsis was the leading cause of readmission at 30 and 90 days but not at 7 days (p < 0.001).

Conclusion : Our study found that for CSM patients who underwent PCDF, the drivers of readmission for 30- and 90-day readmissions included sepsis, especially for those with non-routine discharge dispositions. Further studies are needed to understand how to decrease likelihood for readmission.