More Complications for Inpatient Lumbar Discectomy
(HealthDay News) – Patients undergoing inpatient lumbar discectomy have significantly higher overall complication rates than those treated as outpatients, according to a study published in the Feb. 1 issue of Spine.
Andrew J. Pugely, MD, from the University of Iowa in Iowa City, and colleagues compared the incidence of complications within 30 days in patients undergoing lumbar discectomy (2005–2010) in the inpatient and outpatient setting. Data were reviewed for 4,310 patients identified from the American College of Surgeons National Surgical Quality Improvement Program database.
The researchers found that 61.7% of patients underwent an inpatient hospital stay after surgery and 38.3% had outpatient surgery. Those undergoing inpatient surgeries had significantly higher unadjusted overall complication rates (6.5% vs. 3.5%). The complication rate remained significantly higher even after propensity score matching (5.4% vs. 3.5%; P = 0.0068) and in multivariate logistic regression (odds ratio, 1.52). Independent risk factors for short-term complication after lumbar discectomy included age, diabetes, presence of preoperative wound infection, blood transfusion, operative time, and an inpatient hospital stay.
"After adjusting for confounders using propensity score matching and multivariate logistic regression analysis, patients undergoing outpatient lumbar discectomy had lower overall complication rates than those treated as inpatients," the authors write. "Surgeons should consider outpatient surgery for lumbar discectomy in appropriate candidates."