PDF(Pubmed)
Abstract：
UNASSIGNED: Spinal Infection (SI) is associated with various comorbidities. The interaction of these comorbidities and their impact on costs and complexity of care has not been fully assessed.
UNASSIGNED: This is a retrospective cohort study of SI patients in an urban hospital system to characterize comorbidities and outcomes in adult patients with SI. Adult patients in our hospital system who were hospitalized with an initial diagnosis of SI between July 1, 2017 and June 30, 2019 were included. Outcomes measures included length of stay (LOS) of the index hospitalization for SI, charges and payments for the index hospitalization, and hospital readmissions within one year after discharge from the index hospitalization. Data was obtained by querying our Electronic Data Warehouse (EDW) using ICD-10-CM and CPT procedure codes. Spearman\'s correlation was used to summarize the relationships between LOS, charges, and payments. Multivariable linear regression was used to evaluate associations of demographics, comorbidities, and other factors with LOS. Multivariable Cox regression was used to evaluate associations of demographics, comorbidities, and other factors with hospital readmissions.
UNASSIGNED: 403 patients with a first diagnosis of SI were identified. The average number of comorbidities per patient was 1.3. 294 (73%) had at least 1 medical comorbidity, and 54 (13%) had 3 or more comorbidities. The most common medical comorbidities were diabetes mellitus (26%), intravenous drug use (IVDU, 26%), and malnutrition (20%). 112 patients (28%) had a surgical site infection (SSI). DM (p<.001) and SSI (p=.016) were more common among older patients while IVDU was more common among younger patients (p<.001). Median LOS was 12 days. A larger number of medical comorbidities was associated with a longer LOS (p<.001) while the presence of a SSI was associated with a shorter LOS (p=.007) after multivariable adjustment. LOS was positively correlated with both charges (r=0.83) and payments (r=0.61). Among 389 patients discharged after the index hospitalization, 36% had a readmission within 1 year. The rate of readmission was twice as high for patients with three or more comorbidities than patients with zero comorbidities (hazard ratio: 1.95, p=.017).
UNASSIGNED: Patients with SI often have multiple comorbidities, and the specific type of comorbidity is associated with the patient\'s age. The presence of multiple comorbidities correlates with initial LOS, cost of care, and readmission rate. Readmission in the first year post-discharge is high.
UNASSIGNED: This is a retrospective cohort study of SI patients in an urban hospital system to characterize comorbidities and outcomes in adult patients with SI. Adult patients in our hospital system who were hospitalized with an initial diagnosis of SI between July 1, 2017 and June 30, 2019 were included. Outcomes measures included length of stay (LOS) of the index hospitalization for SI, charges and payments for the index hospitalization, and hospital readmissions within one year after discharge from the index hospitalization. Data was obtained by querying our Electronic Data Warehouse (EDW) using ICD-10-CM and CPT procedure codes. Spearman\'s correlation was used to summarize the relationships between LOS, charges, and payments. Multivariable linear regression was used to evaluate associations of demographics, comorbidities, and other factors with LOS. Multivariable Cox regression was used to evaluate associations of demographics, comorbidities, and other factors with hospital readmissions.
UNASSIGNED: 403 patients with a first diagnosis of SI were identified. The average number of comorbidities per patient was 1.3. 294 (73%) had at least 1 medical comorbidity, and 54 (13%) had 3 or more comorbidities. The most common medical comorbidities were diabetes mellitus (26%), intravenous drug use (IVDU, 26%), and malnutrition (20%). 112 patients (28%) had a surgical site infection (SSI). DM (p<.001) and SSI (p=.016) were more common among older patients while IVDU was more common among younger patients (p<.001). Median LOS was 12 days. A larger number of medical comorbidities was associated with a longer LOS (p<.001) while the presence of a SSI was associated with a shorter LOS (p=.007) after multivariable adjustment. LOS was positively correlated with both charges (r=0.83) and payments (r=0.61). Among 389 patients discharged after the index hospitalization, 36% had a readmission within 1 year. The rate of readmission was twice as high for patients with three or more comorbidities than patients with zero comorbidities (hazard ratio: 1.95, p=.017).
UNASSIGNED: Patients with SI often have multiple comorbidities, and the specific type of comorbidity is associated with the patient\'s age. The presence of multiple comorbidities correlates with initial LOS, cost of care, and readmission rate. Readmission in the first year post-discharge is high.
摘要：
■脊柱感染（SI）与各种合并症有关。这些合并症的相互作用及其对护理成本和复杂性的影响尚未得到充分评估。
■这是一项针对城市医院系统中SI患者的回顾性队列研究，旨在描述成年SI患者的合并症和结局。纳入我们医院系统中在2017年7月1日至2019年6月30日期间初次诊断为SI住院的成年患者。结果指标包括SI指数住院的住院时间（LOS），索引住院的费用和付款，出院后一年内再入院。数据是通过使用ICD-10-CM和CPT程序代码查询我们的电子数据仓库（EDW）获得的。斯皮尔曼的相关性被用来总结LOS之间的关系，charges,和付款。多变量线性回归用于评估人口统计学的关联，合并症,以及LOS的其他因素。多变量Cox回归用于评估人口统计学的关联，合并症,和其他因素与医院再入院。
■确定了403例首次诊断为SI的患者。每位患者的平均合并症数为1.3。294（73%）有至少1种医疗合并症，54例(13%)有3例或3例以上合并症。最常见的合并症是糖尿病（26%），静脉注射药物使用(IVDU，26%），营养不良（20%）。112例患者（28%）有手术部位感染（SSI）。DM（p<.001）和SSI（p=.016）在老年患者中更常见，而IVDU在年轻患者中更常见（p<.001）。LOS中位数为12天。在多变量调整后，更多的医疗合并症与更长的LOS（p<.001）相关，而SSI的存在与更短的LOS（p=.007）相关。LOS与费用（r=0.83）和付款（r=0.61）均呈正相关。在389名患者住院后出院,36%的人在1年内再次入院。三种或三种以上合并症患者的再入院率是零合并症患者的两倍（风险比：1.95，p=0.017）。
■SI患者通常有多种合并症，合并症的具体类型与患者的年龄有关。多种合并症的存在与初始LOS相关，护理费用，和再入院率。出院后第一年的再入院率很高。
■这是一项针对城市医院系统中SI患者的回顾性队列研究，旨在描述成年SI患者的合并症和结局。纳入我们医院系统中在2017年7月1日至2019年6月30日期间初次诊断为SI住院的成年患者。结果指标包括SI指数住院的住院时间（LOS），索引住院的费用和付款，出院后一年内再入院。数据是通过使用ICD-10-CM和CPT程序代码查询我们的电子数据仓库（EDW）获得的。斯皮尔曼的相关性被用来总结LOS之间的关系，charges,和付款。多变量线性回归用于评估人口统计学的关联，合并症,以及LOS的其他因素。多变量Cox回归用于评估人口统计学的关联，合并症,和其他因素与医院再入院。
■确定了403例首次诊断为SI的患者。每位患者的平均合并症数为1.3。294（73%）有至少1种医疗合并症，54例(13%)有3例或3例以上合并症。最常见的合并症是糖尿病（26%），静脉注射药物使用(IVDU，26%），营养不良（20%）。112例患者（28%）有手术部位感染（SSI）。DM（p<.001）和SSI（p=.016）在老年患者中更常见，而IVDU在年轻患者中更常见（p<.001）。LOS中位数为12天。在多变量调整后，更多的医疗合并症与更长的LOS（p<.001）相关，而SSI的存在与更短的LOS（p=.007）相关。LOS与费用（r=0.83）和付款（r=0.61）均呈正相关。在389名患者住院后出院,36%的人在1年内再次入院。三种或三种以上合并症患者的再入院率是零合并症患者的两倍（风险比：1.95，p=0.017）。
■SI患者通常有多种合并症，合并症的具体类型与患者的年龄有关。多种合并症的存在与初始LOS相关，护理费用，和再入院率。出院后第一年的再入院率很高。
