PMID- 37085322 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230510 IS - 2211-4599 (Print) IS - 2211-4599 (Electronic) IS - 2211-4599 (Linking) VI - 17 IP - 2 DP - 2023 Apr TI - Impact of Postoperative Length of Stay on Patient-Reported and Clinical Outcomes After Anterior Lumbar Interbody Fusion. PG - 205-214 LID - 10.14444/8414 [doi] AB - BACKGROUND: Existing literature has not yet evaluated the impact of postoperative length of stay (LOS) on patient-reported outcome measures (PROMs) and minimum clinically important difference (MCID) in patients undergoing anterior lumbar interbody fusion (ALIF). The authors investigates the influence of postoperative LOS following ALIF on PROMs and MCID achievement rates. METHODS: A single-surgeon database was retrospectively reviewed for patients undergoing single-level ALIF. The following 2 cohorts were studied: patients with LOS <45 hours and patients with LOS >/=45 hours. The following PROMs were recorded at preoperative and 6-week, 12-week, 6-month, 1-year, and 2-year postoperative timepoints: visual analog scale (VAS) back and leg, Oswestry Disability Index (ODI), 12-item short form (SF-12) physical composite score (PCS), and patient-reported outcome measurement information system physical function. MCID achievement was compared by LOS grouping using chi (2) analysis. The rates of complications by LOS grouping and the relative risk among demographic and perioperative characteristics for a longer hospital stay of >/=45 hours were calculated. RESULTS: A total of 52 subjects were included in each cohort. LOS >/=45 hours demonstrated worse ODI at 6 weeks and SF-12 PCS preoperative and at 12 weeks (P /=7 (P = 0.012), and American Society of Anesthesiologists classification >/=2 (P = 0.003) served as preoperative risk factors for postoperative stay >/=45 hours. CONCLUSION: Following single-level ALIF, patients with shorter LOS demonstrated significantly greater overall MCID achievement for most PROMs. POUR, fever, and total complications were associated with longer LOS and greater blood loss. Diabetes and higher preoperative leg pain were identified as risk factors for longer LOS. CLINICAL RELEVANCE: Patients undergoing ALIF with shorter LOS had greater MCID achievement for disability, physical function, and leg pain outcomes. Patients with greater preoperative leg pain and diabetes may be at risk for longer LOS. CI - This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright (c) 2023 ISASS. To see more or order reprints or permissions, see http://ijssurgery.com. FAU - Patel, Madhav R AU - Patel MR AD - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA. FAU - Jacob, Kevin C AU - Jacob KC AD - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA. FAU - Chavez, Frank A AU - Chavez FA AD - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA. FAU - Parsons, Alexander W AU - Parsons AW AD - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA. FAU - Seetharaman, Meenakshi AU - Seetharaman M AD - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA. FAU - Pawlowski, Hanna AU - Pawlowski H AD - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA. FAU - Prabhu, Michael C AU - Prabhu MC AD - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA. FAU - Vanjani, Nisheka N AU - Vanjani NN AD - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA. FAU - Singh, Kern AU - Singh K AD - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA kern.singh@rushortho.com. LA - eng PT - Journal Article DEP - 20221213 PL - Netherlands TA - Int J Spine Surg JT - International journal of spine surgery JID - 101579005 PMC - PMC10165643 OTO - NOTNLM OT - ALIF OT - MCID OT - PROMs OT - length of stay OT - relative risk COIS- Declaration of Conflicting Interests : Kern Singh discloses that he has received grants or contracts from the Cervical Spine Research Society; royalties or licenses from RTI Surgical, Zimmer Biomet, Stryker, Lippincott Williams & Wilkins, Theime, Jaypee Publishing, and Slack Publishing; consulting fees from K2M and Zimmer Biomet; patents planned, issued, or pending with TDi LLC; and leadership or fiduciary role on Vitals 5 LLC, TDi LLC, Minimally Invasive Spine Study Group, Contemporary Spine Surgery, Orthopedics Today, and Vertebral Columns. The remaining authors have nothing to report. EDAT- 2023/04/22 10:42 MHDA- 2023/04/22 10:43 PMCR- 2022/12/06 CRDT- 2023/04/21 21:32 PHST- 2023/04/22 10:43 [medline] PHST- 2023/04/22 10:42 [pubmed] PHST- 2023/04/21 21:32 [entrez] PHST- 2022/12/06 00:00 [pmc-release] AID - 8414 [pii] AID - IJSSURGERY-D-21-00442 [pii] AID - 10.14444/8414 [doi] PST - ppublish SO - Int J Spine Surg. 2023 Apr;17(2):205-214. doi: 10.14444/8414. Epub 2022 Dec 13.