Complications, reoperations, readmissions, and length of hospital stay in 34 639 surgical cases of lumbar disc herniation

Author:

Fjeld O. R.123,Grøvle L.4,Helgeland J.5,Småstuen M. C.16,Solberg T. K.789,Zwart J-A.310,Grotle M.16

Affiliation:

1. Research and Communication Unit for Musculoskeletal Health, Oslo University Hospital, Oslo, Norway.

2. Department of Neurology, Oslo University Hospital, Oslo, Norway.

3. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway.

4. Department of Rheumatology, Østfold Hospital Trust, Grålum, Norway.

5. Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway.

6. Faculty of Health Science, OsloMet – Oslo Metropolitan University, Oslo, Norway.

7. Department of Neurosurgery, University Hospital of Northern Norway, Tromsø, Norway.

8. Institute of Clinical Medicine, The Arctic University (UiT) of Norway, Tromsø, Norway.

9. Norwegian Registry for Spine Surgery (NORspine), University Hospital of Northern Norway, Tromsø, Norway.

10. Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.

Abstract

Aims The aims of this study were to determine the rates of surgical complications, reoperations, and readmissions following herniated lumbar disc surgery, and to investigate the impact of sociodemographic factors and comorbidity on the rate of such unfavourable events. Patients and Methods This was a longitudinal observation study. Data from herniated lumbar disc operations were retrieved from a large medical database using a combination of procedure and diagnosis codes from all public hospitals in Norway from 1999 to 2013. The impact of age, gender, geographical affiliation, education, civil status, income, and comorbidity on unfavourable events were analyzed by logistic regression. Results Of 34 639 operations, 2.7% (95% confidence interval (CI) 2.6 to 2.9) had a surgical complication, 2.1% (95% CI 2.0 to 2.3) had repeat surgery within 90 days, 2.4% (95% CI 2.2 to 2.5) had a non-surgical readmission within 90 days, and 6.7% (95% CI 6.4 to 6.9) experienced at least one of these unfavourable events. Unfavourable events were found to be associated with advanced age and comorbidity. Conclusion The results suggest that surgical complications are less frequent than previously suggested. There are limited associations between sociodemographic patient characteristics and unfavourable events. Cite this article: Bone Joint J 2019;101-B:470–477.

Publisher

British Editorial Society of Bone & Joint Surgery

Subject

Orthopedics and Sports Medicine,Surgery

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