The definition of 'outpatient' ACDF and lumbar discectomy procedures can be misleading: 5 insights

Written by Shayna Korol | February 13, 2018 | Print  |

A retrospective study in Clinical Spine Surgery found that "outpatient" anterior cervical discectomy and fusion and lumbar discectomy procedures often did not correlate with same day discharge.

Here are five things to know:

1. While there has been an overall shift towards performing ACDF and lumbar discectomy in the outpatient setting, the distinction between inpatient and outpatient procedures is not always clear because of the possibility of patients staying overnight or longer at the hospital under "observation" status.

2. The study authors identified 45,204 patients who underwent ACDF or lumbar discectomy from 2005 to 2014 in the American College of Surgeons National Surgical Quality Improvement Program database. Outpatient procedures were defined as those termed "outpatient" or with a hospital length of stay of zero days. Differences in the definitions were assessed.

3. Of the 4,123 "outpatient" ACDF patients, only 919 had a length of stay of zero, while 3,204 had a length of stay greater than zero. Of the 13,210 "inpatient" ACDF patients, 337 had a length of stay of zero, whereas 12,873 had a length of stay greater than zero.

4. Of the 15,166 "outpatient" lumbar discectomy patients, 8,968 had a length of stay of zero, whereas 6,198 had a length of stay greater than zero. Of the 12,705 "inpatient" lumbar discectomy patients, 814 had a length of stay of zero, while 11,891 had a length of stay greater than zero.

5. There were differences in adverse outcome risks based on the definition of outpatient status used.

 More articles on outpatient spine surgery:

Inpatient vs. outpatient spinal fusions: 5 findings on complication rates

7 outpatient spine stories — Feb. 12

5 reasons outpatient spine & orthopedic centers should partner

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