gms | German Medical Science

German Congress of Orthopaedics and Traumatology (DKOU 2021)

26. - 29.10.2021, Berlin

Risk Factors Associated with 90-day Readmissions Following Odontoid Fractures – A Nationwide Readmissions Database Study

Meeting Abstract

  • presenting/speaker Alexander von Glinski - BG-Universitätsklinikum Bergmannsheil Bochum, Chirurgische Klinik und Poliklinik, Bochum, Germany
  • Christopher Elia - Swedish Neuroscience Institute, Seattle, United States
  • Clifford Pierre - Swedish Neuroscience Institute, Seattle, United States
  • Basem Ishak - Universität Heidelberg, Abteilung für Neurochirurgie, Swedish Medical Center, Seattle, United States
  • Jens R. Chapman - Swedish Neuroscience Institute, Seattle, United States
  • Rod Oskouian - Swedish Neuroscience Institute, Seattle, United States

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2021). Berlin, 26.-29.10.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocAB87-1272

doi: 10.3205/21dkou595, urn:nbn:de:0183-21dkou5952

Published: October 26, 2021

© 2021 von Glinski et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives: Hospital readmissions represent a large financial burden upon our healthcare system. Management of odontoid fractures, which are the most common isolated spine fracture in the elderly, continues to be debated. We used the Nationwide Readmission Database (NRD) to identify readmission rates and factors related to readmission after surgical and non-surgical management of odontoid fractures.

Methods: A retrospective study was performed using the 2016 Healthcare Utilization Project (HCUP) NRD. Demographic information and factors associated with readmission were collected. Readmission rates, complications, length of hospital stay were collected. Patients treated operatively and non-operatively were analyzed regarding risk factors for readmission. Statistical analysis was performed using open source software SciPy (Python v1.3.0) for all analyses.

Results and Conclusion: We identified 2,921 patients who presented with Type II dens fractures from January 1st 2016 to September 30th 2016, 555 of which underwent surgical intervention.The readmission rate in patients who underwent surgery was 16.4% (91/555) and 29.4% (696/2366) in the non-operative group. Hospital costs for readmitted and non-readmitted patients were $353,704 and $174,922, and $197,099 and $80,715 for non-operatively managed patients, respectively. Medicaid and Medicare patients had the highest readmission rate in both groups. Charlson and Elixhauser comorbidity indices were significantly higher in patients who were readmitted (p<0.0001).

We report an overall 90-day readmission rate of 16.4% and 29.4%, in operative and non-operative management of type II odontoid fractures, respectively. In the face of a rising incidence of this fracture in the elderly population, an understanding of the comorbidities and age-related demographics associated with 90-day readmissions following both surgical and non-surgical treatment are critical.