Predictors of complications and readmission following spinal stereotactic radiosurgery.

AIM: to identify preoperative factors associated with morbidity/mortality, hospital length of stay (LOS), 30-day readmission and operation rates following spinal stereotactic radiosurgery (SRS) for spinal tumors.

METHODS: The American College of Surgeons National Quality Improvement Program was queried from 2012 to 2014 to identify patients undergoing SRS for spinal tumors. Logistic regression was performed to identify predictors.

RESULTS: 2714 patients were identified; 6.8% had major morbidity or mortality, 6.9% were readmitted within 30 days and 4.3% had a subsequent operation within 30 days. Age, BMI and American Society of Anesthesiologist (ASA) class were predictive of LOS. Major morbidity was predicted by age >80, BMI >35, high ASA, pretreatment functional dependence and baseline comorbidities. Predictors of operation within 30 days included preoperative steroid use, renal failure, BMI >35 and if the treatment was nonelective.

DISCUSSION: 4-7% of patients undergoing SRS for spinal tumors have morbidity following the procedure. Factors predictive of morbidity, LOS, and subsequent operation included age, BMI, baseline comorbidities and functional status.

CONCLUSION: Identification of preoperative patient-specific factors that are predictive of post-treatment outcome will aid in patient selection and patient counseling leading to greater patient satisfaction and hospital efficiency.