Preoperative predictors of increased hospital costs in elective anterior cervical fusions: a single-institution analysis of 1,082 patients.
BACKGROUND CONTEXT
The frequency of anterior cervical fusion (ACF) surgery and total hospital costs in spine surgery have substantially increased in the last several years.


PURPOSE
To determine which patient comorbidities are associated with increased total hospital costs after elective one- or two-level ACFs.


STUDY DESIGN/SETTING
Retrospective cohort analysis.


PATIENT SAMPLE
Individuals who have undergone elective one- or two-level ACFs at our single institution. The total number of patients amounted to 1,082.


OUTCOME MEASURES
Total hospital costs during single admission.


METHODS
Multivariate linear regression models were used to analyze independent effects of preoperative patient characteristics on total hospital costs. Univariate analysis was used to examine association of these characteristics on operative time, length of hospital stay (LOS), and complications.


RESULTS
Age, obesity, and diabetes were independently associated with increased average hospital costs of $1,404 (95% confidence interval [CI], $857-$1,951; p<.001), $681 (95% CI, $285-$1,076; p=.001), and $1,877 (95% CI, $726-$3,072; p=.001), respectively. Age was associated with increased LOS (p<.001) and complications (p<.001) but not operative time (p=.431). Diabetes was associated with increased LOS (p<.001) and complications (p=.042) but not operative time (p=.234). Obesity was not associated with increased LOS (p=.164), complications (p=.890), or operative time (p=.067).


CONCLUSIONS
This study highlights the patient comorbidities associated with increased hospital costs after one- or two-level ACFs and the potential drivers of these costs.
['Minhas|Shobhit V|SV|', 'Chow|Ian|I|', 'Jenkins|Tyler J|TJ|', 'Dhingra|Brian|B|', 'Patel|Alpesh A|AA|']
D000328:Adult D000368:Aged D002574:Cervical Vertebrae D017558:Elective Surgical Procedures D005260:Female D017721:Hospital Costs D006801:Humans D008297:Male D008875:Middle Aged D013123:Spinal Fusion
Hospital costs ACF Comorbidities Operation time Complications Cervical spine Length of stay