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Anterior cervical discectomy, fusion a low-risk outpatient procedure
Study results have shown that single-level anterior cervical discectomy and fusion for outpatient procedures results in low complication rates and holds no more risk than for inpatient procedures.
Researchers retrospectively reviewed the American College of Surgeons National Surgical Quality Improvement Program database to identify cases of single-level anterior cervical discectomy and fusion; 2,914 cases were identified, with 597 having received outpatient treatment and 2,317 having received inpatient treatment. In reviewing the patients’ 30-day morbidity and mortality data, the researchers used univariate and multivariate analyses to identify risk factors for complications. Additionally, matched inpatient and outpatient cohorts were created using a propensity score model.
The researchers found an overall incidence of systemic morbidity of 3.2%. A total of five deaths occurred, with four in the inpatient cohort and one in the outpatient cohort.
Multivariate analysis showed that age older than 65 years, a body mass index of more than 30 kg/m2, American Society of Anesthesiologists class of 3 or 4, current dialysis, current corticosteroid use, recent sepsis and operative times of longer than 120 minutes were independent risk factors for complications. However, no significant differences in complication rates were found between the inpatient and outpatient groups, and outpatient treatment was not found to be a risk factor for complication, according to the researchers.
Disclosure: The authors have no relevant financial disclosures.