Predictive Modeling of Length of Hospital Stay Following Adult Spinal Deformity Correction: Analysis of 653 Patients with an Accuracy of 75% within 2 Days.

Safaee, Michael M

Scheer, Justin K

Ailon, Tamir

Smith, Justin S

Hart, Robert A

Burton, Douglas C

Bess, Shay

Neuman, Brian J

Passias, Peter G

Miller, Emily

Shaffrey, Christopher I

Schwab, Frank

Lafage, Virginie

Klineberg, Eric O

Ames, Christopher P

International Spine Study Group

2018-10-05T16:39:20Z

2018-10-05T16:39:20Z

2018-07

2018-10-05T16:39:19Z

Length of stay (LOS) after surgery for adult spinal deformity (ASD) is a critical period that allows for optimal recovery. Predictive models that estimate LOS allow for stratification of high-risk patients.A prospectively acquired multicenter database of patients with ASD was used. Patients with staged surgery or LOS >30 days were excluded. Univariable predictor importance ≥0.90, redundancy, and collinearity testing were used to identify variables for model building. A generalized linear model was constructed using a training dataset developed from a bootstrap sample; patients not randomly selected for the bootstrap sample were selected to the training dataset. LOS predictions were compared with actual LOS to calculate an accuracy percentage.Inclusion criteria were met by 653 patients. The mean LOS was 7.9 ± 4.1 days (median 7 days; range, 1-28 days). Following bootstrapping, 893 patients were modeled (653 in the training model and 240 in the testing model). Linear correlations for the training and testing datasets were 0.632 and 0.507, respectively. The prediction accuracy within 2 days of actual LOS was 75.4%.Our model successfully predicted LOS after ASD surgery with an accuracy of 75% within 2 days. Factors relating to actual LOS, such as rehabilitation bed availability and social support resources, are not captured in large prospective datasets. Predictive analytics will play an increasing role in the future of ASD surgery, and future models will seek to improve the accuracy of these tools.

S1878-8750(18)30780-0

1878-8750

1878-8769

https://hdl.handle.net/10161/17582

eng

Elsevier BV

World neurosurgery

10.1016/j.wneu.2018.04.064

International Spine Study Group

Spinal Cord

Humans

Length of Stay

Neurosurgical Procedures

Retrospective Studies

Prospective Studies

Predictive Value of Tests

Adolescent

Adult

Aged

Aged, 80 and over

Middle Aged

Female

Male

Young Adult

Predictive Modeling of Length of Hospital Stay Following Adult Spinal Deformity Correction: Analysis of 653 Patients with an Accuracy of 75% within 2 Days.

Journal article

Passias, Peter G|0000-0002-1479-4070|0000-0003-2635-2226

Shaffrey, Christopher I|0000-0001-9760-8386

e422

e427

School of Medicine

Duke

Orthopaedics

Clinical Science Departments

Published

115