Dysphagia as Measured by EAT-10 Scores Does Not Influence Readmission After Cervical Surgery

Introduction: Postoperative dysphagia is a common adverse outcome of cervical surgery. Despite the frequency of postoperative dysphagia after cervical surgery, there is limited research on readmission rates due to postoperative dysphagia.

Methods: A prospectively collected multi-institutional quality registry was retrospectively reviewed. Patients readmitted within two weeks after cervical spine surgery were compared with non-readmitted patients for various preoperative and postoperative predictors, including Eating Assessment Tool-10 (EAT-10) dysphagia questionnaire scores.

Results: Among 1,989 patients with readmission data, 90 (4.5%) were readmitted within three months of cervical surgery, 19 (1.0%) of which were readmitted for any reason within two weeks. Of these, there were 17 anterior and 2 posterior fusions. Notably, only 2 patients were specifically readmitted for dysphagia (0.1%), both having anterior fusions and being readmitted either two or four days after surgery. Patients readmitted within this timeframe were significantly older (63.8±9.1 vs. 56.8±11.7, p=0.007), had a higher unemployment rate (74% vs. 41%, p=0.004), experienced greater rates of myelopathy (65% vs. 38%, p=0.026), and did not use preoperative opioids (0% vs. 32%, p=0.005) compared to non-readmitted patients. On average, patients readmitted within two weeks were readmitted 5.2±2.9 days after surgery and stayed for 3.8±3.5 days. The most common reason for readmission within two weeks was congestive heart failure, with 8 people being readmitted (0.4%). No significant differences between patients readmitted within two weeks and non-readmitted patients were observed between baseline (2.26±6.78 vs. 1.70±4.85, p=0.3), 1-month (7.42±8.12 vs. 6.34±7.72, p=0.6), 3-month (3.47±5.89 vs. 2.69±5.25, p=0.6), or 12-month (1.92±3.37 vs. 2.57±5.10, p=0.8) EAT-10 scores.

Conclusion : Our results highlight that readmission for dysphagia is rare. The relatively low readmission rate due to postoperative dysphagia suggests it is not a clinically significant factor for hospital readmission within two weeks of cervical spine surgery.