Medical Student The Larner College of Medicine at the University of Vermont
Introduction: Symptomatic thoracic disc herniations (TDH) are relatively rare and can be incidentally discovered in neuro-imaging. Surgical interventions for TDH represent only 4% of all surgeries performed for intervertebral disc pathologies, typically indicated for myelopathy and radiculopathy. As there are no publications on rates of readmissions following hospitalization for TDH we aim to establish baseline metrics for the 90-day all-cause readmission rate and pertinent risk factors.
Methods: The 2020 Nationwide Readmission Database was screened for patients with TDH and disc degeneration as their primary diagnosis within the first 9 months of the year for. Demographic information, admission details, clinical data, comorbidities, and surgical treatment were extracted. Patients were divided into two groups by readmission status. A sub analysis was performed by treatment.
Results: Overall, 970 patients met our inclusion criteria. Of these, 183 patients (18.9%) were readmitted within a mean of 34.58 days. The readmission group was significantly older and more likely to have been admitted non-electively. Surgical treatment was associated with a lower readmission rate. Eight comorbidities differed significantly between the groups. Independent risk factors for readmission included non-surgical treatment, Medicare insurance, hypertension, and depression.
Conclusion : We established a 90-day all-cause readmission rate of 18.9% for TDH. There was no difference in readmission based on patients’ neurological presentation. Non-surgical treatment was identified as an independent risk factor for readmission, suggesting that timely surgical interventions may reduce the risk of readmission. Medicare insurance, hypertension and depression were also identified as independent risk factors.
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