{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T11:15:56Z","timestamp":1791890156576,"version":"4.3.4"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Emergency department visits 90 days after elective spinal surgery are relatively common, with rates ranging from 9% to 29%. Emergency visits are very costly, so their reduction is of importance. This study\u2019s objective was to evaluate the reasons for emergency department visits and determine potentially modifiable risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This study retrospectively reviewed data queried from the Michigan Spine Surgery Improvement Collaborative (MSSIC) registry from July 2020 to November 2021. MSSIC is a multicenter (28-hospital) registry of patients undergoing cervical and lumbar degenerative spinal surgery. Adult patients treated for elective cervical and\/or lumbar spine surgery for degenerative pathology (spondylosis, intervertebral disc disease, low-grade spondylolisthesis) were included. Emergency department visits within 90 days of surgery (outcome measure) were analyzed utilizing univariate and multivariate regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of 16,224 patients, 2024 (12.5%) presented to the emergency department during the study period, most commonly for pain related to spinal surgery (31.5%), abdominal problems (15.8%), and pain unrelated to the spinal surgery (12.8%). On multivariate analysis, age (per 5-year increase) (relative risk [RR] 0.94, 95% CI 0.92\u20130.95), college education (RR 0.82, 95% CI 0.69\u20130.96), private insurance (RR 0.79, 95% CI 0.70\u20130.89), and preoperative ambulation status (RR 0.88, 95% CI 0.79\u20130.97) were associated with decreased emergency visits. Conversely, Black race (RR 1.30, 95% CI 1.13\u20131.51), current diabetes (RR 1.13, 95% CI 1.01\u20131.26), history of deep venous thromboembolism (RR 1.28, 95% CI 1.16\u20131.43), history of depression (RR 1.13, 95% CI 1.03\u20131.25), history of anxiety (RR 1.32, 95% CI 1.19\u20131.46), history of osteoporosis (RR 1.21, 95% CI 1.09\u20131.34), history of chronic obstructive pulmonary disease (RR 1.19, 95% CI 1.06\u20131.34), American Society of Anesthesiologists class &gt; II (RR 1.18, 95% CI 1.08\u20131.29), and length of stay &gt; 3 days (RR 1.29, 95% CI 1.16\u20131.44) were associated with increased emergency visits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The most common reasons for emergency department visits were surgical pain, abdominal dysfunction, and pain unrelated to index spinal surgery. Increased focus on postoperative pain management and bowel regimen can potentially reduce emergency visits. The risks of diabetes, history of osteoporosis, depression, and anxiety are areas for additional preoperative screening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2024.1.spine23842","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T21:54:21Z","timestamp":1709330061000},"page":"751-757","source":"Crossref","is-referenced-by-count":8,"title":["Risk factors of emergency department visits following elective cervical and lumbar surgical procedures: a multi-institution analysis from the Michigan Spine Surgery Improvement Collaborative"],"prefix":"10.3171","volume":"40","author":[{"given":"Oludotun","family":"Ogunsola","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph R.","family":"Linzey","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark M.","family":"Zaki","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Chang","sequence":"additional","affiliation":[{"name":"Henry Ford Health System, Detroit, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lonni R.","family":"Schultz","sequence":"additional","affiliation":[{"name":"Henry Ford Health System, Detroit, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kylie","family":"Springer","sequence":"additional","affiliation":[{"name":"Henry Ford Health System, Detroit, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muwaffak","family":"Abdulhak","sequence":"additional","affiliation":[{"name":"Henry Ford Health System, Detroit, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jad G.","family":"Khalil","sequence":"additional","affiliation":[{"name":"Beaumont Health System, Royal Oak, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason M.","family":"Schwalb","sequence":"additional","affiliation":[{"name":"Henry Ford Health System, Detroit, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilyas","family":"Aleem","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Nerenz","sequence":"additional","affiliation":[{"name":"Henry Ford Health System, Detroit, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguelangelo","family":"Perez-Cruet","sequence":"additional","affiliation":[{"name":"Beaumont Health System, Royal Oak, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Easton","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, William Beaumont Hospital, Troy, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teck M.","family":"Soo","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Ascension Providence Hospital, Michigan State University, College of Human Medicine, Southfield, Michigan; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doris","family":"Tong","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Ascension Providence Hospital, Michigan State University, College of Human Medicine, Southfield, Michigan; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Park","sequence":"additional","affiliation":[{"name":"University of Tennessee & Semmes Murphey Clinic, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"JAMA","first-page":"364","article-title":"Use of hospital-based acute care among patients recently discharged from the hospital","volume":"309","author":"Vashi AA","year":"2013","unstructured":"Vashi AA, Fox JP, Carr BG,  Use of hospital-based acute care among patients recently discharged from the hospital. 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