Medical Student Cooper Medical School of Rowan University
Introduction: Spinal stenosis is a common cause of pain and disability among elderly patients, affecting over 200,000 patients in the U.S. annually. The likelihood of hospital admission and prolonged length of stay (LOS) among patients who suffer from spinal stenosis varies across hospitals and deserves further examination.
Methods: We used the nationwide emergency department sample database (NEDS) between the years of 2015-2019 to evaluate patients who came into the emergency department with a primary diagnosis of spinal stenosis. Using linear regression to adjust for comorbidities, income quartile, insurance, gender, and age, we determined if certain hospital characteristics were associated with differences in LOS.
Results: Between 2015-2019, 190,141 patients presented to the emergency department with a primary diagnosis of spinal stenosis. Of these patients, 86,910 (45.7%), were admitted to the inpatient setting. The mean LOS for admitted patients was 5.6 days (95%CI 5.47-5.74). Patients admitted to level 1 (1.54, 95%CI 1.17-1.92) and level 2 trauma centers (0.58 95%CI 0.27-0.89) had longer LOS than those admitted to non-trauma centers. There was no difference in the LOS between patients admitted to level 3 trauma centers and those at non-trauma centers. Furthermore, patients who went to a metropolitan teaching hospital (0.36 95%CI 0.09-0.62) had longer LOS than those at metropolitan non-teaching hospitals, while patients who went to non-metropolitan hospitals were more likely to have a shorter LOS than those at metropolitan non-teaching hospitals (-0.52 95%CI -0.98- -0.06).
Conclusion : Hospital type is associated with varying LOS among patients with spinal stenosis. These differences may be attributed to the availability of professionals and resources, or severity of the disease which may vary between institutional settings.
