The effects of chronic pulmonary disease on hospital length of stay and cost of hospitalization after neurosurgery. Clinical article.

Abstract

Chronic pulmonary diseases (CPDs) are common causes of morbidity. However, their effects on the outcome of the neurosurgical patient population are unknown. In this study, the impact of CPD on length of stay (LOS) and cost of hospitalization (COH) in neurosurgical patients was evaluated. This was a retrospective observational study of all neurosurgical patients at the University of Virginia Health System between 1994 and 2008. Patients were divided into those with CPD (4894) and those without CPD (21,274). Patients were further divided by the types of surgery they underwent: laminectomy, ventriculostomy, and craniotomy. Univariate and multiple linear regression analyses were performed to evaluate the impact of CPD and other comorbidities on LOS and COH. Nearly 20% of patients undergoing neurosurgery had CPD. Univariate analysis showed that patients with CPD had a statistically significant increase in LOS and COH after a neurosurgical procedure. The median adjusted COH for patients with CPD undergoing any neurosurgical procedure was $3706 greater than for patients without CPD. Multivariate analysis identified CPD as an independent determining factor in raising LOS by 0.5 days and COH by $6528 per patient for all neurosurgical procedures. History of congestive heart failure and renal failure were also independent determining factors for LOS after neurosurgery. Neurosurgical patients with CPD had a longer LOS and higher COH than patients without CPD.