For a study, the researchers aimed to examine the impact of admission status on patient outcomes and healthcare costs in anterior cervical discectomy and fusion (ACDF). Patients who underwent ACDF at a single institution were placed into elective or non-elective cohorts. Of 708 patients in the final ACDF cohort, 590 underwent an elective procedure, and 118 underwent a non-elective procedure. The non-elective group was younger (53.7 vs 49.5 yr; P=0.0007). Cohorts had similar proportions of private versus public health insurance, elective had increased rates of commercial insurance (39.22% vs 15.25%; P<0.0001), and non-elective had increased rates of managed care (32.77% vs 56.78%; P<0.0001). Operation time came to be longer in non-elective patients (158 vs 177 minutes; P=0.01). Adjusted analysis also demonstrated that admission status independently affected cost ($6,877, 95% CI: $4,906–$8,848; P<0.0001) and length of stay (LOS) (+4.9 days, 95% CI: 3.9–6.0; P<0.0001) for the non-elective cohort. The non-elective cohort was significantly more likely to return to the operating room (OR: 3.39; 95% CI: 1.37–8.36, P=0.0008) and experience non-home discharge (OR:10.95; 95% CI: 5.00–24.02, P<0.0001). Patients who underwent ACDF non-electively reported increased cost of care and longer LOS, as well as higher rates of postoperative adverse outcomes.
