Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Oct 1;41(19):1535-1541.
doi: 10.1097/BRS.0000000000001575.

Predictors of Discharge Destination After Lumbar Spine Fusion Surgery

Sultan Aldebeyan  1   2 , Ahmed Aoude  1 , Maryse Fortin  1 , Anas Nooh  1   3 , Peter Jarzem  1 , Jean Ouellet  1 , Michael H Weber  1
Affiliations

Predictors of Discharge Destination After Lumbar Spine Fusion Surgery

Sultan Aldebeyan et al. Spine (Phila Pa 1976). .

Abstract

Study design: Retrospective cohort study of the prospective collected American College of Surgeons National Surgical Quality Improvement Program database.

Objective: The aim of the study was to identify predictive factors for the need of discharging patients to a facility other than home after lumbar spine fusion surgery.

Summary of background data: Lumbar spine fusion surgery is a common surgical procedure used to treat a variety of lumbar spine conditions. A great number of patients fail to go home after surgery and require admission to a rehabilitation center. Predictive factors for discharging patients to a facility other than home after lumbar fusion surgery do not exist in the literature.

Methods: A total of 15,092 patients undergoing lumbar spine fusion were dichotomized based on discharge destination to patients who were discharged home (N = 12,339) and others who were discharged to a facility other than home (N = 2753). Outcomes included patient demographics, comorbidities, and clinical characteristics. A multivariate logistic regression was used to identify whether outcomes studied were predictive factors for discharging patients to a facility other than home after lumbar fusion surgery.

Results: Majority of patients were discharged home after lumbar fusion surgery (81.76%), with only some discharged to a facility other than home (18.24%). Multivariate analysis identified age, female sex, comorbidities (diabetes, chronic obstructive pulmonary disease, congestive heart failure, hypertension, and obesity), minor and major complications, hospital length of stay, operative time at least 259 minutes, and multilevel surgery as significant predictive factors of discharging patients to a facility other than home after lumbar fusion surgery.

Conclusion: The identified predictive factors can help the health system in developing an algorithm for early recognition of patients requiring postoperative admission to a facility other than home and possibly decreasing their hospital length of stay. This can significantly decrease the hospital costs for such patients.

Level of evidence: 3.

PubMed Disclaimer

References

    1. Weinstein JN, Tosteson TD, Lurie JD, et al. Surgical versus nonsurgical therapy for lumbar spinal stenosis. N Engl J Med 2008; 358:794–810.
    1. Pelton MA, Phillips FM, Singh K. A comparison of perioperative costs and outcomes in patients with and without workers’ compensation claims treated with minimally invasive or open transforaminal lumbar interbody fusion. Spine 2012; 37:1914–1919.
    1. Peng CWB, Yue WM, Poh SY, et al. Clinical and radiological outcomes of minimally invasive versus open transforaminal lumbar interbody fusion. Spine 2009; 34:1385–1389.
    1. Zheng F, Cammisa FP Jr, Sandhu HS, et al. Factors predicting hospital stay, operative time, blood loss, and transfusion in patients undergoing revision posterior lumbar spine decompression, fusion, and segmental instrumentation. Spine 2002; 27:818–824.
    1. Browne JA, Cook C, Pietrobon R, et al. Diabetes and early postoperative outcomes following lumbar fusion. Spine 2007; 32:2214–2219.