AI Article Synopsis
- The study reviews data from a national database to determine factors that impact whether patients are discharged to their homes after cervical disc replacement (CDR) surgery.
- The analysis involved 7,276 patients from 2011 to 2020 and identified several predictors for nonhome discharge, including older age, Hispanic ethnicity, higher BMI, and longer hospital stays.
- Outpatient surgery settings were found to lower the likelihood of nonhome discharge, providing insights for preoperative planning and improving patient discharge efficiency.
Article Abstract
Study Design: Retrospective review of a national database.
Objective: The aim of this study was to identify the factors that increase the risk of nonhome discharge after CDR.
Summary Of Background Data: As spine surgeons continue to balance increasing surgical volume, identifying variables associated with patient discharge destination can help expedite postoperative placement and reduce unnecessary length of stay. However, no prior study has identified the variables predictive of nonhome patient discharge after cervical disc replacement (CDR).
Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for patients who underwent primary 1-level or 2-level CDR between 2011 and 2020. Multivariable Poisson regression with robust error variance was employed to identify the predictors for nonhome discharge destination following surgery.
Results: A total of 7276 patients were included in this study, of which 94 (1.3%) patients were discharged to a nonhome destination. Multivariable regression revealed older age (OR: 1.076, P <0.001), Hispanic ethnicity (OR: 4.222, P =0.001), BMI (OR: 1.062, P =0.001), ASA class ≥3 (OR: 2.562, P =0.002), length of hospital stay (OR: 1.289, P <0.001), and prolonged operation time (OR: 1.007, P <0.001) as predictors of nonhome discharge after CDR. Outpatient surgery setting was found to be protective against nonhome discharge after CDR (OR: 0.243, P <0.001).
Conclusions: Age, Hispanic ethnicity, BMI, ASA class, prolonged hospital stay, and prolonged operation time are independent predictors of nonhome discharge after CDR. Outpatient surgery setting is protective against nonhome discharge. These findings can be utilized to preoperatively risk stratify expected discharge destination, anticipate patient discharge needs postoperatively, and expedite discharge in these patients to reduce health care costs associated with prolonged length of hospital stay.
Level Of Evidence: IV.
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| http://dx.doi.org/10.1097/BSD.0000000000001604 | DOI Listing |
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