title: Predictors of Discharge Destination After Lumbar Spine Fusion Surgery.
abstract: METHODS
  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.
  
  
  BACKGROUND
  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.
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  3.
authors.affiliation: McGill Scoliosis & Spine Centre, McGill University Health Centre, Montreal, Canada.|Department of Orthopedic Surgery, King Fahad Medical City, Riyadh, Saudi Arabia.
authors.forename: Sultan
authors.initials: S
authors.lastname: Aldebeyan
authors.affiliation: McGill Scoliosis & Spine Centre, McGill University Health Centre, Montreal, Canada.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Aoude
authors.affiliation: McGill Scoliosis & Spine Centre, McGill University Health Centre, Montreal, Canada.
authors.forename: Maryse
authors.initials: M
authors.lastname: Fortin
authors.affiliation: McGill Scoliosis & Spine Centre, McGill University Health Centre, Montreal, Canada.|Department of Orthopedic Surgery, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Anas
authors.initials: A
authors.lastname: Nooh
authors.affiliation: McGill Scoliosis & Spine Centre, McGill University Health Centre, Montreal, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Jarzem
authors.affiliation: McGill Scoliosis & Spine Centre, McGill University Health Centre, Montreal, Canada.
authors.forename: Jean
authors.initials: J
authors.lastname: Ouellet
authors.affiliation: McGill Scoliosis & Spine Centre, McGill University Health Centre, Montreal, Canada.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Weber
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011182:Postoperative Care / Q000379:methods*; D011184:Postoperative Period; D058996:Quality Improvement; D012189:Retrospective Studies; D013123:Spinal Fusion