title: Predictors of discharge to an inpatient rehabilitation facility after a single-level posterior spinal fusion procedure.
abstract: To determine perioperative characteristics of patients undergoing single-level spinal fusion surgery that could help predict discharge to an inpatient rehabilitation facility (IRF).
  
  
  
  Demographic, peri- and postoperative characteristics were reviewed for 107 patients who underwent single-level spinal fusion surgery at a high-volume level I trauma center between January 2011 and December 2013. The relationships between discharge to IRF and gender, age, body mass index (BMI), Charlson Comorbidity Index (CCI), insurance provider, length of stay (LOS), intra- and postoperative outcomes and readmission rates in patients undergoing single-level spinal fusion surgery were analyzed using unpaired and paired t testing.
  
  
  
  21.5 % (n = 23) of patients were discharged to an IRF. By using unpaired and paired t tests, it was determined that age, BMI, CCI, LOS and insurance provider were all correlated with a higher probability of being discharged to an IRF. Additionally, a logistic regression model demonstrated a correlation between lower CCI and discharge to an IRF.
  
  
  
  Statistically significant differences were seen regarding age, BMI, CCI, LOS and insurance provider when determining the necessity of a patient being discharged to an IRF. These characteristics can be used to begin the process of setting up discharge disposition preoperatively rather than postoperatively. There were no perioperative characteristics that were statistically significant in determining discharge disposition; therefore, physicians can utilize these preoperative demographics in deciding and organizing discharge before the day of surgery, which can diminish LOS and lead to substantial health system savings.
authors.affiliation: Division of Spine, Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Niedermeier
authors.affiliation: Division of Spine, Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
authors.forename: Ryle
authors.initials: R
authors.lastname: Przybylowicz
authors.affiliation: Division of Spine, Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
authors.forename: Sohrab S
authors.initials: SS
authors.lastname: Virk
authors.affiliation: Division of Spine, Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
authors.forename: Kari
authors.initials: K
authors.lastname: Stammen
authors.affiliation: Division of Trauma, Critical Care, and Burn, Department of Surgery, Wexner Medical Center, The Ohio State University, 395 West 12th Avenue, Columbus, OH, 43210, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: S Eiferman
authors.affiliation: Division of Spine, Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, OH, USA. Safdar.Khan@osumc.edu.|Department of Integrated Systems Engineering Clinical Faculty, Spine Research Institute, The Ohio State University, 725 Prior Hall, Columbus, OH, 43210, USA. Safdar.Khan@osumc.edu.
authors.forename: Safdar N
authors.initials: SN
authors.lastname: Khan
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D013122:Spinal Diseases / Q000453:epidemiology / Q000601:surgery; D013123:Spinal Fusion / Q000706:statistics & numerical data*
keywords: Discharge; Disposition; Inpatient extended-care facility; Spinal fusion