title: Predictors for Patient Discharge Destination After Elective Anterior Cervical Discectomy and Fusion.
abstract: METHODS
  Retrospective study of prospectively collected data.
  
  
  OBJECTIVE
  To identify risk factors for nonhome patient discharge after elective anterior cervical discectomy and fusion (ACDF).
  
  
  BACKGROUND
  ACDF is one of the most performed spinal procedures and this is expected to increase in the coming years. To effectively deal with an increasing patient volume, identifying variables associated with patient discharge destination can expedite placement applications and subsequently reduce hospital length of stay.
  
  
  METHODS
  The 2011 to 2014 ACS-NSQIP database was queried using Current Procedural Terminology (CPT) codes 22551 or 22554. Patients were divided into two cohorts based on discharge destination. Bivariate and multivariate logistic regression analyses were employed to identify predictors for patient discharge destination and extended hospital length of stay.
  
  
  RESULTS
  A total of 14,602 patients met the inclusion criteria for the study of which 498 (3.4%) had nonhome discharge. Multivariate logistic regression found that Hispanic versus Black race/ethnicity (odds ratio, OR =0.21, 0.05-0.91, P =0.037), American Indian or Alaska Native, Asian, Native Hawaiian or Pacific Islander versus Black race/ethnicity (OR = 0.52, 0.34-0.80, p-value = 0.003), White versus Black race/ethnicity (OR = 0.55, 0.42-0.71), elderly age ≥65 years (OR = 3.32, 2.72-4.06), obesity (OR = 0.77, 0.63-0.93, P = 0.008), diabetes (OR = 1.32, 1.06-1.65, P = 0.013), independent versus partially/totally dependent functional status (OR = 0.11, 0.08-0.15), operation time ≥4 hours (OR = 2.46, 1.87-3.25), cardiac comorbidity (OR = 1.38, 1.10-1.72, P = 0.005), and ASA Class ≥3 (OR = 2.57, 2.05-3.20) were predictive factors in patient discharge to a facility other than home. In addition, multivariate logistic regression analysis also found nonhome discharge to be the most predictive variable in prolonged hospital length of stay.
  
  
  CONCLUSIONS
  Several predictive factors were identified in patient discharge to a facility other than home, many being preoperative variables. Identification of these factors can expedite patient discharge applications and potentially can reduce hospital stay, thereby reducing the risk of hospital acquired conditions and minimizing health care costs.
  
  
  METHODS
  3.
authors.affiliation: Department of Orthopedics Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: John
authors.initials: J
authors.lastname: Di Capua
authors.affiliation: Department of Orthopedics Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Sulaiman
authors.initials: S
authors.lastname: Somani
authors.affiliation: Department of Orthopedics Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Jun S
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Orthopedics Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Nathan J
authors.initials: NJ
authors.lastname: Lee
authors.affiliation: Department of Orthopedics Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Parth
authors.initials: P
authors.lastname: Kothari
authors.affiliation: NeuroSpine Surgery Research Group, University of New South Wales, Sydney, Australia.|Faculty of Medicine, University of New South Wales, Sydney, Australia.
authors.forename: Kevin
authors.initials: K
authors.lastname: Phan
authors.affiliation: Ponce Health Sciences University, Ponce, Puerto Rico.
authors.forename: Nahyr
authors.initials: N
authors.lastname: Lugo-Fagundo
authors.affiliation: Department of Orthopedics Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Samuel K
authors.initials: SK
authors.lastname: Cho
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017586:Diskectomy / Q000009:adverse effects / Q000639:trends*; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000639:trends*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology / Q000517:prevention & control; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000639:trends*; D010360:Patient Transfer / Q000639:trends*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D013122:Spinal Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects / Q000639:trends*