• Neurosurgery · Mar 2023

    Time of Discharge and 30-Day Re-Presentation to an Acute Care Setting After Elective Lumbar Decompression Surgery.

    • Rahul A Sastry, Matthew Hagan, Joshua Feler, Hael Abdulrazeq, Konrad Walek, Patricia Z Sullivan, Jose Fernandez Abinader, Joaquin Q Camara, Tianyi Niu, Jared S Fridley, Adetokunbo A Oyelese, Prakash Sampath, Albert E Telfeian, Ziya L Gokaslan, Steven A Toms, and Robert J Weil.
    • Department of Neurosurgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA.
    • Neurosurgery. 2023 Mar 1; 92 (3): 507514507-514.

    BackgroundEvidence regarding the consequence of efforts to increase patient throughput and decrease length of stay in the context of elective spine surgery is limited.ObjectiveTo evaluate whether early time of discharge results in increased rates of hospital readmission or return to emergency department for patients admitted after elective, posterior, lumbar decompression surgery.MethodsWe conducted a retrospective cohort study of 779 patients admitted to hospital after undergoing elective, posterior, lumbar decompression surgery. Multiple logistic regression evaluated the relationship between time of discharge and the primary outcome of return to acute care within 30 days, while controlling for sociodemographic, procedural, and discharge characteristics.ResultsIn multiple logistic regression, time of discharge earlier in the day was not associated with increased odds of return to acute care within 30 days (odds ratio [OR] 1.18, 95% CI 0.92-1.52, P = .19). Weekend discharge (OR 1.99, 95% CI 1.04-3.79, P = .04) increased the likelihood of return to acute care. Surgeon experience (<1 year of attending practice, OR 0.43, 95% CI 0.19-1.00, P = .05 and 2-5 years of attending practice, OR 0.50, 95% CI 0.25-1.01, P = .054), weekend discharge (OR 0.49, 95% CI 0.27-0.89, P = .02), and physical therapy evaluation (OR 0.20, 95% CI 0.12-0.33, P < .001) decreased the likelihood of discharge before noon.ConclusionTime of discharge is not associated with risk of readmission or presentation to the emergency department after elective lumbar decompression. Weekend discharge is independently associated with increased risk of readmission and decreased likelihood of prenoon discharge.Copyright © Congress of Neurological Surgeons 2022. All rights reserved.

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