• Steven Niedermeier, Ryle Przybylowicz, Sohrab S Virk, Kari Stammen, S Eiferman Daniel D Division of Trauma, Critical Care, and Burn, Department of Surgery, Wexner Medical Center, The Ohio State University, 395 West 12th Avenue, Columbus, , and Safdar N Khan.
• Division of Spine, Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
• Eur Spine J. 2017 Mar 1; 26 (3): 771-776.

PurposeTo determine perioperative characteristics of patients undergoing single-level spinal fusion surgery that could help predict discharge to an inpatient rehabilitation facility (IRF).MethodsDemographic, 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.Results21.5 % (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.ConclusionsStatistically 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.

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