Predictors of Patients' Disposition Following Spine Deformity Correction Surgery: A National Database Analysis

Retrospective study.

This study used a national surgical outcomes database to identify demographic and clinical factors predicting postoperative discharge disposition for patients undergoing spinal deformity correction, aiming to enhance predictability and streamline care transitions.

Delays in discharge to non-home rehabilitation facilities contribute to inefficiencies in the US health care system, often prolonging hospitalization after spinal surgery. These delays hinder patients' progress in their recovery, leading to longer durations of physical therapy or rehab.

Data from the National Surgical Quality Improvement Program (NSQIP) were analyzed for patients undergoing spinal deformity correction surgeries between 2011 and 2021, identified by specific CPT codes. Factors examined included age, sex, race, diabetes, transfusion history, functional status, and bleeding disorders. Non-home discharges included inpatient rehabilitation, skilled nursing, long-term acute hospitals, and home health services.

Among 2785 patients, 32.7% (n=910) required non-home discharge. Older patients were more likely to need rehabilitation, with proportions increasing from 57.6% in the 70-79 age group (n=684) to 74.8% in those aged 80-90 (n=103). Diabetes combined with transfusion history significantly increased non-home discharge rates (85.7%, n=7), as did diabetes and bleeding disorders (83.3%, n=12). Black diabetic patients had higher rehab rates than diabetics overall (69%, n=42 vs. 48.9%, n=348).

Age, race, diabetes, transfusion history, and bleeding disorders were significant predictors of non-home discharge after spinal deformity surgery. Early identification of high-risk patients and tailored discharge planning are crucial for improving outcomes and reducing delays.