Researchers conducted a cohort study that looked back. For a study, they sought to assess 30-day post-discharge morbidity for 3-or-more level (multilevel) posterior lumbar fusion patients discharged to home with those referred to rehabilitation. The National Surgical Quality Improvement Program (NSQIP) database was used to find patients who had multilevel posterior lumbar fusion between 2005 and 2018. To compare primary outcomes between discharge dispositions and look for factors, regression was used. Investigators found 5,276 patients as a result of the research. According to an unadjusted study, patients who were discharged to rehabilitation had higher post-discharge morbidity (5.6% vs 2.6%). Discharge to rehabilitation no longer predicted postdischarge morbidity after correcting for baseline differences [odds ratio (OR)=1.409, CI: 0.918–2.161, P=0.117]. Age (P=0.026, OR=1.023), disseminated cancer (P=0.037, OR=6.699), and readmission (P<0.001, OR=28.889) were also found to be independent predictors of post-discharge morbidity in multivariate analysis. About 30-day morbidity was statistically comparable between patients discharged to home and those referred to rehabilitation. For more medically frail patients following multilevel posterior lumbar fusion, discharge to rehabilitation can potentially reduce 30-day post-discharge morbidity with proper patient selection. The outcomes were especially significant in light of the aging population, as many older patients may benefit from post-acute care facility discharge following spine surgery.
