Wednesday, September 26, 2018 7:35 AM–9:00 AM ePosters: P58. Identifying discharge destination in patients undergoing vertebral ORIF: analysis of 1,055 cases

Abstract

BACKGROUND CONTEXT Literature isolating the risk factors correlated with postoperative discharge destination after open reduction internal fixation (ORIF) procedures for vertebral fractures or dislocations is scarce. Delineating these risk factors is crucial to risk stratification and outcome improvement in high-risk populations. The purpose of this study was to identify risk factors associated with discharge to a nonhome facility in patients undergoing ORIF in order to isolate predictive factors that may be used to plan patient discharge. METHODS This was a retrospective analysis of prospectively collected data from ACS-NSQIP database from 2010 to 2014. Patients undergoing ORIF of vertebral fractures and/or dislocations were identified and different independent risk factors were analyzed for their correlation with discharge to a nonhome facility. Nonhome destinations include skilled and nonskilled care facilities, nursing homes, assisted living, and rehabilitation center. Vertebral ORIF procedures occurring in the cervical spine were compared to thoracic and lumbar procedures with respect to nonhome discharge destination. Univariate analysis was used to assess patient baseline characteristics, comorbidities, and perioperative outcomes. Multivariable stepwise logistic regression models were employed, adjusting for patient demographic, and patient comorbidities, to identify the clinical risk factors associated with nonhome discharge. RESULTS A total of 1,055 vertebral ORIF cases were identified, and 387 (36.68%) of these patients were discharged to a nonhome facility. In comparison to cervical vertebral ORIF procedures, thoracic and lumbar procedures did not show a statistically significant propensity for nonhome discharge but both did show different statistical trends: thoracic procedures had a 1.5times risk of nonhome discharge compared to cervical procedures (OR=1.476; P=.076), whereas lumbar procedures had a reduced risk of nonhome discharged compared to cervical procedures (OR=0.701; P=.051). Other independent risk factors for discharge to nonhome location were age>65 (OR=3.605; P CONCLUSIONS The current study identified multiple and specific risk factors predictive of discharge to a nonhome facility in patients undergoing open reduction internal fixation for vertebral fracture or dislocations.