What are the predictors of nonroutine discharge after surgery for grade 2 lumbar spondylolisthesis? A Spine CORe™ analysis of QOD data
Year: 2026
Type: article
Abstract: OBJECTIVE: Discharge to an inpatient rehabilitation facility or other acute care facility is a significant driver of healthcare costs. The authors sought to identify predictors of nonroutine discharge after surgery for grade 2 lumbar spondylolisthesis. METHODS: The Quality Outcomes Database from the 14 highest enrolling sites (Spine CORe™ study group) was queried for adult patients who underwent surgery for grade 2 lumbar spondylolisthesis. Nonroutine discharge was defined as discharge to a postacute or nonacute care setting or transfer to another acute care facility. Univariate analysis and multivariate logistic regression were utilized to identify predictors of nonroutine discharge. The follow-up rate at 5 years was 81%. RESULTS: Of the 328 patients identified, 47 (14.3%) had nonroutine discharge. On univariate analysis, patients with nonroutine discharge were more likely to be older (67.4 ± 11.3 years vs 59.4 ± 12.2 years, p < 0.0001), be female (85.1% vs 65.5%, p = 0.007), have diabetes (36.2% vs 12.1%, p < 0.0001), have osteoporosis (21.3% vs 8.2%, p = 0.02), have a higher mean baseline numeric rating scale (NRS) leg pain score (7.5 ± 2.2 vs 6.6 ± 2.8, p = 0.04), and have a higher mean baseline Oswestry Disability Index (ODI) score (55.4 ± 15.7 vs 46.5 ± 16.5, p = 0.0006) compared to patients with a routine discharge. Patients who had completed a 4-year college degree, were employed and working, and were independently ambulatory were more likely to have a routine discharge (p < 0.0001). Multivariate analysis showed that older age (OR 1.06, 95% CI 1.01-1.11, p = 0.01), female sex (OR 2.64, 95% CI 1.01-6.87, p = 0.04), need for an assistive device to ambulate preoperatively (OR 3.01, 95% CI 1.02-7.36, p = 0.02), and diabetes (OR 2.80, 95% CI 1.20-6.56, p = 0.02) were independently associated with nonroutine discharge. Patients with a nonroutine discharge had significantly greater length of stay compared to patients with a routine discharge (4.7 ± 2.2 vs 3.2 ± 2.1 days, p < 0.0001). CONCLUSIONS: In this large, prospective, multicenter study, patients with nonroutine discharge after surgery for grade 2 lumbar spondylolisthesis were more likely to be older, female, have diabetes, and require an assistive device to ambulate preoperatively.
Source: Neurosurgical FOCUS
Authors: Joseph R. Linzey, Allie Harbert, Aaron Gelinne, Cheerag D. Upadhyaya, Jay D. Turner, Juan S. Uribe, Anthony L. Asher, Paul K. Kim, Kai-Ming G. Fu, Michael S. Virk, Christopher I. Shaffrey, Oren N. Gottfried, Eric A. Potts, Vincent J. Alentado, Mohamad Bydon, Paul Park, Michael Y. Wang, Steven D. Glassman, Mladen Djurasovic, Kevin T. Foley, Andrew K. Chan, Dean Chou, Praveen V. Mummaneni, Chun-Po Yen, Erica F. Bisson, Regis Haid, Timothy J. Yee
Institutions: University of Michigan, University of North Carolina at Chapel Hill, Barrow Neurological Institute, Weill Cornell Medical Center, Duke University, University of Chicago, University of Miami, Norton Hospital, Columbia University Irving Medical Center, University of California, San Francisco, University of Virginia, University of Utah
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7159801949
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