Predicting discharge placement and health care needs after lumbar spine laminectomy

To explore factors associated with discharge placement (DP) and need for skilled assistance after patients are discharged from hospital following lumbar laminectomy. METHODS: A retrospective analysis of 339 patients who underwent lumbar laminectomy was conducted. We used multivariable logistic regression analysis to identify significant covariates and to construct two regression models: a primary model to predict DP, home vs inpatient rehabilitation/skilled nursing facility (IR/SNF), and a secondary model to predict the need for skilled assistance once patients are discharged to home. RESULTS: The sample included 48.7% females, 68.2% married, 56.3% independent in daily activities, and 85.2% discharged to home. Subjects were a mean 56.06±12.75 years old and had a BMI of 31.35±6.2. Of those discharged to home, 17.7% needed skilled assistance. Patients stayed 4.41±3.55 days in the hospital and walked 203.38±144.87 ft during hospital stay. Age, distance walked during hospital stay, and length of hospital stay (LOS) were significant positive predictors for discharge to home vs IR/SNF, whereas single living status, diminished prior level of function, and longer LOS were predictors of need for skilled assistance after discharge to home. CONCLUSION: Age, mobility, marital status, prior level of function, and LOS are key variables in determining healthcare needs following lumbar laminectomy.