Factors Predisposing Patients to Non-Home Discharge After Surgery for Degenerative Cervical Myelopathy: A Retrospective Analysis

Abstract

Objective The objective of this study is to evaluate factors associated with discharge to subacute care after surgery for degenerative cervical myelopathy (DCM). Design This is a retrospective chart review of adults who underwent cervical spine surgery at a for DCM between 2014 and 2020 (n = 135). Results Patients discharged to a subacute setting were older (68.1 +/- 8.6 vs. 64.1 years +/- 8.8; p = 0.01); more likely to be unmarried (55.8% vs. 33.7% married; p = 0.01); and more likely to have Medicare or Medicaid (83.7% vs. 65.9% private insurance; p = 0.03). than patients discharged home. A posterior surgical approach was associated with discharge to a subacute setting (62.8% vs. 43.5% anterior approach; p = 0.04). 87.8% of patients discharged to a subacute setting required moderate or maximum assistance for bed mobility vs. 26.6% of patients discharged home (p < 0.0001).Compared to patients discharged home, patients discharged to a subacute setting ambulated a shorter distance in their first Physical Therapy Evaluation after surgery (8.9 meters +/- 35.8 vs. 53.7 meters +/- 61.78 in the home discharge group; p < 0.0001). Conclusion Analysis of these factors may guide discussions about patient expectations for postoperative discharge placement.