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Niedermeier S, Przybylowicz R, Virk SS, Stammen K, S Eiferman D, Khan SN. Predictors of discharge to an inpatient rehabilitation facility after a single-level posterior spinal fusion procedure. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2016; 26:771-776. [PMID: 27170268 DOI: 10.1007/s00586-016-4605-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 05/02/2016] [Accepted: 05/03/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE To determine perioperative characteristics of patients undergoing single-level spinal fusion surgery that could help predict discharge to an inpatient rehabilitation facility (IRF). METHODS Demographic, peri- and postoperative characteristics were reviewed for 107 patients who underwent single-level spinal fusion surgery at a high-volume level I trauma center between January 2011 and December 2013. The relationships between discharge to IRF and gender, age, body mass index (BMI), Charlson Comorbidity Index (CCI), insurance provider, length of stay (LOS), intra- and postoperative outcomes and readmission rates in patients undergoing single-level spinal fusion surgery were analyzed using unpaired and paired t testing. RESULTS 21.5 % (n = 23) of patients were discharged to an IRF. By using unpaired and paired t tests, it was determined that age, BMI, CCI, LOS and insurance provider were all correlated with a higher probability of being discharged to an IRF. Additionally, a logistic regression model demonstrated a correlation between lower CCI and discharge to an IRF. CONCLUSIONS Statistically significant differences were seen regarding age, BMI, CCI, LOS and insurance provider when determining the necessity of a patient being discharged to an IRF. These characteristics can be used to begin the process of setting up discharge disposition preoperatively rather than postoperatively. There were no perioperative characteristics that were statistically significant in determining discharge disposition; therefore, physicians can utilize these preoperative demographics in deciding and organizing discharge before the day of surgery, which can diminish LOS and lead to substantial health system savings.
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Affiliation(s)
- Steven Niedermeier
- Division of Spine, Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Ryle Przybylowicz
- Division of Spine, Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Sohrab S Virk
- Division of Spine, Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Kari Stammen
- Division of Spine, Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Daniel S Eiferman
- Division of Trauma, Critical Care, and Burn, Department of Surgery, Wexner Medical Center, The Ohio State University, 395 West 12th Avenue, Columbus, OH, 43210, USA
| | - Safdar N Khan
- Division of Spine, Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, OH, USA. .,Department of Integrated Systems Engineering Clinical Faculty, Spine Research Institute, The Ohio State University, 725 Prior Hall, Columbus, OH, 43210, USA.
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von Matthey F, Biberthaler P. [Rehabilitation after polytrauma : Definitions and treatment approaches]. DER ORTHOPADE 2016; 44:241-51. [PMID: 25749429 DOI: 10.1007/s00132-015-3081-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
After initial resuscitation and surgical reconstruction of structural damages, the functional rehabilitation is one of the critical columns of polytraumatized patient management. This programme starts as early as the initial therapy in the trauma bay and proceeds until socio-professional reintegration of the patient into his pre-traumatic environment.Thus, three phases of a rehabilitation were identified: the early rehabilitation, the post-acute rehabilitation and the continuative rehabilitation.Since the mortality after major trauma is continuously decreasing, the life quality of trauma victims came more and more into the focus of the actual scientific discussion. To improve this life quality, several rehabilitation programmes were developed and varius instruments were developed to quantify outcome results, such as the GOS or the SF-36, respectively.The aim of this review is to describe these various programmes and instruments, to improve the individual rehabilitation process for polytraumatized patients.
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Affiliation(s)
- Francesca von Matthey
- Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, München, Deutschland
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