Same-day discharge following lumbar spine neural decompression

Introduction

The concept of same-day discharge following lumbar spine surgery for neural elements decompression, introduced in the 1980 s, represents a significant paradigm shift in postoperative care, offering potential benefits in terms of efficiency, convenience, and cost-effectiveness. However, concerns regarding patient safety and complications have persisted. This study aims to assess same-day discharge rates following lumbar spine decompression surgery, identify preoperative predictors, and compare outcomes between same-day discharge and hospitalization.

Methods

A retrospective comparative analysis was conducted using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Participant Use File spanning 2016 to 2021. A total of 58,430 patients undergoing lumbar spine decompression procedures were included. Statistical analysis was performed using SPSS software, with significance determined at p < 0.05.

Results

Significant differences were observed in preoperative factors, operative variables, and postoperative outcomes between patients discharged on the same day and those hospitalized. Preoperative comorbidities, operative time, length of stay, utilization of minimally invasive approaches, and 30-day mortality rates differed significantly between the two groups. Notably, same-day discharge demonstrated superior outcomes, with lower rates of unplanned intubation, readmission, and reoperation compared to hospitalization.

Conclusion

In conclusion, same-day discharge following lumbar spine decompression procedures holds promise as a safe and effective practice, offering advantages in terms of patient outcomes and healthcare resource utilization. Further research and implementation of standardized protocols are warranted to maximize the benefits of same-day discharge while ensuring patient safety and satisfaction.