A new study demonstrates that patients undergoing vertebroplasty as in-patients are often discharged to rehabilitation centres rather than home, irrespective of their status before hospitalisation, or their pre- and postoperative pain levels.
Researchers David Kallmes, professor of Radiology, Mayo Clinic, Rochester, USA, et al write in the paper published in the October issue of the American Journal of Neuroradiology that many different factors such as pain level at rest and with activity have been used to assess outcome of the vertebroplasty procedure. They make the point that only a few studies have correlated discharge disposition to the efficacy of the vertebroplasty procedure in the in-patient population.
They carried out a retrospective review of inpatients who underwent consultation for consideration of spinal augmentation for treatment of painful vertebral compression fractures. The investigators gathered data concerning patients’ demographics, living arrangements before hospitalisation, discharge disposition, quantitative and qualitative pain levels, and length of hospital stay before and following vertebroplasty.
Kallmes et al undertook the study in order to compare patient disposition status before and after vertebroplasty and determine what relationship exists between the treatment and patient discharge status.
The researchers found that 90 in-patients underwent vertebroplasty, 73 (81%) of whom lived independently at home before hospitalisation. Of these 73 patients, 31 (42%) returned home after discharge, 9 (12%) returned home with healthcare assistance, and 32 (44%) were sent to skilled nursing facilities. Six (7%) of the 90 patients lived in assisted-living centres before hospitalisation and all these patients were discharged to assisted-living or skilled nursing facilities.
Eight (9%) of the 90 patients resided at skilled nursing centres before hospitalisation, and all returned to nursing centres after their hospital stay. Discharge disposition was not significantly associated with pre-operative pain levels at rest or with activity (p=0.76 and p=0.23, respectively) or with postoperative pain levels at rest or with activity (p=0.08 and p=0.25, respectively).