Impact of patient and hospital-level risk factors on extended length of stay following spinal fusion for adolescent idiopathic scoliosis

Journal of Neurosurgery. Pediatrics
Aladine A ElsamadicyMichael L DiLuna

Abstract

Health policy changes have led to increased emphasis on value-based care to improve resource utilization and reduce inpatient hospital length of stay (LOS). Recently, LOS has become a major determinant of quality of care and resource utilization. For adolescent idiopathic scoliosis (AIS), the determinants of extended LOS after elective posterior spinal fusion (PSF) remain relatively unknown. In the present study, the authors investigated the impact of patient and hospital-level risk factors on extended LOS following elective PSF surgery (≥ 4 levels) for AIS. The Kids' Inpatient Database (KID) was queried for the year 2012. Adolescent patients (age range 10-17 years) with AIS undergoing elective PSF (≥ 4 levels) were selected using the International Classification of Diseases, Ninth Revision, Clinical Modification coding system. Extended hospital LOS was defined as greater than the 75th percentile for the entire cohort (> 6 days), and patients were dichotomized as having normal LOS or extended LOS. Patient demographics, comorbidities, complications, LOS, discharge disposition, and total cost were recorded. A multivariate logistic regression model was used to determine the odds ratio for risk-adjusted LOS. The primary outcome was...Continue Reading

References

Feb 28, 2008·Spine·Vidyadhar V UpasaniPeter O Newton
Jun 6, 2009·The New England Journal of Medicine·Michael E Porter
Apr 29, 2014·Journal of Children's Orthopaedics·Nicholas D FletcherRobert W Bruce
Sep 10, 2014·Clinical Orthopaedics and Related Research·Bryce A BasquesJonathan N Grauer
Oct 21, 2017·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·Johan von HeidekenPaul Gerdhem
Feb 11, 2018·The Journal of Pediatrics·Jennifer K WorkmanJohn T Smith
Sep 27, 2018·Journal of Pediatric Orthopedics. Part B·Matthew R BoylanDavid S Feldman

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Citations

Jan 12, 2021·The Spine Journal : Official Journal of the North American Spine Society·Sidsel FruergaardMartin Gehrchen

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