Predictors of Increased Hospital Stay in Adolescent Idiopathic Scoliosis Patients Undergoing Posterior Spinal Fusion: Analysis of National Database

被引：0

作者：

Yoshihara H. ^{[1
,2
]}

Paulino C. ^{[1
]}

Yoneoka D. ^{[3
]}

机构：

[1] Department of Orthopaedic Surgery & Rehabilitation Medicine, SUNY Downstate Medical Center, 450 Clarkson Ave, Brooklyn, 11203, NY

[2] Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medicine, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya

[3] Department of Medicine, University of Tokyo Graduate School of Medicine, 7-3-1, Hongo, Bunkyo-ku, Tokyo

来源：

Spine Deformity | 2018年 / 6卷 / 3期

关键词：

Adolescent idiopathic scoliosis; Increased hospital stay; Nationwide inpatient sample; Posterior spinal fusion; Predictor;

D O I：

10.1016/j.jspd.2017.09.053

中图分类号：

学科分类号：

摘要：

Study Design: Analysis of population-based national hospital discharge data collected for the Nationwide Inpatient Sample (NIS). Objective: To examine the predictors of increased hospital stay in adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion. Summary of Background Data: As policy makers and hospitals are increasingly looking to cut costs, length of stay (LOS) after surgery has come into focus as an area for improvement. Despite this, there is limited research about the factors contributing to increased LOS for AIS patients undergoing posterior spinal fusion. Methods: The Nationwide Inpatient Sample was used to identify pediatric patients with idiopathic scoliosis who underwent posterior spinal fusion from 2004 to 2009, using the International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) codes. Patient demographics, surgical variables, hospital characteristics, and in-hospital outcomes were retrieved. LOS was divided into two groups (longer- and shorter-stay groups) by its average. Longer stay was defined as ≥6 days. Multivariable logistic regression analysis was performed to identify the predictors of increased LOS in AIS patients undergoing posterior spinal fusion. Results: Significant predictors of increased LOS in posterior spinal fusion for AIS patients included increased Elixhauser Comorbidity Score, number of fused levels ≥9 vertebrae, teaching hospital status, in-hospital complications, and nonroutine disposition. Wound-related complications were the strongest predictor and patients with wound-related complications were 3.14-fold more likely to have an increased LOS compared to those without wound-related complications. Conclusions: This study identified significant predictors of increased hospital stay in posterior spinal fusion for pediatric patients with idiopathic scoliosis and patients at higher risk of longer hospitalization can be recognized. Eventually these data are expected to help optimize LOS and cost containment. © 2017 Scoliosis Research Society

引用

页码：226 / 230

页数：4

共 17 条

[1]

Menendez M.E., Baker D.K., Fryberger C.T., Ponce B.A., Predictors of extended length of stay after elective shoulder arthroplasty, J Shoulder Elbow Surg, 24, pp. 1527-1533, (2015)

[2]

Krell R.W., Girotti M.E., Dimick J.B., Extended length of stay after surgery: complications, inefficient practice, or sick patients?, JAMA Surg, 149, pp. 815-820, (2014)

[3]

Jones S., Alnaib M., Kokkinakis M., Et al., Pre-operative patient education reduces length of stay after knee joint arthroplasty, Ann R Coll Surg Engl, 93, (2011)

[4]

Teeny S.M., York S.C., Benson C., Et al., Does shortened length of hospital stay affect total knee arthroplasty rehabilitation outcomes?, J Arthroplasty, 20, 7, (2005)

[5]

Cram P., Lu X., Kaboli P.J., Et al., Clinical characteristics and outcomes of Medicare patients undergoing total hip arthroplasty, 1991–2008, JAMA, 305, (2011)

[6]

Steele M., McLean M.B., Gaunt R., Et al., The Joint Ventures Program: improving outcomes and satisfaction in joint surgery patients, J Clin Outcomes Manag, 7, (2000)

[7]

El Bitar Y.F., Illingworth K.D., Scaife S.L., Et al., Hospital length of stay following primary total knee arthroplasty: data from the nationwide inpatient sample database, J Arthroplasty, 30, pp. 1710-1715, (2015)

[8]

Basques B.A., Bohl D.D., Golinvaux N.S., Et al., Patient factors are associated with poor short-term outcomes after posterior fusion for adolescent idiopathic scoliosis, Clin Orthop Relat Res, 473, pp. 286-294, (2015)

[9]

Overview of the Nationwide Inpatient Sample (NIS)

[10]

Elixhauser A., Steiner C., Harris D.R., Et al., Comorbidity measures for use with administrative data, Med Care, 36, pp. 8-27, (1998)

← 1 2 →