A National Analysis on Predictors of Discharge to Rehabilitation After Corrective Surgery for Adolescent Idiopathic Scoliosis.
Adolescent
Child
Female
Hospital Charges
/ statistics & numerical data
Hospitals, Rehabilitation
/ statistics & numerical data
Humans
Length of Stay
/ statistics & numerical data
Male
Patient Discharge
/ statistics & numerical data
Postoperative Complications
/ etiology
Reoperation
/ statistics & numerical data
Retrospective Studies
Risk Factors
Scoliosis
/ economics
United States
Journal
Spine
ISSN: 1528-1159
Titre abrégé: Spine (Phila Pa 1976)
Pays: United States
ID NLM: 7610646
Informations de publication
Date de publication:
15 Jan 2019
15 Jan 2019
Historique:
pubmed:
23
6
2018
medline:
21
5
2019
entrez:
23
6
2018
Statut:
ppublish
Résumé
Retrospective study of a national database. To identify the incidence and risk factors for discharge to a rehabilitation facility after corrective surgery for adolescent idiopathic scoliosis (AIS). The vast majority of patients who undergo surgery for AIS are discharged home, with limited data on rates and causes for discharge to a rehabilitation facility. The United States National Inpatient Sample (NIS) database was queried for the years 2012 to 2014. Inclusion criteria were children aged 10 to 18 who underwent surgery for idiopathic scoliosis. Studied data included patient demographics, operative parameters, length of stay, and hospital charges. Perioperative complications were also examined, along with their association with discharge to an inpatient rehabilitation facility. Statistical analysis was performed via chi-squared testing and multivariate analysis, with significance defined as a P-value <0.05. A total of 17,275 patients were included (76.3% female, mean age 14 yr). Out of the entire cohort, 4.8% of patients developed a complication and 0.6% were discharged to a rehabilitation facility. The most common complications included respiratory failure (2.3%), reintubation (0.8%), and postoperative hematoma (0.8%). Following multivariate analysis, male sex (Odds ratio (OR) 4.7; 95% Confidence Interval (CI), 1.8-12.2; P = 0.002), revision surgery (OR 29.6; 95% CI, 5.7-153.5; P < 0.001), and development of a perioperative complication (OR 12.3; 95% CI, 4.7-32.4; P < 0.001) were found to be significant predictors of discharge to rehabilitation. Average length of stay was 8 ± 6 versus 5 ± 3 days and hospital charges were $254,425 versus $186,273 in the complication and control groups, respectively (both P < 0.001). Discharge to rehabilitation after AIS surgery is uncommon. However, patients who are male, undergo revision procedures, or develop a complication may have a higher risk of a non-routine discharge. Complication occurrence also resulted in significantly longer lengths of stay and healthcare costs. 3.
Sections du résumé
STUDY DESIGN
METHODS
Retrospective study of a national database.
OBJECTIVE
OBJECTIVE
To identify the incidence and risk factors for discharge to a rehabilitation facility after corrective surgery for adolescent idiopathic scoliosis (AIS).
SUMMARY OF BACKGROUND DATA
BACKGROUND
The vast majority of patients who undergo surgery for AIS are discharged home, with limited data on rates and causes for discharge to a rehabilitation facility.
METHODS
METHODS
The United States National Inpatient Sample (NIS) database was queried for the years 2012 to 2014. Inclusion criteria were children aged 10 to 18 who underwent surgery for idiopathic scoliosis. Studied data included patient demographics, operative parameters, length of stay, and hospital charges. Perioperative complications were also examined, along with their association with discharge to an inpatient rehabilitation facility. Statistical analysis was performed via chi-squared testing and multivariate analysis, with significance defined as a P-value <0.05.
RESULTS
RESULTS
A total of 17,275 patients were included (76.3% female, mean age 14 yr). Out of the entire cohort, 4.8% of patients developed a complication and 0.6% were discharged to a rehabilitation facility. The most common complications included respiratory failure (2.3%), reintubation (0.8%), and postoperative hematoma (0.8%). Following multivariate analysis, male sex (Odds ratio (OR) 4.7; 95% Confidence Interval (CI), 1.8-12.2; P = 0.002), revision surgery (OR 29.6; 95% CI, 5.7-153.5; P < 0.001), and development of a perioperative complication (OR 12.3; 95% CI, 4.7-32.4; P < 0.001) were found to be significant predictors of discharge to rehabilitation. Average length of stay was 8 ± 6 versus 5 ± 3 days and hospital charges were $254,425 versus $186,273 in the complication and control groups, respectively (both P < 0.001).
CONCLUSION
CONCLUSIONS
Discharge to rehabilitation after AIS surgery is uncommon. However, patients who are male, undergo revision procedures, or develop a complication may have a higher risk of a non-routine discharge. Complication occurrence also resulted in significantly longer lengths of stay and healthcare costs.
LEVEL OF EVIDENCE
METHODS
3.
Identifiants
pubmed: 29933335
doi: 10.1097/BRS.0000000000002758
pii: 00007632-201901150-00009
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
118-122Références
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