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Open Access 01-05-2014 | Original Clinical Article

Clinical and economic implications of early discharge following posterior spinal fusion for adolescent idiopathic scoliosis

Authors: Nicholas D. Fletcher, Nader Shourbaji, Phillip M. Mitchell, Timothy S. Oswald, Dennis P. Devito, Robert W. Bruce

Published in: Journal of Children's Orthopaedics | Issue 3/2014

Abstract

Objective

To evaluate the clinical and economic impact of a novel postoperative pathway following posterior spinal fusion (PSF) in patients with adolescent idiopathic scoliosis (AIS).

Methods

Patient charts were reviewed for demographic data and to determine length of surgery, implant density, use of osteotomies, estimated blood loss, American Society of Anesthesiologists (ASA) score, length of hospital stay, and any subsequent complications. Hospital charges were divided by charge code to evaluate potential savings.

Results

Two hundred and seventy-nine of 365 patients (76.4 %) treated with PSF carried a diagnosis of AIS and had completed 6 months of clinical and radiologic follow-up, a period of time deemed adequate to assess early complications. There was no difference between groups in age at surgery, sex, number of levels fused, or length of follow-up. Patients managed under the accelerated discharge (AD) pathway averaged 1.36 (31.7 %) fewer days of inpatient stay. Operative time was associated with a shorter length of stay. There was no difference in complications between groups. Hospital charges for room and board were significantly less in the AD group ($1.885 vs. $2,779, p < 0.001).

Conclusions

A pathway aimed to expedite discharge following PSF for AIS decreased hospital stay by nearly one-third without any increase in early complication rate. A small but significant decrease in hospital charges was seen following early discharge. Early discharge following PSF for AIS may be achieved without increased risk of complications, while providing a small cost savings.

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Title: Clinical and economic implications of early discharge following posterior spinal fusion for adolescent idiopathic scoliosis
Authors: Nicholas D. Fletcher
Nader Shourbaji
Phillip M. Mitchell
Timothy S. Oswald
Dennis P. Devito
Robert W. Bruce
Publication date: 01-05-2014
Publisher: Springer Berlin Heidelberg
Published in: Journal of Children's Orthopaedics / Issue 3/2014
Print ISSN: 1863-2521
Electronic ISSN: 1863-2548
DOI: https://doi.org/10.1007/s11832-014-0587-y

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Clinical and economic implications of early discharge following posterior spinal fusion for adolescent idiopathic scoliosis

Abstract

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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