Abstract
Study design
Retrospective review of a prospectively collected multicenter database.
Objectives
To identify risk factors for early and late readmission of surgically treated patients with adolescent idiopathic scoliosis (AIS).
Summary of background data
Specific risk factors associated with readmission in patients with AIS remain poorly understood.
Methods
Patients with AIS who were operatively treated from 19 centers specializing in the treatment of pediatric spinal deformity were studied. Data from a minimum 2 years of clinical follow-up and any readmission were available for analysis. Characteristics of patients with no readmission, early readmission (< 90 days), and late readmission (> 90 days) were evaluated. Both univariate and multivariate analyses of risk factors for readmission were performed.
Results
2049 patients were included in our cohort, with 1.6% requiring early readmission and 3.3% late readmission. In the multivariate analysis, greater preoperative coronal imbalance was associated with early readmission. Longer operative time was associated with late readmission. Finally, greater preoperative pain (SRS-22 pain scale) was associated with both early and late readmission. GI complications accounted for a higher proportion of early readmissions than previously reported in the literature.
Conclusions
Preoperative counseling of patients with higher levels of pain and coronal imbalance and the implementation of a thorough postoperative bowel regimen may help optimize patient outcomes.
Level of evidence
3.
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Acknowledgements
This study was supported in part by grants to the Setting Scoliosis Straight Foundation in support of Harms Study Group research from DePuy Synthes Spine, EOS Imaging, K2M, Medtronic, NuVasive and Zimmer Biomet. The members of the Harms Study Group: Aaron Buckland MD, New York University; Amer Samdani MD, Shriners Hospitals for Children—Philadelphia; Amit Jain MD, Johns Hopkins Hospital; Baron Lonner MD, Mount Sinai Hospital; Benjamin Roye MD, Columbia University; Burt Yaszay MD, Rady Children’s Hospital; Chris Reilly MD, BC Children’s Hospital; Daniel Hedequist MD, Boston Children’s Hospital; Daniel Sucato MD, Texas Scottish Rite Hospital; David Clements MD, Cooper Bone & Joint Institute New Jersey; Firoz Miyanji MD, BC Children’s Hospital; Harry Shufflebarger MD, Nicklaus Children's Hospital; Jack Flynn MD, Children’s Hospital of Philadelphia; Jahangir Asghar MD, Cantor Spine Institute; Jean Marc Mac-Thiong MD, CHU Sainte-Justine; Joshua Pahys MD, Shriners Hospitals for Children—Philadelphia; Juergen Harms MD, Klinikum Karlsbad-Langensteinbach, Karlsbad; Keith Bachmann MD, University of Virginia; Larry Lenke MD, Columbia University; Mark Abel MD, University of Virginia; Michael Glotzbecker MD, Boston Children’s Hospital; Michael Kelly MD, Washington University; Michael Vitale MD, Columbia University; Michelle Marks, PT MA, Setting Scoliosis Straight Foundation; Munish Gupta MD, Washington University; Nicholas Fletcher MD, Emory University; Patrick Cahill MD, Children’s Hospital of Philadelphia; Paul Sponseller MD, Johns Hopkins Hospital; Peter Gabos MD, Nemours/Alfred I. duPont Hospital for Children; Peter Newton MD, Rady Children’s Hospital; Peter Sturm MD, Cincinnati Children’s Hospital; Randal Betz MD, Institute for Spine & Scoliosis; Ron Lehman MD, Columbia University; Stefan Parent MD, CHU Sainte-Justine; Stephen George MD, Nicklaus Children's Hospital; Steven Hwang MD, Shriners Hospitals for Children—Philadelphia; Suken Shah MD, Nemours/Alfred I. duPont Hospital for Children; Tom Errico MD, Nicklaus Children's Hospital; Vidyadhar Upasani MD, Rady Children’s Hospital.
Funding
This study was supported in part by grants to the Setting Scoliosis Straight Foundation in support of Harms Study Group research from DePuy Synthes Spine, EOS Imaging, K2M, Medtronic, NuVasive and Zimmer Biomet.
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Conceptualization: AFS, SWH; Data curation: TPB, HSG; Funding acquisition: HSG; Investigation: SWH; Methodology: AFS, SWH; Project administration: PON, HSG; Resources: HSG; Software: HSG; Supervision: AFS, PON, SAS, FM; Writing—original draft: AP, SWH; Writing—review and editing: AP, JMP, AFS, PON, TPB, SAS, FM, HSG, SWH; Final approval of submission: AP, JMP, AFS, PON, TPB, SAS, FM, HSG, SWH.
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This study was approved by the institutional review board at each participating institution, and the consent of the patients or their guardians was obtained.
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The members of the Harms Study Group are listed in acknowledgements.
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Patel, A., Pahys, J.M., Samdani, A.F. et al. Early and late hospital readmissions in adolescent idiopathic scoliosis. Spine Deform 9, 1041–1048 (2021). https://doi.org/10.1007/s43390-021-00294-7
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DOI: https://doi.org/10.1007/s43390-021-00294-7