PMID- 25201091
OWN - NLM
STAT- MEDLINE
DCOM- 20150311
LR  - 20231111
IS  - 1528-1132 (Electronic)
IS  - 0009-921X (Print)
IS  - 0009-921X (Linking)
VI  - 473
IP  - 1
DP  - 2015 Jan
TI  - Patient factors are associated with poor short-term outcomes after posterior 
      fusion for adolescent idiopathic scoliosis.
PG  - 286-94
LID - 10.1007/s11999-014-3911-4 [doi]
AB  - BACKGROUND: Posterior spinal fusion (PSF) is commonly performed for patients with 
      adolescent idiopathic scoliosis (AIS). Identifying factors associated with 
      perioperative morbidity and PSF may lead to strategies for reducing the frequency 
      of adverse events (AEs) in patients and total hospital costs. QUESTIONS/PURPOSES: 
      What is the frequency of and what factors are associated with postoperative: (1) 
      AEs, (2) extended length of stay (LOS), and (3) readmission in patients with AIS 
      undergoing PSF? PATIENTS AND METHODS: Patients, aged 11 to 18 years, who 
      underwent PSF for AIS during 2012, were identified from the American College of 
      Surgeons National Surgical Quality Improvement Program(R) (ACS NSQIP(R)) Pediatric 
      database. Patient were assessed for characteristics associated with AEs, extended 
      LOS (defined as more than 6 days), and hospital readmission using multivariate 
      logistic regression. Individual AEs captured in the database were grouped into 
      two categories, "any adverse event" (AAE) and "severe adverse events" (SAEs) for 
      analysis. A total of 733 patients met inclusion criteria. RESULTS: Twenty-seven 
      patients (3.7%) had AAE and 19 patients (2.6%) had SAEs. Both AAE and SAEs were 
      associated with BMI-for-age ninety-fifth percentile or greater (AAE: odds ratio 
      [OR], 3.31; 95% CI, 1.43-7.65; p=0.005. SAE: OR, 3.46; 95% CI, 1.32-9.09; 
      p=0.012). Extended LOS occurred for 60 patients (8.2%) and was associated with 
      greater than 13 levels instrumented (OR, 2.00; 95% CI, 1.11-3.61; p=0.021) and 
      operative time of 365 minutes or more (OR, 2.57; 95% CI, 1.39-4.76; p=0.003). 
      Readmission occurred for 11 patients (1.5%), most often for surgical site 
      infection, and was associated with the occurrence of any complication during the 
      initial hospital stay (OR, 180.44; 95% CI, 35.47-917.97; p<0.001). CONCLUSIONS: 
      Further research on prevention and management of obesity and surgical site 
      infections may reduce perioperative morbidity for patients with AIS undergoing 
      PSF. LEVEL OF EVIDENCE: Level III, prognostic study. See Instructions for Authors 
      for a complete description of levels of evidence.
FAU - Basques, Bryce A
AU  - Basques BA
AD  - Department of Orthopaedics and Rehabilitation, Yale University School of 
      Medicine, 800 Howard Avenue, New Haven, CT, 06510, USA.
FAU - Bohl, Daniel D
AU  - Bohl DD
FAU - Golinvaux, Nicholas S
AU  - Golinvaux NS
FAU - Smith, Brian G
AU  - Smith BG
FAU - Grauer, Jonathan N
AU  - Grauer JN
LA  - eng
GR  - UL1 TR000142/TR/NCATS NIH HHS/United States
PT  - Journal Article
DEP - 20140909
PL  - United States
TA  - Clin Orthop Relat Res
JT  - Clinical orthopaedics and related research
JID - 0075674
SB  - IM
CIN - Clin Orthop Relat Res. 2015 Jan;473(1):295-6. PMID: 25245532
MH  - Adolescent
MH  - Child
MH  - Databases, Factual
MH  - Female
MH  - Humans
MH  - Length of Stay
MH  - Logistic Models
MH  - Male
MH  - Multivariate Analysis
MH  - Obesity/epidemiology
MH  - Odds Ratio
MH  - Patient Readmission
MH  - Postoperative Complications/*etiology/therapy
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Scoliosis/diagnosis/epidemiology/*surgery
MH  - Spinal Fusion/*adverse effects
MH  - Surgical Wound Infection/etiology
MH  - Treatment Outcome
MH  - United States/epidemiology
PMC - PMC4390920
EDAT- 2014/09/10 06:00
MHDA- 2015/03/12 06:00
PMCR- 2016/01/01
CRDT- 2014/09/10 06:00
PHST- 2014/04/18 00:00 [received]
PHST- 2014/08/19 00:00 [accepted]
PHST- 2014/09/10 06:00 [entrez]
PHST- 2014/09/10 06:00 [pubmed]
PHST- 2015/03/12 06:00 [medline]
PHST- 2016/01/01 00:00 [pmc-release]
AID - 3911 [pii]
AID - 10.1007/s11999-014-3911-4 [doi]
PST - ppublish
SO  - Clin Orthop Relat Res. 2015 Jan;473(1):286-94. doi: 10.1007/s11999-014-3911-4. 
      Epub 2014 Sep 9.