PMID- 31359785
OWN - NLM
STAT- MEDLINE
DCOM- 20210712
LR  - 20230202
IS  - 1741-2889 (Electronic)
IS  - 1367-4935 (Linking)
VI  - 24
IP  - 3
DP  - 2020 Sep
TI  - Pediatric complex care and surgery comanagement: Preparation for spinal fusion.
PG  - 402-410
LID - 10.1177/1367493519864741 [doi]
AB  - The aim of this study is to assess the impact of preoperative comanagement with 
      complex care pediatricians (CCP) on children with neuromuscular scoliosis 
      undergoing spinal fusion. We performed chart review of 79 children aged 5-21 
      years undergoing spinal fusion 1/2014-6/2016 at a children's hospital, with 
      abstraction of clinical documentation from preoperative health evaluations 
      performed regularly by anesthesiologists and irregularly by a CCP. Preoperative 
      referrals to specialists, labs, tests, and care plans needed last minute for 
      surgical clearance were measured. The mean age at surgery was 14 (SD 3) years; 
      cerebral palsy (64%) was the most common neuromuscular condition. Thirty-nine 
      children (49%) had a preoperative CCP evaluation a median 63 days (interquartile 
      range (IQR) 33-156) before the preanesthesia visit. Children with CCP evaluation 
      had more organ systems affected by coexisting conditions than children without an 
      evaluation (median 11 (IQR 9-12) vs. 8 (IQR 5-11); p < .001). The rate of 
      last-minute care coordination activities required for surgical clearance was 
      lower for children with versus without CCP evaluation (1.8 vs. 3.6). A lower 
      percentage of children with CCP evaluation required last-minute development of 
      new preoperative plans (26% vs. 50%, p = .002). Children with CCP involvement 
      were better prepared for surgery, requiring fewer last-minute care coordination 
      activities for surgical clearance.
FAU - Berry, Jay G
AU  - Berry JG
AUID- ORCID: 0000-0003-3917-4465
AD  - Complex Care Service, Division of General Pediatrics, Boston Children's Hospital, 
      Harvard Medical School, Boston, MA, USA.
FAU - Glaspy, Tyler
AU  - Glaspy T
AD  - Tufts University School of Medicine, Boston, MA, USA.
FAU - Eagan, Brian
AU  - Eagan B
AD  - Complex Care Service, Division of General Pediatrics, Boston Children's Hospital, 
      Harvard Medical School, Boston, MA, USA.
FAU - Singer, Sara
AU  - Singer S
AD  - Stanford University School of Medicine, Stanford, CA, USA.
FAU - Glader, Laurie
AU  - Glader L
AD  - Complex Care Service, Division of General Pediatrics, Boston Children's Hospital, 
      Harvard Medical School, Boston, MA, USA.
FAU - Emara, Norah
AU  - Emara N
AD  - Complex Care Service, Division of General Pediatrics, Boston Children's Hospital, 
      Harvard Medical School, Boston, MA, USA.
FAU - Cox, Joanne
AU  - Cox J
AD  - Complex Care Service, Division of General Pediatrics, Boston Children's Hospital, 
      Harvard Medical School, Boston, MA, USA.
FAU - Glotzbecker, Michael
AU  - Glotzbecker M
AD  - Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical 
      School, Boston, MA, USA.
FAU - Crofton, Charis
AU  - Crofton C
AD  - Complex Care Service, Division of General Pediatrics, Boston Children's Hospital, 
      Harvard Medical School, Boston, MA, USA.
FAU - Ward, Erin
AU  - Ward E
AD  - Complex Care Service, Division of General Pediatrics, Boston Children's Hospital, 
      Harvard Medical School, Boston, MA, USA.
FAU - Leahy, Izabela
AU  - Leahy I
AD  - Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's 
      Hospital, Harvard Medical School, Boston, MA, USA.
FAU - Salem, Joseph
AU  - Salem J
AD  - Healthcare Systems Engineering Institute, College of Engineering, Northeastern 
      University, Boston, MA, USA.
FAU - Troy, Michael
AU  - Troy M
AD  - Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical 
      School, Boston, MA, USA.
FAU - O'Neill, Margaret
AU  - O'Neill M
AD  - University of Connecticut School of Medicine, Farmington, CT, USA.
FAU - Johnson, Connor
AU  - Johnson C
AD  - Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's 
      Hospital, Harvard Medical School, Boston, MA, USA.
FAU - Ferrari, Lynne
AU  - Ferrari L
AD  - Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's 
      Hospital, Harvard Medical School, Boston, MA, USA.
LA  - eng
GR  - P30 HS024453/HS/AHRQ HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20190730
PL  - England
TA  - J Child Health Care
JT  - Journal of child health care : for professionals working with children in the 
      hospital and community
JID - 9806360
MH  - Adolescent
MH  - Cerebral Palsy/complications
MH  - *Comorbidity
MH  - Female
MH  - Hospitals, Pediatric
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - *Preoperative Care
MH  - Retrospective Studies
MH  - *Scoliosis/complications/surgery
MH  - Spinal Fusion/*nursing
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Children with medical complexity
OT  - coexisting conditions
OT  - complex care
OT  - preoperative evaluation
OT  - spinal fusion surgery
EDAT- 2019/07/31 06:00
MHDA- 2021/07/13 06:00
CRDT- 2019/07/31 06:00
PHST- 2019/07/31 06:00 [pubmed]
PHST- 2021/07/13 06:00 [medline]
PHST- 2019/07/31 06:00 [entrez]
AID - 10.1177/1367493519864741 [doi]
PST - ppublish
SO  - J Child Health Care. 2020 Sep;24(3):402-410. doi: 10.1177/1367493519864741. Epub 
      2019 Jul 30.