A recent study sheds new light on the factors influencing hospital stays for adolescents undergoing spinal fusion surgery for scoliosis.
While reducing inpatient duration is a common goal, researchers are exploring whether longer stays might actually enhance patient wellbeing, opening the door to a nuanced approach that balances efficiency with quality care.
The study explored factors influencing extended inpatient length of stay (LOS) following posterior segmental instrumented fusion (PSIF) for adolescent idiopathic scoliosis (AIS).
It aimed to determine whether longer LOS correlates with improved patient-reported outcomes, utilising Scoliosis Research Society (SRS) scores that assess pain, mental health, and satisfaction post-surgery.
AIS affects 1% to 3% of children, often necessitating surgical intervention to prevent progression of spinal curvature.
Extended hospital stays are associated with higher healthcare costs, increased risk of complications, and higher readmission rates.
Understanding determinants of LOS and their impact on patient perceptions could inform strategies to optimise recovery, care quality, and cost-efficiency.
The study retrospectively reviewed 118 AIS patients aged 10 to 18 years who underwent PSIF at a single institution from 2020 to 2024. Data on demographics, surgical details, and pre- and postoperative SRS scores were collected.
LOS was analysed as a continuous variable, and statistical methods identified correlations among LOS, perioperative factors, and patient-reported outcomes.
Results indicated that patients with fusion levels exceeding 11 experienced significantly longer hospital stays.
Longer LOS was associated with higher postoperative mental health scores on the SRS.
Trends toward greater satisfaction and reduced pain were observed but did not reach statistical significance.
Factors such as patient age, sex, ethnicity, curve severity, blood loss, and the training level of surgical assistants were not significantly associated with LOS.
The findings highlight that although minimising LOS remains crucial for reducing costs and risks, longer stays may offer mental health benefits. This indicates a need to carefully assess discharge protocols, balancing efficiency with patient-centred outcomes.
The paper’s authors recommend further prospective research to determine whether accelerated discharge adversely affects patient-reported outcomes.
