Implications of An Accelerated Discharge Following Posterior Spinal Fusions for Adolescent Idiopathic Scoliosis Open Access

Thampalakattu, Alvin (Spring 2018)

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Scoliosis is defined as an abnormal, three-dimensional spinal deformity associated with a lateral curvature of at least 10 degrees within the coronal plane and a rotational misalignment of the spinal column within the sagittal and transverse planes of the body. Although there are many classifications of scoliosis, the most common type, by far, is Adolescent Idiopathic Scoliosis (AIS). AIS is estimated to be found in as many as 4 in 100 children between the ages of 10 and 18, and depending on the severity of the curve, surgical intervention may be necessary for treatment. The most common surgical procedure used to treat AIS is called a posterior spinal fusion. In 2005, Children’s Healthcare of Atlanta began the development of an accelerated discharge following posterior spinal fusions that would maximize post-operative efficiency without compromising care. Afterwards, through a retrospective analysis comparing patients treated with and without the accelerated discharge, it was revealed that the accelerated discharge resulted in a 31.7% decrease in length of stay without any increase in adverse effects, but the major limitation with this initiative was the lack of health assessments to determine the quality of life for the patients after their discharge. With this in mind, our medical team at Children’s Healthcare of Atlanta began an initiative in order to prospectively evaluate the feasibility, efficacy, safety, and quality provided by the accelerated discharge following posterior spinal fusions for AIS. In addition to measuring the patient’s perspective of the quality of care delivered, the secondary objective of the following study was to create a parent satisfaction survey that will ultimately be utilized in order to compare how a patient’s perspective of their quality of care differs from their parent’s perspective. The implications of this study are important as they will help determine if the accelerated discharge is able to expedite the discharge process without compromising care, and if this is true, the accelerated discharge following posterior spinal fusions for AIS developed at Children’s Healthcare of Atlanta can ultimately serve as a model for future widespread adoption. 

Table of Contents

Introduction, 1

Figure 1, 7

Figure 2, 8

Table 1, 10

Materials and Methods, 14

Table 2, 15

Table 3, 17

Table 4, 19

Table 5, 20

Table 6, 21

Table 7, 24

Results, 26

Figure 3, 26

Figure 4, 27

Discussion, 28

References, 30

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