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Purpose <p>Advances in operative and recovery protocols such as the rapid recovery pathway (RRP) in the last decade have shortened inpatient stays for adolescent idiopathic scoliosis (AIS). This study aimed to evaluate the impact of these national trends on length of stay (LOS), complication rates, and costs in patients with AIS undergoing posterior spinal fusion (PSF) using a large, nationally representative dataset.</p> Methods <p>A retrospective review of 10,081 patients requiring PSF for AIS was conducted using the Healthcare Cost and Utilization Project’s (HCUP) Kids’ Inpatient Database (KID) in the latest available year prior to the popularity of protocols like RRP (2012) and most recently (2019). Patients and complications were identified via ICD-9 and ICD-10 codes. Multivariate linear and logistic regression analyses were performed to assess the impact of year of surgery while adjusting for demographic variables.</p> Results <p>Average LOS decreased in 2019 vs. 2012 (3.9&#xa0;days vs. 5.4&#xa0;days, <i>p</i> &lt; 0.001), year of surgery (β = –1.4&#xa0;days, <i>p</i> &lt; 0.001), and absence of complications (β = –2.8&#xa0;days, <i>p</i> &lt; 0.001) were the largest predictors of LOS. Overall complication rates declined from 12.8% to 6.5% (<i>p</i> &lt; 0.001). Year of surgery showed significantly increased charges after inflation adjustment (β = $12,452.6, <i>p</i> &lt; 0.001), though other demographic variables demonstrated larger impact on cost.</p> Conclusions <p>More recent surgical year resulted in reduced hospital stays with fewer complications and without substantial increases in cost. These findings support continued adoption and refinement of operative and recovery protocols in pediatric spine surgery.</p>

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Recent national improvements in length of stay and complications after posterior spinal fusion for adolescent idiopathic scoliosis: a database analysis and review of literature

  • 期刊论文

  • 发表日期：

    2025年12月13日

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  • Utsav Kapoor,
  • Jennifer M. Bauer,
  • Burt Yaszay,
  • Scott Yang

摘要

Purpose

Advances in operative and recovery protocols such as the rapid recovery pathway (RRP) in the last decade have shortened inpatient stays for adolescent idiopathic scoliosis (AIS). This study aimed to evaluate the impact of these national trends on length of stay (LOS), complication rates, and costs in patients with AIS undergoing posterior spinal fusion (PSF) using a large, nationally representative dataset.

Methods

A retrospective review of 10,081 patients requiring PSF for AIS was conducted using the Healthcare Cost and Utilization Project’s (HCUP) Kids’ Inpatient Database (KID) in the latest available year prior to the popularity of protocols like RRP (2012) and most recently (2019). Patients and complications were identified via ICD-9 and ICD-10 codes. Multivariate linear and logistic regression analyses were performed to assess the impact of year of surgery while adjusting for demographic variables.

Results

Average LOS decreased in 2019 vs. 2012 (3.9 days vs. 5.4 days, p < 0.001), year of surgery (β = –1.4 days, p < 0.001), and absence of complications (β = –2.8 days, p < 0.001) were the largest predictors of LOS. Overall complication rates declined from 12.8% to 6.5% (p < 0.001). Year of surgery showed significantly increased charges after inflation adjustment (β = $12,452.6, p < 0.001), though other demographic variables demonstrated larger impact on cost.

Conclusions

More recent surgical year resulted in reduced hospital stays with fewer complications and without substantial increases in cost. These findings support continued adoption and refinement of operative and recovery protocols in pediatric spine surgery.