LENGTH OF STAY IN ADOLESCENT IDIOPATHIC SCOLIOSIS SURGERY

Abstract

Aim: To determine the length of stay after adolescent idiopathic scoliosis (AIS) surgery in Starship and Mercy Hospitals to ascertain whether there is a difference in the length of stay of patients having AIS surgery in a private hospital compared with a public hospital. To determine the variables having significant influence on the length of stay.

Methods: Patients between the ages of 10 and 20 who had surgery for AIS during the period 1/1/96 to 31/12/2000 were identified from theatre logbooks. Patients who had anterior and posterior surgery were excluded. A retrospective analysis of case notes was carried out. Fisher’s Exact Test was used to analyse categorical data while Student T Test was used for continuous variables.

Results: Thirty-three patients fulfilled the entry criteria. Sixteen male patients were operated on in Starship Hospital. Seventeen patients had operations at Mercy Hospital but only one of these was male. The groups were not significantly different in terms of age, sex, weight, ASA, number of levels, or curve pattern. The Mercy Hospital patients had a significantly lower Cobb angle (by 12 degrees). The Starship Hospital patients tended to retain their PCA pumps longer and tended to use more PCA morphine, however, this result was not significant. The Mercy Hospital patients had their intravenous access removed and were mobilised significantly earlier (1.7 and 1.9 days earlier respectively). The Mercy Hospital patients had a significantly shorter length of stay (6.4 and 8.4 days respectively, p= 0.0002).

Conclusions: Patients at the Mercy Hospital had a significantly shorter post-operative length of stay after AIS surgery. This was not completely explained by the lower Cobb angle seen in the Mercy Hospital patients. The Mercy Hospital patients had their drips removed and were mobilised significantly earlier. This may be the key to early discharge.