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Spinal surgery in children with idiopathic and neuromuscular scoliosis. What's the difference?
Nancy Alice Murphy1, Sean Firth, Trisha Jorgensen
1University of Utah, Salt Lake City, UT 84132, USA.
Insights
Children with neuromuscular scoliosis (NMS) face significantly more complex and expensive hospitalizations compared to those with idiopathic scoliosis (IS). This includes longer stays, higher costs, and increased complications, impacting care decisions.
Area of Science:
- Pediatric Orthopedics
- Healthcare Management
- Spinal Deformities
Background:
- Idiopathic scoliosis (IS) and neuromuscular scoliosis (NMS) are common spinal conditions in children.
- Understanding hospitalization differences is crucial for resource allocation and patient care.
Purpose of the Study:
- To compare the hospitalization characteristics and outcomes of children with IS versus NMS.
- To identify key differences in length of stay, costs, diagnoses, procedures, and complications.
Main Methods:
- Analysis of the 2000 Healthcare Cost and Utilization Project Kid Inpatient Database.
- Comparison of inpatient data for pediatric patients diagnosed with IS and NMS.
Main Results:
- Children with NMS had longer hospital stays (9.2 vs. 6.1 days), higher total charges ($66,953 vs. $47,463), more diagnoses (6.3 vs. 2.5), and more procedures (4.2 vs. 3.0) than IS patients.
- NMS patients experienced higher rates of pneumonia (3.5% vs. 0.7%), respiratory failure (24.1% vs. 9.2%), UTIs (5.3% vs. 0.7%), and surgical wound infections (1.3% vs. 0.3%).
- Spinal surgery for NMS accounted for $105 million in charges and 14,444 hospital days.
Conclusions:
- Children with NMS incur significantly more complicated and costly hospitalizations than those with IS.
- Findings can inform preoperative care, surgical decision-making, informed consent, and anticipatory guidance for NMS patients and caregivers.
Abstract:
We compared children who were hospitalized for the management of idiopathic scoliosis (IS) and neuromuscular scoliosis (NMS) via analysis of the 2000 Healthcare Cost and Utilization Project Kid Inpatient Database. Children with NMS had longer lengths of stay (9.2 vs. 6.1 days, P < 0.001), higher total charges (66,953 US dollars vs. 47,463 US dollars, P < 0.001), more diagnoses (6.3 vs. 2.5, P < 0.001), and more total procedures (4.2 vs. 3.0, P < 0.001) than did children with IS. Children with NMS more frequently developed pneumonia (3.5% vs. 0.7%, P < 0.001), respiratory failure (24.1% vs. 9.2%, P < 0.001), urinary tract infections (5.3% vs. 0.7%, P < 0.001), and surgical wound infections (1.3% vs. 0.3%, P < 0.001). Overall, 1570 children with NMS underwent spinal surgery, totaling to 105 US dollars million in hospital charges and 14,444 hospital days. We conclude that children with NMS experience significantly more complicated and costly hospitalizations than do children with IS. These results may add information on preoperative care, surgical decision-making, discussions of informed consent, and the provision of anticipatory guidance for children and their caregivers.
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