A room with a view: Recovery bed environment following pediatric spinal fusion

Patients in a double-occupancy room during recovery will have different experiences based on bed location. For instance, patients near a window will have access to natural light while a patient near the door may experience higher noise levels. This study aims to assess the impact of inpatient bed placement on postoperative recovery for adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion (PSF).

This retrospective cohort study included 448 AIS patients who underwent PSF from 2011 to 2017 at a single center. Demographics and baseline radiographic measurements were summarized using appropriate statistics. Intraoperative and postoperative outcomes, NRS pain scores and total daily opioid administration were compared across bed types using t-tests, Wilcoxon rank sum tests, chi-squared tests, or Fisher's exact tests, as appropriate. GEE models were constructed to examine the influence of bed type and days since surgery on outcomes such as postoperative complication, PACU pain levels, length of stay, daily numerical ranking scale (NRS) pain scores and total daily opioid administration.

325 (73%) patients in the cohort were assigned to a bed by the window and 123 (27%) were assigned to a bed by the door. The mean age was 15±2 years and 85% of patients were female. Length of hospital stay, complication rates, 2-year outcomes, inpatient pain scores, and daily opioid usage did not significantly differ between bed types (all p>.05). Adjusted GEE models revealed no significant associations between bed type and pain scores (p=.9) or between bed type and total opioid dosage (p=.95).

Proximity to a window while recovering from PSF surgery for AIS does not impact inpatient outcomes. When bed space is scarce, usage of all available beds can serve as a relief valve to continue elective practices without compromising postoperative outcomes.