From 2014 to 2019, a retrospective review of patients aged 10 to 18 who had posterior fusion for adolescent idiopathic scoliosis (AIS) at a single institution was conducted. For a study, the researchers sought to determine how a standardized Care Path affected perioperative outcomes in patients receiving spinal fusion for AIS. The study included 336 patients ranging in age from 10 to 18 years old, with 117 in the pre-Care Path cohort (2014–2015) and 219 in the post-Care Path cohort (2016–2019). Intraoperative data, duration of stay, mobilization time, inpatient complications, ER visits, readmissions after discharge, postoperative complications, and reoperations were all compared. The post-Care Path cohort had better mobilisation on postoperative day 0 (pre 16.7%, post 53.3%, P<0.00001), shorter hospital stays (pre 4.14 days, post 3.36 days, P=0.00006), fewer total inpatient complications (pre 17.1%, post 8.1%, P=0.0469), and fewer cases of postoperative ileus (pre 8.5%, post 1.9%, P=0.0102). The post-Care Path cohort had fewer ER visits (pre 12.8% vs post 7.2%, P=0.0413), fewer postoperative infections (pre 5.1% vs post 0.48%, P=0.00547), fewer readmissions (pre 6.0% vs post 0.48%, P=0.0021), and fewer reoperations (pre 5.1% vs post 0.96%, P=0.0195) within 60 days of surgery In the Care Path cohort, inpatient oral morphine equivalents decreased (before 118.7, post 84.7, P=0.0003). The AIS Care Path resulted in significant improvements in postoperative mobilization and reductions in length of stay, complications, infections, ER visits, readmissions, and reoperations for the investigator’s patients.

 

Source:journals.lww.com/jspinaldisorders/Abstract/2022/02000/Use_of_a_Standardized_Perioperative_Care_Path_for.19.aspx

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