Comorbidities up resource use in pediatric spinal fusion

(HealthDay)—For children with medical complexity undergoing spinal fusion, chronic respiratory insufficiency, bladder dysfunction, and epilepsy are significantly associated with hospital resource use, according to a study published online Feb. 2 in Pediatrics.

Jay G. Berry, M.D., M.P.H., from the Boston Children's Hospital, and colleagues conducted a retrospective analysis of 7,252 children aged 5 years and older with an underlying complex chronic condition undergoing spinal fusion. The authors compared hospital length of stay (LOS), cost, and 30-day readmission rates across comorbid conditions.

The researchers found that 59 percent of children had four or more comorbid conditions. An increase in the number of chronic conditions from one to three to 10 or more correlated with a 60 percent increase in median LOS (five to eight days), a 53 percent increase in median hospital costs ($52,319 to $80,429), and a 293 percent increase in readmission rate (5.4 to 15.8 percent) (all P < 0.001). Chronic respiratory insufficiency and bladder dysfunction were strongly associated with LOS (+2.1 and +0.8 days, respectively) and cost (+$12,070 and +$4,014, respectively) in multivariable analysis (all P < 0.001). The likelihood of readmission was highest with bladder dysfunction and epilepsy (odds ratios, 1.5 and 1.2, respectively).

"Pediatricians, patients, and families may find it useful to consider these conditions when striving to benefit the children's perioperative health and outcomes," the authors write.

One author disclosed financial ties to Depuy Synthes.