A new study published in Spine shows high volume hospitals for adolescent spinal deformity correction have lower complication rates.
The researchers examined the National Inpatient Sample for patients age 10 to 18 years old with in-hospital stays for spinal deformity surgery. There were 6,100 spinal fusions included in the study. The researchers found:
1. There were fewer complications for high volume surgeons after a primary fusion diagnosis for all diagnoses and all complication categories.
2. The pattern remained true for high volume surgeons when increasing surgical invasiveness, such as fusing nine or more levels.
3. The trend for high volume surgeons became more distinct for neurological complications when comparing surgeons performing anterior-posterior combination procedures.
4. High surgical volumes were also associated with decreased length of stay and hospital charges for adolescent scoliosis fusions. "The impact of volume on reduced length of stay and hospital charges has implications for future healthcare economics measures," concluded the study authors.
5. The higher complication rate for low volume settings could reflect a learning curve for more complex cases since these trends were magnified in neuromuscular and congenital scoliosis cases. The authors also posited the trend could reflect that higher volume surgeons are more adept at these fusions.