Qingyu Wang, Yan Gao, Juan Du
A comparative study on teaching satisfaction of smart class and traditional class in pharmacy administration
BMC medical education
objective objective study determine recent changes technology surgical techniques surgical literature influenced practice trends spinal fusion surgery pediatric neuromuscular scoliosis nms study authors analyzed recent trends surgical management nms investigated effect various patient surgical factors inhospital complications outcomes costs using nationwide inpatient sample nis database methods nis queried 2002 2011 using international classification diseases ninth edition clinical modification codes identify pediatric cases age 18 years spinal fusion nms several patient surgical shortterm outcome factors included analyses trend analyses factors conducted univariate multivariable analyses used determine effect various patient surgical factors shortterm outcomes results 2002 2011 total 2154 nms fusion cases identified volume spinal fusion procedures increased 93 148 2002 286 2011 p 00001 mean patient age 128 310 years 456 study population female overall complication rate 401 respiratory complication rate 282 2002 2011 upward trends p 00001 demonstrated medicaid insurance status 365 528 presence 1 comorbidity 402 521 blood transfusions 252 573 utilization posterioronly fusions psfs increased 662 902 p 00001 combined anterior releasefusions psf arpsf decreased 338 98 00001 intraoperative neurophysiological monitoring ionm underwent increasing utilization 2009 2011 155 203 p 00001 useharvest autograft underwent significant upward trend 2002 2011 313 598 p 00001 univariate analysis ionm use associated decreased complications 407 331 p 0049 length stay los 921 670 days p 00001 inflationadjusted mean hospital costs increased nearly 75 2002 2011 36805 65244 p 00001 multivariable analysis nonwhite race highest quartile median household income greater preexisting comorbidity longsegment fusions use blood transfusions found increase likelihood complication occurrence p 005 multivariable analysis independent predictors prolonged los included older age increased preexisting comorbidity arpsf approach longsegment fusions p 005 lastly likelihood increased hospital costs 90th percentile los 14 days increased older age female sex medicaid insurance status highest quartile median household income arpsf approach longsegment fusion blood transfusion p 005 multivariable analysis use autograft associated lower likelihood complication occurrence prolonged los p 005 conclusions increasing use ionm posterioronly approaches may combat high complication rates nms trends increasing comorbidities blood transfusions total costs spinal fusion surgery pediatric nms may indicate increasingly aggressive approach cases