Early and late hospital readmissions in adolescent idiopathic scoliosis

Study design: Retrospective review of a prospectively collected multicenter database. Objectives: To identify risk factors for early and late readmission of surgically treated patients with adolescent idiopathic scoliosis (AIS). Summary of background data: Specific risk factors associated with readmission in patients with AIS remain poorly understood. Methods: Patients with AIS who were operatively treated from 19 centers specializing in the treatment of pediatric spinal deformity were studied. Data from a minimum 2 years of clinical follow-up and any readmission were available for analysis. Characteristics of patients with no readmission, early readmission (< 90 days), and late readmission (> 90 days) were evaluated. Both univariate and multivariate analyses of risk factors for readmission were performed. Results: 2049 patients were included in our cohort, with 1.6% requiring early readmission and 3.3% late readmission. In the multivariate analysis, greater preoperative coronal imbalance was associated with early readmission. Longer operative time was associated with late readmission. Finally, greater preoperative pain (SRS-22 pain scale) was associated with both early and late readmission. GI complications accounted for a higher proportion of early readmissions than previously reported in the literature. Conclusions: Preoperative counseling of patients with higher levels of pain and coronal imbalance and the implementation of a thorough postoperative bowel regimen may help optimize patient outcomes. Level of evidence: 3.