Bosco Alexa P, Sullivan Margaret L, Gabriel Daniel, De Silva Shanika, Hedequist Daniel J, Hresko Michael T, Birch Craig M, Hogue Grant D
Department of Orthopaedic Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
Harvard Medical School, Boston, MA, USA.
Spine Deform. 2025 May 2. doi: 10.1007/s43390-025-01093-0.
Single occupancy inpatient recovery rooms are perceived by health care professionals to positively influence patients' experience, while double rooms are associated with higher noise levels, sleep disturbances, and a lack of privacy. These differing physical environments may manifest in differing length of stay, pain scores, and opioid use. When bed space is scarce, identifying ideal populations for double occupancy rooming is important. This study aims to assess how inpatient room assignment impacts recovery time, opioid consumption, and patient reported pain for adolescent idiopathic scoliosis (AIS) patients undergoing a posterior spinal fusion (PSF).
A retrospective cohort study of AIS patients who underwent PSF from 2011 to 2017 at a single center was conducted. Demographics and baseline radiographic measurements were summarized using appropriate statistics. Intraoperative and postoperative outcomes, as well as numerical ranking scale (NRS) pain scores and total daily opioid administration, were compared across room types using t tests, Wilcoxon rank sum tests, Chi-squared tests, or Fisher's exact tests, as appropriate. GEE models were constructed to examine the influence of room type and days since surgery on outcomes.
The cohort included 635 patients: 448 (71%) assigned to a double room and 187 (29%) to a single room. The mean age was 15 ± 2 years and 83% of patients were female. Length of hospital stay, complication rates, 2-year outcomes, inpatient pain scores, and daily opioid usage did not significantly differ between room types (all p > 0.05). Adjusted GEE models revealed no significant associations between room type and pain scores (p = 0.9) or between room type and total opioid dosage (p = 0.95).
When bed space is scarce, double occupancy rooming for pediatric patients after PSF surgery for AIS can serve as a relief valve to continue elective practices without compromising post-operative outcomes.
医疗保健专业人员认为单人住院康复病房对患者体验有积极影响，而双人病房则与更高的噪音水平、睡眠干扰和缺乏隐私相关。这些不同的物理环境可能表现为住院时间、疼痛评分和阿片类药物使用情况的差异。当床位紧张时，确定适合双人病房的理想人群很重要。本研究旨在评估住院病房分配如何影响接受后路脊柱融合术（PSF）的青少年特发性脊柱侧凸（AIS）患者的恢复时间、阿片类药物消耗以及患者报告的疼痛情况。
对2011年至2017年在单一中心接受PSF的AIS患者进行回顾性队列研究。使用适当的统计方法总结人口统计学和基线影像学测量数据。根据情况，使用t检验、Wilcoxon秩和检验、卡方检验或Fisher精确检验比较不同病房类型的术中及术后结果，以及数字评分量表（NRS）疼痛评分和每日阿片类药物总用量。构建广义估计方程（GEE）模型以检查病房类型和术后天数对结果的影响。
该队列包括635名患者：448名（71%）被分配到双人病房，187名（29%）被分配到单人病房。平均年龄为15±2岁，83%的患者为女性。不同病房类型之间的住院时间、并发症发生率、2年结果、住院疼痛评分和每日阿片类药物使用量无显著差异（所有p>0.05）。调整后的GEE模型显示病房类型与疼痛评分之间无显著关联（p = 0.9），病房类型与阿片类药物总剂量之间也无显著关联（p = 0.95）。
当床位紧张时，AIS患者PSF手术后儿科患者的双人病房可作为一种缓解措施，在不影响术后结果的情况下继续进行择期手术。
