Less OR time, shorter hospital stay seen for high- vs. regular-volume scoliosis surgeons
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CHICAGO — Adolescent idiopathic scoliosis procedural costs were significantly lower when a high-volume surgeon performed the surgery, according to research presented here.
There were other advantages of having a high-volume surgeon perform posterior spinal fusion for patients with adolescent idiopathic scoliosis (AIS) instead of a regular-volume surgeon, such as less estimated blood loss, according to research presented at the American Academy of Orthopaedic Surgeons Annual Meeting.
The increasing incidence of AIS surgery led Sayyida Hasan, BS, and colleagues at Cohen Children’s Medical Center to conduct a retrospective study to determine if a surgeon’s case volume made a difference in outcomes.
“High-volume surgeons were defined as having average case volume of over 50 cases per year, while standard-volume surgeons were defined as having less than or equal to 50 cases per year,” Hasan said.
Researchers conducted a retrospective study of patients who underwent AIS surgery performed by one high-volume and three regular-volume surgeons at their institution from 2013 to 2019. Among 335 patients studied, 198 patients were treated by a high-volume surgeon and 137 patients were treated by a regular-volume surgeon.
Despite similar radiographic parameters for the two groups, high-volume surgeons had significantly lower estimated blood loss in procedures (325 mL) vs. regular-volume surgeons (600 mL). Results also showed fewer intraoperative transfusions were required for cases done by high-volume surgeons (9.1%) vs. regular-volume surgeons (17.5%).
“We graphed OR time throughout the years and found, over time, the gap widened showing shorter OR times for high-level surgeons were likely the result of volume rather than just experience over time,” Hasan said.
“Length of stay was a day shorter for high-volume surgeons,” she said.
Total surgical costs were lower for high-volume surgeons, according to the results, “and they accumulated almost $11,000 less in overall costs,” Hasan said.
This included costs for the OR, transfusions and costs related to a 30-day return to the ED, results showed.
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Sarwahi V, et al. Paper 386. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 22-26, 2022; Chicago.
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