Preoperative Biopsychosocial Assessment and Length of Stay in Orthopaedic Surgery Admissions of Youth with Cerebral Palsy
Abstract
1. Introduction
Background
2. Materials and Methods
2.1. Biopsychosocial Assessment
2.2. Statistical Analysis
3. Results
3.1. Group Analysis
3.1.1. Length of Stay
3.1.2. Extended Length of Stay
3.1.3. Thirty-Day Readmission
3.2. Multivariate Analyses
3.2.1. Length of Stay
3.2.2. Extended Length of Stay
3.2.3. Thirty-Day Readmission
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | BPSA | p Value | Test | ||
---|---|---|---|---|---|
No | Yes | ||||
Age | Median (CI) | 10.6 (0.94) | 10.9 (0.97) | 0.72 | Wilcoxon |
Race | Asian | 1 | 0 | 0.68 | Chi-squared |
Asian Indian | 1 | 0 | |||
Black or African American | 13 | 13 | |||
Guamanian or Chamorro | 0 | 1 | |||
Some other race | 3 | 4 | |||
White or Caucasian | 28 | 28 | |||
GMFCS | IV | 16 | 17 | 0.83 | Chi-squared |
V | 30 | 29 | |||
Surgery type | Hip | 28 | 28 | 1 | Chi-squared |
Spine | 18 | 18 | |||
Range of medical issues | None = 0 | 6 | 8 | 0.84 | Chi-squared |
Small = 1.2 | 24 | 23 | |||
Large = 3.4 | 16 | 15 |
Surgery Type | BPSA | Comorbidities | n | LOS Days | 30-Day Readmission | ||
---|---|---|---|---|---|---|---|
Median | IQR | CI | |||||
Hip | No | None | 4 | 5.5 | 1.75 | 2.72 | 0 |
Hip | No | Small | 16 | 6.5 | 4 | 1.76 | 2 |
Hip | No | Large | 8 | 6.5 | 7.75 | 4.07 | 2 |
Spine | No | None | 2 | 11 | 3 | 38.1 | 1 |
Spine | No | Small | 8 | 11 | 2.5 | 21.2 | 0 |
Spine | No | Large | 8 | 21 | 31 | 21.8 | 0 |
Hip | Yes | None | 6 | 6 | 1.5 | 21.6 | 0 |
Hip | Yes | Small | 16 | 5.5 | 2.25 | 1.06 | 1 |
Hip | Yes | Large | 6 | 8 | 1.5 | 3.8 | 0 |
Spine | Yes | None | 2 | 9 | 1 | 12.7 | 0 |
Spine | Yes | Small | 7 | 10 | 5 | 3.16 | 1 |
Spine | Yes | Large | 9 | 7 | 1 | 1.96 | 2 |
Subject Number | Surgery | Reason for 30-Day Readmission |
---|---|---|
1 | HR | Oropharyngeal dysphagia, diabetes insipidus |
2 | HR | Postoperative pain management |
3 | HR | Vomiting, constipation |
4 | HR | Decubitus ulcer |
5 | PSF | Urinary retention |
6 | HR | Wound infection |
7 | PSF | Urinary tract infection |
8 | PSF | Wound infection |
9 | PSF | Wound infection |
Length of Stay Models Fit | ||||
---|---|---|---|---|
PSF | ||||
χ2 (5) | 186.96 | |||
p | 0.00 | |||
Pseudo-R2 (McFadden) | 0.29 | |||
Standard errors: MLE | ||||
Est. | S.E. | z val. | p | |
(Intercept) | 0.17 | 0.64 | 0.27 | 0.78 |
BPSA (yes) | −1.08 | 0.10 | 11.16 | <0.001 |
additional comorbidities (small) | 0.37 | 0.17 | 2.16 | 0.03 |
additional comorbidities (large) | 0.63 | 0.19 | 3.27 | <0.001 |
Age | 0.05 | 0.02 | 1.90 | 0.06 |
GMFCS | 0.41 | 0.12 | 3.48 | 0.005 |
Hip Reconstruction | ||||
χ2 (3) | 22.56 | |||
p | 0.00 | |||
Pseudo-R2 (McFadden) | 0.06 | |||
Standard errors: MLE | ||||
Est. | S.E. | z val. | p | |
(Intercept) | 2.23 | 0.12 | 19.24 | 0.00 |
Additional comorbidities (small) | −0.46 | 0.12 | −3.89 | <0.001 |
Additional comorbidities (large) | −0.13 | 0.13 | −1.03 | 0.30 |
Sex (male) | 0.23 | 0.1 | 2.34 | 0.019 |
Extended Length of Stay Models Fit | ||||
---|---|---|---|---|
PSF | ||||
χ2 (1) | 9.77 | |||
p | 0.00 | |||
Pseudo-R2 (McFadden) | 0.20 | |||
Standard errors: MLE | ||||
Est. | S.E. | z val. | p | |
(Intercept) | 0.69 | 0.5 | 1.39 | 0.17 |
BPSA (Yes) | −2.3 | 0.81 | −2.86 | 0.004 |
Hip Reconstruction | ||||
χ2 (3) | 11.66 | |||
p | 0.01 | |||
Pseudo-R2 (McFadden) | 0.22 | |||
Standard errors: MLE | ||||
Est. | S.E. | z val. | p | |
(Intercept) | −13.99 | 6.07 | −2.31 | 0.02 |
BPSA (yes) | −2.16 | 1.01 | −2.13 | 0.03 |
Sex (male) | 1.96 | 1.02 | 1.92 | 0.05 |
GMFCS | 2.56 | 1.22 | 2.09 | 0.04 |
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Lennon, N.; Sewell-Roberts, C.; Banjo, T.; Kraft, D.B.; Salazar-Torres, J.J.; Church, C.; Shrader, M.W. Preoperative Biopsychosocial Assessment and Length of Stay in Orthopaedic Surgery Admissions of Youth with Cerebral Palsy. Behav. Sci. 2023, 13, 383. https://doi.org/10.3390/bs13050383
Lennon N, Sewell-Roberts C, Banjo T, Kraft DB, Salazar-Torres JJ, Church C, Shrader MW. Preoperative Biopsychosocial Assessment and Length of Stay in Orthopaedic Surgery Admissions of Youth with Cerebral Palsy. Behavioral Sciences. 2023; 13(5):383. https://doi.org/10.3390/bs13050383
Chicago/Turabian StyleLennon, Nancy, Carrie Sewell-Roberts, Tolulope Banjo, Denver B. Kraft, Jose J. Salazar-Torres, Chris Church, and M. Wade Shrader. 2023. "Preoperative Biopsychosocial Assessment and Length of Stay in Orthopaedic Surgery Admissions of Youth with Cerebral Palsy" Behavioral Sciences 13, no. 5: 383. https://doi.org/10.3390/bs13050383
APA StyleLennon, N., Sewell-Roberts, C., Banjo, T., Kraft, D. B., Salazar-Torres, J. J., Church, C., & Shrader, M. W. (2023). Preoperative Biopsychosocial Assessment and Length of Stay in Orthopaedic Surgery Admissions of Youth with Cerebral Palsy. Behavioral Sciences, 13(5), 383. https://doi.org/10.3390/bs13050383