ArticleJournal of the Pediatric Orthopaedic Society of North America2026
Predictors of Prolonged Pediatric Intensive Care Unit Length of Stay Following Posterior Spinal Fusion for Neuromuscular Scoliosis.
Article in Journal of the Pediatric Orthopaedic Society of North America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Pediatric patients with neuromuscular scoliosis (NMS) undergoing posterior spinal fusion (PSF) frequently experience prolonged postoperative recovery, including extended pediatric intensive care unit (PICU) stays. Identifying perioperative predictors of prolonged critical care utilization may inform strategies to optimize perioperative management and improve outcomes. Methods: A retrospective cohort study of NMS patients who underwent PSF by a single surgeon (2017-2022) was conducted. Patients were stratified based on PICU length of stay (LOS) into short (0-2 days) and prolonged (≥3 days) groups. Preoperative, intraoperative, and postoperative variables were compared between groups using two-sample Results: Fifty-two patients were included, of whom 33 (63%) had short PICU stays and 19 (37%) had prolonged stays. Prolonged PICU stay was significantly associated with higher preoperative hemoglobin (Hgb; Conclusions: Prolonged PICU stay following PSF for NMS is associated with markers of medical complexity, perioperative anemia, and increased transfusion burden. These findings suggest that perioperative Hgb optimization in medically fragile patients may represent an opportunity to improve postoperative recovery and resource utilization. Prospective studies are warranted to define optimal transfusion and Hgb management strategies in this high-risk population. Key Concepts: (1)Prolonged pediatric intensive care unit (PICU) stay is significantly associated with higher preoperative hemoglobin (Hgb; Level of Evidence: III, Retrospective Cohort Study.
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