125. High volume surgeons have better surgical outcomes and lower costs

Abstract

BACKGROUND CONTEXT Increased surgical volume has been associated with improved perioperative outcomes after spinal deformity correction. However, there is a lack of information on how this may affect hospital costs. PURPOSE To determine whether high volume surgeons have lower costs than low-volume surgeons in spinal deformity surgery. STUDY DESIGN/SETTING Retrospective review. PATIENT SAMPLE This study included 335 AIS patients. OUTCOME MEASURES Age, BMI, Cobb, kyphosis, surgical time, anesthesia time, transfusion, blood products, overall hospital costs, extubation rate, return to ED. METHODS A retrospective study of adolescent idiopathic scoliosis (AIS) patients undergoing PSF from 2013 – 2019 was performed. Demographic, XR, chart review and hospital costs were collected and compared between high-volume (HV) surgeons (>50 AIS cases/yr) and low-volume (LV) surgeons (≤50/yr). Comparative analyses were computed using Wilcoxon Rank-Sum, Kruskal-Wallis, and Fisher's exact tests. Median values with corresponding IQRs were reported. RESULTS A total of 335 patients (HV: 198, LV: 137) operated by 4 surgeons (1 HV, 3 LV). Radiographic parameters were similar between the groups. HV surgeons had significantly lower EBL (325v600 mL, p CONCLUSIONS High volume surgeons had lower transfusion rates, shorter surgery time and were more likely to be extubated in the OR than their low volume counterparts. In addition, high volume surgeons had lower overall costs compared to low volume surgeons. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.