Search

Objective: The objective of this study is to evaluate factors associated with discharge to subacute care after surgery for degenerative cervical myelopathy., Design: This is a retrospective chart review of adults who underwent cervical spine surgery for degenerative cervical myelopathy between 2014 and 2020 ( N = 135)., Results: Patients discharged to a subacute setting were older (68.1 ± 8.6 vs. 64.1 yrs ± 8.8, P = 0.01), more likely to be unmarried (55.8% vs. 33.7% married, P = 0.01), and more likely to have Medicare or Medicaid (83.7% vs. 65.9% private insurance, P = 0.03) than patients discharged home. A posterior surgical approach was associated with discharge to a subacute setting (62.8% vs. 43.5% anterior approach, P = 0.04). A total of 87.8% of patients discharged to a subacute setting required moderate or maximum assistance for bed mobility versus 26.6% of patients discharged home ( P < 0.0001). Compared with patients discharged home, patients discharged to a subacute setting ambulated a shorter distance in their first physical therapy evaluation after surgery (8.9 ± 35.8 vs. 53.7 ± 61.78 m in the home discharge group, P < 0.0001)., Conclusions: Analysis of these factors may guide discussions about patient expectations for postoperative discharge placement., Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction and Purpose: A number of studies have evaluated visual acuity (VA) of special needs children, but no analyses of the parents' perception of VA testing or the utilization of VA test results by pediatric ophthalmologists have been reported., Patients and Methods: Special needs children referred for an initial VA test (Teller Acuity Cards) during a 2-year period were enrolled (n = 309). Within the overall cohort, twenty consecutive parents whose child attended during a 6-week period completed a Parent Questionnaire before and after VA testing. Also, 58 parents of infants with cortical visual impairment (CVI) completed the Parental Stress Index-Short Form (PSI-SF) before VA testing and 3 months later. Referring pediatric ophthalmologists (n = 12) completed a Physician Questionnaire., Results: VA testing was associated with parents reporting increased knowledge scores and decreased concerns about their children's vision on the Parent Questionnaire. VA testing was also associated with reduced Total and Parental Distress subscale scores on the PSI-SF by parents of infants with CVI. Ophthalmologists reported that VA results were useful in diagnosis and clinical management and provided new information to parents, Early Childhood Intervention programs, schools, and social agencies., Conclusion: VA testing is of benefit in children with special needs to both their parents and ophthalmologists, providing quantitative information about visual impairment and reducing stress experienced by parents.