The Impact of Standardized Recovery Pathways on Language Barriers and Inpatient Pain Management

作者：Kathryn R. Segal, Jaime A. Gómez, Jacob F. Schulz, Leila Mehraban Alvandi, Eric D. Fornari · 发表于：Hospital Pediatrics · 年份：2023 · DOI：10.1542/hpeds.2023-007232 · 被引用次数：6 · 研究领域：Scoliosis diagnosis and treatment、Anesthesia and Pain Management、Enhanced Recovery After Surgery

BACKGROUND AND OBJECTIVES: Inpatient postoperative care is reliant upon clear, open communication between providers and patient-families, and thus is particularly vulnerable to disparities when discordant languages exist. It is not yet understood how standardized postoperative protocols may mitigate disparities related to language discordance. METHODS: This is a retrospective cohort study among adolescent idiopathic scoliosis patients who underwent posterior spinal fusion at a tertiary care children's hospital in Bronx, New York after implementation of a postoperative pathway in 2017. Outcomes reliant upon communication between patient-families and providers were measured, including measures of pain management (number and type of pain medications requested, daily pain assessments, total opioids consumed), as well as outpatient pain scores. RESULTS: A total of 160 patients were included (39 language other than English [LOE]). Between patient cohorts, there were no significant differences in demographic or operative characteristics. On univariate analyses, LOE patients were more likely to be given a basal dosing of patient-controlled analgesia or additional boluses (26% vs 12%, P = .03), consumed 0.53 fewer benzodiazepine medications per day (P = .01), and were more likely to have pain at outpatient follow-up (67% vs 43%, P = .03). On multivariate analyses, LOE patients were more likely to be placed on basally dosed or receive additional boluses of patient-controlled analgesia ...