Abstract Details

Spasticity is a motor disorder observed in cerebral palsy and a leading driver of morbidity in 70-80% of pediatric cerebral palsy patients. Increased muscle co-activation and velocity-dependent stiffness coupled with decreased strength result in major rehabilitation challenges. Corresponding diminished day-to-day function, pain, and poor sleep quality introduce additional challenges for caregivers. Although pediatric patients suffering from movement disorders and spasticity may be treated with oral medications and botulinum toxin injections, neurosurgical procedures, including selective dorsal rhizotomy and intrathecal baclofen pump insertion are often necessary to relieve more severe spasticity. Following surgical treatment to relieve spasticity, short-term morbidity rates are minimal and post-operative mortality rates are negligible.

Uninsured patients had a significantly shorter hospital length of stay compared to Medicaid patients (-1.42 days, P=0.030) as did privately-insured patients (-0.74 days; P=0.035). Discharge disposition and inpatient mortality rate were not associated with insurance status. There were no significant associations with hospital ownership type. Free-standing children’s hospitals retained patients significantly longer compared to non-children’s hospitals (+1.48 days; P=0.012) and had a significantly higher likelihood of favorable discharge disposition (P=0.004). Mortality rate was not associated with children’s hospital designation.