Compared to the general US poplulation, Mexican-born US immigrants have more favorable sleep, possibly contributing to their lower reported risk of diabetes, hypertension, CVD, and all-cause mortality (the "Hispanic Paradox").

comorbidities, preop labs. SSI was defined as infection within 90 days of surgery, as per the Centers for Disease Control. Results: In total, 255 patients with CP were identified. Of these, 146 (57%) were male and 109 (43%) were female. The mean age at surgery was 14.5 years. The overall SSI risk was 11.7%. Regression analysis showed that ambulatory status (OR 5.0, p<0.05), bowel incontinence (OR 3.7, p<0.05), Cobb angle >90° (OR 1.5, p<0.05), behavioral disorder/delay (OR 1.1), revision surgery (OR 1.1), and hemoglobin<14 g/dL (OR 1.1) were prognostic of SSI. The RSS model predicted SSI risk of 0.88% when none of these factors were present, and 23.3% when all factors were present. The predictive ability of the RSS was 71%, which demonstrates good discriminatory ability. Conclusions/Significance: This study shows that patients with CP experience high risk of SSI (11.7%) subsequent to spinal surgery. A RSS to predict the probability of SSI developing within 90 days after spinal surgery was created. The CP RSS is a significant addition to a surgeon's arsenal for predicting SSI risk following spine surgery. It facilitates perioperative planning discussions among the clinical team as well as between patient and family members. It allows for fair comparisons of surgical outcomes among different medical centers , based on patients' risk factors. By identifying patients with high risk of SSI, preoperative optimization can help reduce SSI incidence. This has the potential to improve patient outcomes, reduce health care costs associated with SSI, and serves as a stepping stone for future research. Background and Objective(s): Spinal fusion for patients with cerebral palsy is time-consuming, expensive and associated with a high complication rate in comparison to spinal fusion in the idiopathic population. The purpose of this study was to evaluate outcomes and associated costs for spinal fusion performed by two attending co-surgeons versus a single attending surgeon with a surgical trainee acting as surgical assistant. Study Design: A retrospective cohort study was completed. Study Participants & Setting: A consecutive series of all children with a diagnosis of cerebral palsy who underwent posterior spinal fusion at a tertiary care pediatric hospital between 2011 and 2015 was reviewed. All patients who were fused from T1/ 2 to the pelvis with a unit rod and sublaminar wires performed by a single surgeon were eligible for and included in analysis. Materials/Methods: From this cohort, two cohorts were identified those in which a co-surgeon was utilized and those in which an orthopaedic trainee assisted. Statistical analysis was completed using independent t-tests and chi-square tests. A team of expert stakeholders created detailed process maps, determined space and product costs and calculated personnel

All levels of anemia were significantly associated with prolonged length of hospitalization and poorer operative or 30-day outcomes in patients undergoing elective spine surgery. Our findings, using a large multi-institutional sample of prospectively collected data, suggests that anemia should be regarded as an independent risk factor for perioperative and postoperative complications that deserves attention prior to elective spine surgery.

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