Assessing malnutrition in cerebral palsy patients and its impact on complications following spinal fusion.

IF 1.8 Q3 CLINICAL NEUROLOGY

Spine deformity Pub Date : 2025-06-23 DOI:10.1007/s43390-025-01129-5

Haseeb E Goheer, Phillip T Yang, Yasmine S Ghattas, Gabriel Ramirez, Ram Haddas, Andrew G Dubina, Susan E Nelson, Varun Puvanesarajah

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引用次数: 0

Abstract

Background: Cerebral palsy (CP) patients with severe scoliosis are frequently malnourished. However, there is a paucity of literature focusing on the impact of pediatric malnutrition indicators on post-operative surgical complications. This study aims to examine the relationship between measures of nutritional status and their ability to predict post-operative complications in patients with CP undergoing spinal fusion for neuromuscular scoliosis.

Methods: The American College of Surgeons National Surgical Quality Improvement Program Pediatric was queried retrospectively to identify pediatric CP patients who had undergone spinal fusions for neuromuscular scoliosis between 2016 and 2022 using the Current Procedural Terminology Code 22804. Univariate and multivariate regression were employed to assess differences in preoperative patient characteristics as well as postoperative complications across malnutrition definitions (stunting, wasting, and requiring nutritional support).

Results: A total of 2017 patients were identified between 2016 and 2022, of which 1124 received nutritional support and 893 did not. Among all patients, 93.3% (n = 1882) met at least one definition of malnutrition, 58.1% (n = 1172) met two or more definitions, and 9.3% (n = 187) met all three definitions of malnutrition. After adjustment, requiring nutritional support independently increased the risk for an extended intensive care unit stay (OR:1.35; 95 CI [1.01-1.83]; p = 0.047). Wasting independently increased the risk for unplanned intubation (OR:1.77; 95 CI [1.02-3.02]; p = 0.038) while stunting increased the risk for deep/organ space surgical site infection (OR:2.50; 95 CI [1.20-6.10]; p = 0.025).

Conclusion: Patients with malnutrition (defined as nutritional support) are at increased risk for an extended intensive unit care stay in the postoperative period. Personalized postoperative management with multidisciplinary teams, guided by risk assessment, may help mitigate postoperative complications and address the challenges associated with malnutrition.

Level of evidence: III.

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评估脑瘫患者营养不良及其对脊柱融合术后并发症的影响。

背景：伴有严重脊柱侧凸的脑瘫（CP）患者经常出现营养不良。然而，缺乏关注儿童营养不良指标对术后手术并发症影响的文献。本研究旨在探讨营养状况与CP患者行脊柱融合术治疗神经肌肉性脊柱侧凸术后并发症预测能力之间的关系。方法：回顾性查询美国外科医师学会国家儿科手术质量改进计划，使用现行程序术语代码22804，确定2016年至2022年间接受神经肌肉性脊柱侧凸脊柱融合的儿科CP患者。采用单因素和多因素回归来评估术前患者特征以及不同营养不良定义（发育迟缓、消瘦和需要营养支持）的术后并发症的差异。结果：2016 - 2022年共发现2017例患者，其中1124例接受营养支持，893例未接受营养支持。在所有患者中，93.3% （n = 1882）符合至少一种营养不良定义，58.1% （n = 1172）符合两种或两种以上定义，9.3% （n = 187）符合所有三种营养不良定义。调整后，独立需要营养支持增加了延长重症监护病房住院的风险(OR:1.35；95 ci [1.01-1.83]；p = 0.047)。消瘦单独增加了计划外插管的风险(OR:1.77；95 ci [1.02-3.02]；p = 0.038)，而发育迟缓增加了深部/器官间隙手术部位感染的风险(OR:2.50；95 ci [1.20-6.10]；p = 0.025)。结论：营养不良（定义为营养支持）患者在术后延长重症监护时间的风险增加。在风险评估的指导下，由多学科团队进行个性化的术后管理，可能有助于减轻术后并发症并解决与营养不良相关的挑战。证据水平：III。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Spine deformity

CiteScore

3.20

自引率

18.80%

发文量

167

期刊介绍： Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.