Complications associated with surgical treatment for pediatric spine deformities: A single center 10-years experience.

IF 1.4 4区 医学 Q3 RHEUMATOLOGY
ARP Rheumatology Pub Date : 2023-01-01
Pedro Fernandes, Isabel Flores, Joaquim Soares do Brito
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Abstract

Introduction: The surgical treatment for pediatric spine deformity is complex and often associated with complications, which generates important clinical and economic impact. Herein the authors analyze the prevalence of complications in surgery for pediatric spine deformity, the correlation between complications and several risk factors, and present a preventive algorithm for these events.

Material and methods: We collected for analysis the data regarding pediatric patients with spine deformities surgically treated in our institution through a 10 years period with 100% revision rate and a 24-month minimum follow-up were included. The statistical analysis was performed using SPSS Statistics 23.

Results: 70 complications (33,4%) were identified in 56 patients (26,7%), of which 38 (54,2%) were acute and 32 (45,7%) late complications. Pulmonary complications (7.1%), surgical site infection (6.6%) and junctional kyphosis (4.3%) were the most frequent events. Scoliosis etiology was especially correlated with general complications (p < 0.05) and early complications (p < 0.01). A logistic regression model identified preoperative hemoglobin (Exp =1.476; P=0.044), fused levels (Exp =-0.677; P=0.023) and titanium implants (Exp =0.257, P < 0.000) as relevant factors for complications. Area under the curve was 0.744, and, when using the best cutting point, the model was capable of predicting absence of complications in 84% of cases, and its occurrence in 56%.

Discussion: Pulmonary complications, surgical site infection and junctional events were identified as the most frequent complications after pediatric scoliosis surgery. By developing high risk protocols to decrease these events, patient safety will be significantly enhanced. Risk assessment makes part of this process and our predictive model by identifying two modifiable factors and including another that relates to procedure invasiveness may help avoiding complications and improve outcomes. ctors for complications. Area under the curve was 0.744, and, when using the best cutting point, the model was capable of predicting absence of complications in 84% of cases, and its occurrence in 56%.

小儿脊柱畸形手术治疗的并发症:单中心10年经验。
导读:小儿脊柱畸形的手术治疗复杂且常伴有并发症,对临床和经济产生重要影响。本文作者分析了小儿脊柱畸形手术并发症的发生率,并发症与几种危险因素之间的关系,并提出了预防这些事件的算法。材料和方法:我们收集了10年期间在我院手术治疗的脊柱畸形患儿的资料,翻修率为100%,最低随访时间为24个月。采用SPSS Statistics 23进行统计分析。结果:56例(26.7%)患者共发现并发症70例(33.4%),其中急性并发症38例(54.2%),晚期并发症32例(45.7%)。肺部并发症(7.1%)、手术部位感染(6.6%)和关节后凸(4.3%)是最常见的事件。脊柱侧凸病因与一般并发症(p < 0.05)和早期并发症(p < 0.01)相关。logistic回归模型确定术前血红蛋白(Exp =1.476;P=0.044),融合关卡(Exp =-0.677;P=0.023)和钛种植体(Exp =0.257, P < 0.000)是并发症的相关因素。曲线下面积为0.744,当使用最佳切割点时,该模型能够预测84%的病例没有并发症,56%的病例出现并发症。讨论:肺部并发症、手术部位感染和关节事件是小儿脊柱侧凸手术后最常见的并发症。通过制定高风险方案来减少这些事件,将大大提高患者的安全性。风险评估是这个过程和我们的预测模型的一部分,通过确定两个可修改的因素,包括另一个与手术侵入性相关的因素,可以帮助避免并发症和改善结果。治疗并发症。曲线下面积为0.744,当使用最佳切割点时,该模型能够预测84%的病例没有并发症,56%的病例出现并发症。
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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CiteScore
1.20
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