有术后并发症的脑瘫性脊柱侧凸患者术后2年CPCHILD评分较差吗?

IF 1.5 3区 医学 Q3 ORTHOPEDICS
Journal of Pediatric Orthopaedics Pub Date : 2025-10-01 Epub Date: 2025-05-27 DOI:10.1097/BPO.0000000000003010
Vineet M Desai, Thomas Coleman, John W Stelzer, Margaret Bowen, Jason B Anari, John M Flynn, Burt Yaszay, Paul Sponseller, Mark Abel, Patrick J Cahill
{"title":"有术后并发症的脑瘫性脊柱侧凸患者术后2年CPCHILD评分较差吗?","authors":"Vineet M Desai, Thomas Coleman, John W Stelzer, Margaret Bowen, Jason B Anari, John M Flynn, Burt Yaszay, Paul Sponseller, Mark Abel, Patrick J Cahill","doi":"10.1097/BPO.0000000000003010","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Surgical intervention for scoliosis in the cerebral palsy (CP) population is associated with high rates of postoperative complications. Research regarding whether complications after spinal fusion for CP scoliosis patients affect long-term health-related quality of life (HRQOL) remains limited. The goal of this study was to determine if CP scoliosis patients with major postoperative complications have worse HRQOL 2 years after surgery.</p><p><strong>Materials and methods: </strong>A retrospective analysis of a prospectively collected, multicenter registry was performed for all patients with nonambulatory CP treated with spinal fusion from 2008 to 2019 with at least 2 years of follow-up. HRQOL was measured through the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) questionnaire. Complications included anything life-threatening, extended hospitalization, spinal cord/nerve injury, or reoperation. Complications were also classified as \"existing\" or \"resolved\" based on the 2-year postoperative visit. Patients with existing or unresolved complications at the 2-year postoperative visit were excluded.</p><p><strong>Results: </strong>There were 298 CP patients operated on during the study period (51% male, mean age: 14.3±3 y). Within this cohort, 208 patients (70.0%) were identified as GMFCS V. 76 patients (26%) experienced a postoperative complication. Seventy-one patients (93%) had a complication that resolved by 2 years postoperatively. Five patients (7%) had complications that did not resolve and required ongoing treatment. The most common complication was infection (13%). There was no difference in CPCHILD total, as well as domain HRQOL scores at 2 years postoperatively between patients without complications and patients with resolved complications ( P >0.05). Similarly, there was no difference in mean improvements in CPCHILD total and domain scores at 2 years postoperatively between the no complication and resolved complication cohorts ( P >0.05).</p><p><strong>Conclusion: </strong>Patients with CP scoliosis who experience postoperative complications that resolved by 2 years postoperatively have no significant difference in HRQOL in comparison to those without postoperative complications as measured through the CPCHILD questionnaire. Patients and surgeons can be reassured that despite a high complication rate in CP scoliosis surgery, the initial expectations of improved HRQOL are not diminished as long as the complication is appropriately identified and managed.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"e775-e781"},"PeriodicalIF":1.5000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Do Cerebral Palsy Scoliosis Patients With Postoperative Complications Have Worse CPCHILD Scores 2 Years After Surgery?\",\"authors\":\"Vineet M Desai, Thomas Coleman, John W Stelzer, Margaret Bowen, Jason B Anari, John M Flynn, Burt Yaszay, Paul Sponseller, Mark Abel, Patrick J Cahill\",\"doi\":\"10.1097/BPO.0000000000003010\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Surgical intervention for scoliosis in the cerebral palsy (CP) population is associated with high rates of postoperative complications. Research regarding whether complications after spinal fusion for CP scoliosis patients affect long-term health-related quality of life (HRQOL) remains limited. The goal of this study was to determine if CP scoliosis patients with major postoperative complications have worse HRQOL 2 years after surgery.</p><p><strong>Materials and methods: </strong>A retrospective analysis of a prospectively collected, multicenter registry was performed for all patients with nonambulatory CP treated with spinal fusion from 2008 to 2019 with at least 2 years of follow-up. HRQOL was measured through the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) questionnaire. Complications included anything life-threatening, extended hospitalization, spinal cord/nerve injury, or reoperation. Complications were also classified as \\\"existing\\\" or \\\"resolved\\\" based on the 2-year postoperative visit. Patients with existing or unresolved complications at the 2-year postoperative visit were excluded.</p><p><strong>Results: </strong>There were 298 CP patients operated on during the study period (51% male, mean age: 14.3±3 y). Within this cohort, 208 patients (70.0%) were identified as GMFCS V. 76 patients (26%) experienced a postoperative complication. Seventy-one patients (93%) had a complication that resolved by 2 years postoperatively. Five patients (7%) had complications that did not resolve and required ongoing treatment. The most common complication was infection (13%). There was no difference in CPCHILD total, as well as domain HRQOL scores at 2 years postoperatively between patients without complications and patients with resolved complications ( P >0.05). Similarly, there was no difference in mean improvements in CPCHILD total and domain scores at 2 years postoperatively between the no complication and resolved complication cohorts ( P >0.05).</p><p><strong>Conclusion: </strong>Patients with CP scoliosis who experience postoperative complications that resolved by 2 years postoperatively have no significant difference in HRQOL in comparison to those without postoperative complications as measured through the CPCHILD questionnaire. Patients and surgeons can be reassured that despite a high complication rate in CP scoliosis surgery, the initial expectations of improved HRQOL are not diminished as long as the complication is appropriately identified and managed.</p><p><strong>Level of evidence: </strong>Level III.</p>\",\"PeriodicalId\":16945,\"journal\":{\"name\":\"Journal of Pediatric Orthopaedics\",\"volume\":\" \",\"pages\":\"e775-e781\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Pediatric Orthopaedics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/BPO.0000000000003010\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/27 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatric Orthopaedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/BPO.0000000000003010","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/27 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

摘要

背景:脑瘫(CP)人群脊柱侧凸的手术干预与术后并发症的高发率相关。关于CP脊柱侧凸患者脊柱融合术后并发症是否影响长期健康相关生活质量(HRQOL)的研究仍然有限。本研究的目的是确定CP脊柱侧凸患者术后主要并发症是否在术后2年HRQOL更差。材料和方法:对2008年至2019年接受脊柱融合术治疗的所有非门诊CP患者的前瞻性多中心登记进行回顾性分析,随访至少2年。HRQOL通过照顾者优先级和儿童残疾生活健康指数(CPCHILD)问卷进行测量。并发症包括任何危及生命的情况,延长住院时间,脊髓/神经损伤或再次手术。根据术后2年随访将并发症分为“存在”或“解决”。排除术后2年随访时存在或未解决并发症的患者。结果:研究期间共手术CP 298例,其中男性51%,平均年龄14.3±3岁。在该队列中,208例患者(70.0%)被确定为GMFCS, 76例患者(26%)出现术后并发症。71例(93%)患者术后2年出现并发症。5名患者(7%)有并发症,但没有解决,需要持续治疗。最常见的并发症是感染(13%)。无并发症患者与并发症缓解患者术后2年CPCHILD总分及domain HRQOL评分差异无统计学意义(P < 0.05)。同样,无并发症组和有并发症组术后2年CPCHILD总分和域评分的平均改善无差异(P < 0.05)。结论:CPCHILD问卷调查显示,出现术后并发症且术后2年消退的CP型脊柱侧凸患者的HRQOL与无术后并发症的患者相比无显著差异。患者和外科医生可以放心,尽管CP脊柱侧凸手术的并发症发生率很高,但只要并发症得到适当识别和管理,最初对改善HRQOL的期望就不会降低。证据等级:三级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Do Cerebral Palsy Scoliosis Patients With Postoperative Complications Have Worse CPCHILD Scores 2 Years After Surgery?

Background: Surgical intervention for scoliosis in the cerebral palsy (CP) population is associated with high rates of postoperative complications. Research regarding whether complications after spinal fusion for CP scoliosis patients affect long-term health-related quality of life (HRQOL) remains limited. The goal of this study was to determine if CP scoliosis patients with major postoperative complications have worse HRQOL 2 years after surgery.

Materials and methods: A retrospective analysis of a prospectively collected, multicenter registry was performed for all patients with nonambulatory CP treated with spinal fusion from 2008 to 2019 with at least 2 years of follow-up. HRQOL was measured through the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) questionnaire. Complications included anything life-threatening, extended hospitalization, spinal cord/nerve injury, or reoperation. Complications were also classified as "existing" or "resolved" based on the 2-year postoperative visit. Patients with existing or unresolved complications at the 2-year postoperative visit were excluded.

Results: There were 298 CP patients operated on during the study period (51% male, mean age: 14.3±3 y). Within this cohort, 208 patients (70.0%) were identified as GMFCS V. 76 patients (26%) experienced a postoperative complication. Seventy-one patients (93%) had a complication that resolved by 2 years postoperatively. Five patients (7%) had complications that did not resolve and required ongoing treatment. The most common complication was infection (13%). There was no difference in CPCHILD total, as well as domain HRQOL scores at 2 years postoperatively between patients without complications and patients with resolved complications ( P >0.05). Similarly, there was no difference in mean improvements in CPCHILD total and domain scores at 2 years postoperatively between the no complication and resolved complication cohorts ( P >0.05).

Conclusion: Patients with CP scoliosis who experience postoperative complications that resolved by 2 years postoperatively have no significant difference in HRQOL in comparison to those without postoperative complications as measured through the CPCHILD questionnaire. Patients and surgeons can be reassured that despite a high complication rate in CP scoliosis surgery, the initial expectations of improved HRQOL are not diminished as long as the complication is appropriately identified and managed.

Level of evidence: Level III.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
3.30
自引率
17.60%
发文量
512
审稿时长
6 months
期刊介绍: ​Journal of Pediatric Orthopaedics is a leading journal that focuses specifically on traumatic injuries to give you hands-on on coverage of a fast-growing field. You''ll get articles that cover everything from the nature of injury to the effects of new drug therapies; everything from recommendations for more effective surgical approaches to the latest laboratory findings.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信