Hip Reconstruction in Nonambulatory Children With Cerebral Palsy: Identifying Risk Factors Associated With Postoperative Complications and Prolonged Length of Stay
| Autor: | Rachel L. DiFazio, Jodie Shea, Brian D. Snyder, Patricia E. Miller, Kianna D. Nunally, Benjamin J. Shore, Travis Matheney |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Walking Speech Disorders Arthroplasty law.invention Cerebral palsy Young Adult 03 medical and health sciences Postoperative Complications Sex Factors 0302 clinical medicine Risk Factors Seizures law medicine Hip Dislocation Humans Orthopedics and Sports Medicine Femur Child Retrospective Studies Hip surgery 030222 orthopedics business.industry Cerebral Palsy Age Factors Acetabulum Retrospective cohort study Gross Motor Function Classification System General Medicine Odds ratio Length of Stay medicine.disease Intensive care unit Surgery Child Preschool Pediatrics Perinatology and Child Health Cohort Female Respiratory Insufficiency business Cohort study |
| Zdroj: | Journal of Pediatric Orthopaedics. 40:e972-e977 |
| ISSN: | 0271-6798 |
| DOI: | 10.1097/bpo.0000000000001643 |
| Popis: | BACKGROUND The purpose of this study is to examine the relationship between preoperative comorbidities, surgical complications, and length of stay (LOS) after hip reconstruction in nonambulatory children with cerebral palsy (CP). METHODS This single-center retrospective cohort study included 127 patients undergoing hip surgery between 2007 and 2016 who were diagnosed with CP (GMFCS IV/V). The cohort was 54% Gross Motor Function Classification System (GMFCS) V with an average age at surgery of 9 years (range, 3-19 y). Preoperative comorbidities included: presence of a gastrostomy tube, respiratory difficulty requiring positive-pressure ventilation or tracheostomy, history of seizures, and nonverbal status. Complications were dichotomized into major and minor complications according to severity. Multivariable general linear modeling was used to identify factors associated with complications and prolonged LOS. RESULTS The median LOS in the hospital was 6 days (intequartile range, 5-9 d). The majority of procedures (72%) involved both the femur and acetabulum and 82% of surgeries were performed bilaterally. Patients who experienced a major complication were mostly GMFCS level V and were more likely to spend time in intensive care unit than postanesthetic care unit (P=0.001). Multivariable analysis for a major complication determined that the addition of each comorbid risk fact increased the odds of developing a major complication by 2.6 times (odds ratio, 2.64; 95% confidence interval, 1.56-4.47; P |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|