Probability analysis of sequential SCFE (PASS score)
| Autor: | Walter P. Samora, Kevin E. Klingele, Satbir Singh, Baruch Danino, Junxin Shi, Jingzhen Yang, Christopher A Iobst |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
030222 orthopedics
medicine.medical_specialty Scoring system business.industry posterior epiphyseal angle slipped capital femoral epiphysis posterior sloping angle superior epiphyseal extension ratio medicine.disease 03 medical and health sciences 0302 clinical medicine Radiological weapon Pediatrics Perinatology and Child Health Original Clinical Article Medicine Orthopedics and Sports Medicine 030212 general & internal medicine Radiology business Slipped capital femoral epiphysis |
| Zdroj: | Journal of Children's Orthopaedics |
| ISSN: | 1863-2548 1863-2521 |
| DOI: | 10.1302/1863-2548.14.200080 |
| Popis: | Purpose The study aimed to develop a scoring system based on clinical and radiological findings to predict the risk of a sequential slipped capital femoral epiphysis (SCFE). Methods Paediatric patients with unilateral SCFE and at least two years of radiographic follow-up were screened for inclusion. Medical records were reviewed for multiple variables including age, gender, body mass index (BMI), stability of SCFE, and time to sequential presentation. Radiographic analysis included triradiate physeal status, Risser staging, superior epiphyseal extension ratio (EER), posterior epiphyseal angle (PEA), posterior sloping angle (PSA) and slip severity. Results In total, 163 patients (88 male, 54%, 75 female, 46%) met inclusion criteria. Of those, 65 (40%) with a mean age of 11.9 ± 1.3 years developed sequential SCFE at a mean of 9.8 ± 6.4 months after the initial slip. Eight independent variables were statistically different (p < 0.05) between unilateral and sequential groups. Following multivariate analysis, Risser stage and triradiate status were no longer significant and did not influence the strength of the final model (overall area under the curve (AUC) = 0.954) and were consequently excluded. We developed the PASS score using three radiographic parameters using chosen cut-off values that were close to their maximized value and weighted the point value assigned to each parameter based on the strength of predictor. Conclusion A PASS score of three or higher predicts a high probability of sequential SCFE with 95% confidence and may warrant prophylactic screw fixation. PASS score calculation can be used to predict a sequential SCFE and provide an objective method to determine the utility prophylactic screw fixation. Level of Evidence II |
| Databáze: | OpenAIRE |
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