A Retrospective Identification of Gastroesophageal Reflux Disease as a New Risk Factor for Surgical Site Infection in Cerebral Palsy Patients After Spine Surgery

Chidambaran, Vidya; Gentry, Carol; Ajuba-Iwuji, Chinwe; Sponsellar, Paul D.; Ain, Michael C.; Lin, Elaina E.; Zhang, Xue; Klaus, Sybil Ann; Njoku, Dolores B.

doi:10.1213/ane.0b013e318290c542

Cited by 13 publications

(5 citation statements)

References 22 publications

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“…Furthermore patients with CP have a more severe degree of scoliosis with greater Cobb angles and need for extended spinal fusions. All these factors may play a role in the higher risk for postoperative complications (10,14,23). In the multivariate risk factor analysis for our cohort, we found a 13 times higher risk for postoperative pneumonia in patients with epilepsy.…”

Section: Discussionmentioning

confidence: 52%

Complication rate after scoliosis surgery in children with cerebral palsy

Vandendriessche¹,

Proesmans²,

Ortibus³

et al. 2021

Acta Orthop Belg

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Scoliosis is an important problem in children with cerebral palsy (CP). However, the choice for a spinal fusion has to be weighed against the risks of major surgery in this vulnerable population. Paediatricians are frequently consulted preoperatively to assess the (respiratory) risk involved, but data on this question specific for CP are rare. Therefore, we investigated the complication rate after scoliosis surgery in children with CP, compared to idiopathic scoliosis (IS), and we searched for risk factors for the most common complications. In a retrospective monocenter study we analyzed the medical records from all children with CP and IS undergoing scoliosis surgery from 2010 until 2014. Duration of hospitalization and postoperative complications were compared within a 6-month follow-up. Univariate and multivariate logistic regression models were used to identify risk factors. The study included 44 patients with CP (mean age 15y0mo) and 78 patients with IS (mean age 14y6mo). Children with CP experience a higher rate of complications : respiratory and cardiovascular, as well as wound infections and decubitus ulcers (p<0.05). Postoperative pneumonia was the most frequent complication in both patient groups (43% and 18% in CP and IS respectively), with epilepsy being a significant risk factor (OR 3.85, p= 0.037) in children with CP. Intensive care unit and total hospital stay were longer in the CP group (p<0.001). These results may add information on perioperative care and surgical decision making.

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Section: Discussionmentioning

confidence: 52%

Complication rate after scoliosis surgery in children with cerebral palsy

Vandendriessche¹,

Proesmans²,

Ortibus³

et al. 2021

Acta Orthop Belg

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“…Twelve studies included posterior approaches to surgery only, 33 studies included posterior approaches or combined/staged anterio‐posterior approaches, while approach was not reported, or was not defined for participants with CP, in six studies. Length of follow‐up varied greatly among the studies and all except for five studies did not state measurement time points or they were not standardized. Only six studies reported any missing data or loss to follow‐up .…”

Section: Resultsmentioning

confidence: 99%

“…Eighteen studies reported preoperative factors for poor postoperative outcomes; however, only 11 of these reported statistical associations or correlations separately for CP samples (Table SIV, online supporting information) . Comorbidities including gastrointestinal issues, respiratory conditions, seizures, malnutrition, intellectual disability, reduced speech ability, and prior surgical infection were identified as risk factors in addition to an increased weight, older age, higher preoperative platelet or white cell count, and the type or severity of preoperative spinal or pelvic deformity.…”

Section: Resultsmentioning

confidence: 99%

Outcomes after scoliosis surgery for children with cerebral palsy: a systematic review

Toovey

Harvey

Johnson

et al. 2017

Develop Med Child Neuro

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“…In children treated with us the esophagus biopsy is not an action that is still being protocols and has not been performed. It should be taken in account that the diagnosis of esophagitis does not interfere with interventionism (21). On the other hand, fibrogatroscopy and more esophageal biopsy in young children is an action that requires special susceptibility and a special technical skill (22).…”

Section: Discussionmentioning

confidence: 99%