Gross Motor Function Classification System Specific Growth Charts-Utility as a Risk Stratification Tool for Surgical...

Area of Science:

• Pediatric Orthopedics
• Surgical Outcomes
• Cerebral Palsy Research

Background:

• Limited evidence links preoperative malnutrition to surgical site infection (SSI) risk in pediatric cerebral palsy (CP) patients undergoing spinal surgery.
• CP-specific growth charts exist but haven't been used for preoperative risk stratification in orthopedic surgery.
• Hypothesis: Children with CP below the 10th percentile BMI on CP-specific charts have increased SSI risk post-spinal deformity surgery.

Purpose of the Study:

• To evaluate the utility of CP-specific growth charts for identifying children with CP at increased risk of SSI after spinal deformity surgery.
• To determine the association between preoperative BMI percentile on CP-specific growth charts and SSI development.

Main Methods:

• Retrospective, single-center review of spinal deformity surgeries in patients with CP.
• Patients stratified by BMI-for-age percentiles using CP-specific growth charts.
• Statistical analysis using odds ratios (OR) and Pearson chi-squared tests to assess SSI risk.

Main Results:

• 13.5% SSI rate observed in 65 patients (74 procedures); all SSIs occurred in GMFCS IV-V patients.
• Significant association found between BMI below the 10th percentile and SSI development (OR, 13.6; P=0.005).
• No association between SSI and height, weight, feeding method, or pelvic instrumentation.

Conclusions:

• CP-specific growth charts effectively identify patients at higher risk for SSI after spinal instrumentation.
• Preoperative BMI percentile on CP-specific charts strongly correlates with SSI risk in pediatric CP patients undergoing spinal surgery.
• Standard growth charts are less sensitive for identifying SSI risk in this population.