Risk Estimates of Five Adverse Outcomes Following Hip and Spine Surgery Among Children with Cerebral Palsy to Inform Peri-operative Care
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View abstract on PubMed
Summary
This summary is machine-generated.Children with cerebral palsy (CP) undergoing surgery face risks of adverse outcomes. The number of anti-seizure medications (ASMs) can predict these risks, aiding in pre-operative planning and shared decision-making.
Area Of Science
- Pediatric Orthopaedic Surgery
- Clinical Risk Stratification
- Neurology
Background
- Children with cerebral palsy (CP) have increased vulnerability to post-operative complications after orthopaedic surgery.
- Clinically applicable risk estimates for these adverse outcomes are often underreported.
- The number of anti-seizure medications (ASMs) may serve as a proxy for medical complexity and a tool for risk stratification.
Purpose Of The Study
- To generate post-operative risk estimates for five adverse outcomes in children with CP undergoing hip or spine surgery.
- To assess the association between the number of pre-operative ASMs and the risk of specific post-operative complications.
- To provide data for improved peri-operative care planning and shared decision-making.
Main Methods
- Retrospective cohort study using IBM MarketScan databases (2009-2022).
- Included children with CP (aged 3-21) undergoing hip or spine surgery.
- ASMs counted over a 2-year pre-operative period; logistic regression used to estimate risks of respiratory failure/pulmonary collapse, pneumonia, surgical site infection, SIRS, and fracture based on ASM count (0, 1-2, or ≥3).
Main Results
- Analysis included 2,378 hip surgery and 2,216 spine surgery patients.
- Higher ASM counts (≥3) were generally associated with increased risk of post-operative adverse outcomes.
- Specific risks reported for respiratory failure/pulmonary collapse, pneumonia, SSI, SIRS, and fracture for each surgical cohort based on ASM usage.
Conclusions
- Clinically relevant risk estimates for post-operative adverse outcomes were generated based on pre-operative ASM use in children with CP.
- This data can inform shared decision-making, pre-operative optimization, and preventive strategies.
- Number of ASMs is a practical measure for stratifying surgical risk in this population.
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