Mortality in Early-Onset Scoliosis During the Growth-friendly Surgery Era

被引：6

作者：

Guzek, Ryan H. ^{[1
]}

Murphy, Robert ^{[2
]}

Hardesty, Christina K. ^{[3
]}

Emans, John B. ^{[5
]}

Garg, Sumeet ^{[6
]}

Smith, John T. ^{[7
]}

Roye, Benjamin D. ^{[8
]}

Glotzbecker, Michael P. ^{[3
]}

Sturm, Peter F. ^{[4
]}

Snyder, Brian D. ^{[5
]}

Poon, Selina C. ^{[9
]}

Poe-Kochert, Connie ^{[3
]}

Anari, Jason B. ^{[1
]}

机构：

[1] Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA

[2] Med Univ South Carolina, Charleston, SC 29425 USA

[3] Rainbow Babies & Childrens Hosp, 2101 Adelbert Rd, Cleveland, OH 44106 USA

[4] Cincinnati Childrens Hosp & Med Ctr, Cincinnati, OH USA

[5] Boston Childrens Hosp, Boston, MA USA

[6] Univ Colorado, Aurora, CO USA

[7] Primary Childrens Med Ctr, Salt Lake City, UT USA

[8] Columbia Univ, Med Ctr, New York, NY USA

[9] Shriners Children Med Ctr, Pasadena, CA USA

来源：

JOURNAL OF PEDIATRIC ORTHOPAEDICS | 2022年 / 42卷 / 03期

关键词：

early-onset scoliosis; spine; mortality; growth-friendly surgery; complications; THORACIC INSUFFICIENCY SYNDROME; TERM-FOLLOW-UP; CONGENITAL SCOLIOSIS; PULMONARY-FUNCTION; CHILDREN; FUSION; SPINE; LIFE;

D O I：

10.1097/BPO.0000000000001983

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Introduction: Early-onset scoliosis (EOS) is a spinal deformity that occurs in patients 9 years of age or younger. Severe deformity may result in thoracic insufficiency, respiratory failure, and premature death. The purpose of this study is to describe the modern-day natural history of mortality in patients with EOS. Methods: The multicenter Pediatric Spine Study Group database was queried for all patients with EOS who are deceased, without exclusion. Demographics, underlying diagnoses, EOS etiology, operative and nonoperative treatments or observation, complications, and date of death were retrieved. Descriptive statistics and survival analysis with Kaplan-Meier curves were performed. Results: There were 130/8009 patients identified as deceased for a registry mortality rate of 16 per 1000 patients. The mean age at death was 10.6 years (range: 1.0 to 30.2 y) and the most common EOS etiology was neuromuscular (73/130, 56.2%; P<0.001). Deceased patients were more likely be treated operatively than nonoperatively or observed (P<0.001). The mean age of death for patients treated operatively (12.3 y) was older than those treated nonoperatively (7.0 y) or observed (6.3 y) (P<0.001) despite a larger deformity and similar index visit body mass index and ventilation requirements. Kaplan-Meier analysis confirmed an increased survival time in patients with a history of any spine operation compared with patients without a history of spine operation (P<0.0001). Operatively treated patients experienced a median of 3.0 complications from diagnosis to death. Overall, cardiopulmonary related complications were the most common (129/271, 47.6%; P<0.001), followed by implant-related (57/271, 21.0%) and wound-related (26/271, 9.6%). The primary cause of death was identified for 78/130 (60.0%) patients, of which 57/78 (73.1%) were cardiopulmonary related. Conclusions: This study represents the largest collection of EOS mortality to date, providing surgeons with a modern-day examination of the effects of surgical intervention to better council patients and families. Both fatal and nonfatal complications in children with EOS are most likely to involve the cardiopulmonary system.

引用

页码：131 / 137

页数：7