Cluster analysis describes constellations of cardiac anomalies presenting in spinal anomaly patients

Peter G. Passias, Gregory W. Poorman, Dennis Vasquez-Montes, Charles Wang, Cyrus Jalai, Samantha R. Horn, Leah M. Steinmetz, Cole A. Bortz, Frank A. Segreto, John Moon, Peter L. Zhou, Bassel G. Diebo, Shaleen Vira

Research output: Contribution to journalArticle

Abstract

Background: Cardiac anomalies are prevalent in patients with bony spinal anomalies. Prior studies evaluating incidences of bony congenital anomalies of the spine are limited. The Kids’ Inpatient Database (KID) yields national discharge estimates of rare pediatric conditions like congenital disorders. This study utilized cluster analysis to study patterns of concurrent vertebral anomalies, anal atresia, cardiac malformations, trachea-esophageal fistula, renal dysplasia, and limb anomalies (VACTERL anomalies) co-occurring in patients with spinal congenital anomalies. Methods: Retrospective review of KID 2003–2012. KID-supplied hospital- and year-adjusted weights allowed for incidence assessment of bony spinal anomalies and cardiac, gastrointestinal, urinary anomalies of VACTERL. K-means clustering assessed relationships between most frequent anomalies within bony spinal anomaly discharges; k set to n − 1(n = first incidence of significant drop/little gain in sum of square errors within clusters). Results: There were 12,039,432 KID patients 0–20 years. Incidence per 100,000 discharges: 2.5 congenital fusion of spine, 10.4 hemivertebra, 7.0 missing vertebra. The most common anomalies co-occurring with bony vertebral malformations were atrial septal defect (ASD 12.3%), large intestinal atresia (LIA 11.8%), and patent ductus arteriosus (PDA 10.4%). Top congenital cardiac anomalies in vertebral anomaly patients were ASD, PDA, and ventricular septal defect (VSD); all three anomalies co-occur at 6.6% rate in this vertebral anomaly population. Cluster analysis revealed that of bony anomaly discharges, 55.9% of those with PDA had ASD, 34.2% with VSD had PDA, 22.9% with LIA had ASD, 37.2% with ureter obstruction had LIA, and 35.5% with renal dysplasia had LIA. Conclusions: In vertebral anomaly patients, the most common co-occurring congenital anomalies were cardiac, renal, and gastrointestinal. Top congenital cardiac anomalies in vertebral anomaly patients were ASD, PDA, and VSD. VACTERL patients with vertebral anomalies commonly presented alongside cardiac and renal anomalies.

Original languageEnglish (US)
Pages (from-to)1613-1619
Number of pages7
JournalActa Neurochirurgica
Volume160
Issue number8
DOIs
StatePublished - Aug 1 2018

Keywords

  • Cardiac anomaly
  • Congenital scoliosis
  • Kids’ Inpatient Database (KID)
  • Spine deformity
  • Surgical correction
  • VACTERL

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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  • Cite this

    Passias, P. G., Poorman, G. W., Vasquez-Montes, D., Wang, C., Jalai, C., Horn, S. R., Steinmetz, L. M., Bortz, C. A., Segreto, F. A., Moon, J., Zhou, P. L., Diebo, B. G., & Vira, S. (2018). Cluster analysis describes constellations of cardiac anomalies presenting in spinal anomaly patients. Acta Neurochirurgica, 160(8), 1613-1619. https://doi.org/10.1007/s00701-018-3596-7