TY - JOUR
T1 - Congenital Etiology Is an Independent Risk Factor for Complications in Adolescents Undergoing Corrective Scoliosis Surgery
T2 - Comparison of In-hospital Comorbidities Using Nationwide KID's Inpatient Database
AU - Poorman, Gregory W.
AU - Jalai, Cyrus M.
AU - Diebo, Bassel
AU - Vira, Shaleen
AU - Buza, John
AU - Baker, Joe
AU - Tishelman, Jared
AU - Horn, Samantha
AU - Bono, Olivia
AU - Shenoy, Kartik
AU - Hasan, Saqib
AU - Paul, Justin
AU - Isaacs, Evan
AU - Kaye, Ian
AU - Atanda, Abiola
AU - Buckland, Aaron J.
AU - Lafage, Virginie
AU - Errico, Thomas
AU - Passias, Peter G.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Background:Congenital scoliosis (CS) is associated with more rigid, complex deformities relative to adolescent idiopathic scoliosis (AIS) which theoretically increases surgical complications. Despite extensive literature studying AIS patients, few studies have been performed on CS patients. The purpose of this study was to evaluate complications associated with spinal fusions for CS and AIS.Methods:A retrospective review of the Kid's Inpatient Database (KID) years 2000 to 2009 was performed. Inclusion: patients under 20 years with ICD-9 diagnosis codes for idiopathic scoliosis (IS-without concomitant congenital anomalies) and CS, undergoing spinal fusion from the KID years 2000 to 2009. Two analyses were performed according to age below 10 years and 10 years and above. Univariate analysis described differences in demographics, comorbidities, intraoperative complications, and clinical values between groups. Binary logistic regression controlling for age, sex, race, and invasiveness predicted complications risk in CS (odds ratios; 95% confidence interval).Results:In total, 25,131 patients included (IS, n=22443; CS, n=2688). For patients under age 10, CS patients underwent 1 level shorter fusions (P<0.001), had fewer comorbidities (P<0.001), and sustained similar complication incidence. In the 10 and over age analysis, CS patients similarly had shorter fusions, but greater comorbidities, and significantly more complications (odds ratio, 1.6; confidence interval, 1.4-1.8).Conclusions:CS patients have higher in-hospital complication rates. With more comorbidities, these patients have increased risk of sustaining procedure-related complications such as shock, infection, and Adult Respiratory Distress Syndrome. These data help to counsel patients and their families before spinal fusion.Level of Evidence:Level III-retrospective review of a prospectively collected database.
AB - Background:Congenital scoliosis (CS) is associated with more rigid, complex deformities relative to adolescent idiopathic scoliosis (AIS) which theoretically increases surgical complications. Despite extensive literature studying AIS patients, few studies have been performed on CS patients. The purpose of this study was to evaluate complications associated with spinal fusions for CS and AIS.Methods:A retrospective review of the Kid's Inpatient Database (KID) years 2000 to 2009 was performed. Inclusion: patients under 20 years with ICD-9 diagnosis codes for idiopathic scoliosis (IS-without concomitant congenital anomalies) and CS, undergoing spinal fusion from the KID years 2000 to 2009. Two analyses were performed according to age below 10 years and 10 years and above. Univariate analysis described differences in demographics, comorbidities, intraoperative complications, and clinical values between groups. Binary logistic regression controlling for age, sex, race, and invasiveness predicted complications risk in CS (odds ratios; 95% confidence interval).Results:In total, 25,131 patients included (IS, n=22443; CS, n=2688). For patients under age 10, CS patients underwent 1 level shorter fusions (P<0.001), had fewer comorbidities (P<0.001), and sustained similar complication incidence. In the 10 and over age analysis, CS patients similarly had shorter fusions, but greater comorbidities, and significantly more complications (odds ratio, 1.6; confidence interval, 1.4-1.8).Conclusions:CS patients have higher in-hospital complication rates. With more comorbidities, these patients have increased risk of sustaining procedure-related complications such as shock, infection, and Adult Respiratory Distress Syndrome. These data help to counsel patients and their families before spinal fusion.Level of Evidence:Level III-retrospective review of a prospectively collected database.
KW - AIS
KW - Kids Inpatient Database
KW - adolescent idiopathic scoliosis
KW - complications
KW - congenital scoliosis
KW - pediatric spinal fusion
KW - spinal fusion
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U2 - 10.1097/BPO.0000000000000990
DO - 10.1097/BPO.0000000000000990
M3 - Article
C2 - 31393299
SN - 0271-6798
VL - 39
SP - 406
EP - 410
JO - Journal of Pediatric Orthopaedics
JF - Journal of Pediatric Orthopaedics
IS - 8
ER -