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首页> 外文期刊>Open Journal of Urology >Perioperative Outcomes Following Surgical Treatment of the Neuromuscular Hip: An Analysis of the National Surgical Quality Improvement Program—Pediatrics
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Perioperative Outcomes Following Surgical Treatment of the Neuromuscular Hip: An Analysis of the National Surgical Quality Improvement Program—Pediatrics

机译：外科手术治疗神经肌肉性髋关节围手术期的结果：国家外科质量改进计划-儿科分析

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Background: Surgical treatment for neuromuscular (NM) hip subluxation or dislocation is undertaken to maintain functionality and decrease pain. Longterm complications are well described; however, the acute complication profile is poorly understood. Questions/Purpose: The aim of this study was to identify the rate of and risk factors for complications following surgical treatment of hip subluxation/dislocation, especially as it relate to NM children. Methods: Hip reconstruction cases in patients with a NM diagnosis and non-NM patients were obtained from the 2015 American College of Surgeons NSQIP-Pediatric database by CPT code. 30-day postoperative complications were classified according to the Clavien-Dindo system as minor (grade 1 or 2) or major (grade 3+). Patient and surgical factors were assessed in univariate and multivariate logistic regression analyses for association with post-operative complications. Results: 1081 cases were identified (median age 7.7, 55% female), of whom 420 (39%) had a NM diagnosis. Overall complication rate was significantly higher in NM patients (33% vs. 19%, p < 0.001). Numerous factors were associated with postoperative complication on univariate analysis. Multivariate analysis identified NM diagnosis (OR 1.5), age > 6 years (OR 1.5), or pelvic osteotomy (OR 1.9) as independent risk factors for complication. Conclusion: In pediatric reconstructive hip surgery requiring pelvic osteotomy, a NM diagnosis is associated with an increased risk of 30-day postoperative complications. Older age and increasing surgical complexity were also independently associated with complications. These findings support special attention for the older patients undergoing concomitant pelvic osteotomies to minimize complication rate.
机译：背景：进行神经肌肉（NM）髋关节半脱位或脱位的手术治疗可维持功能并减轻疼痛。长期并发症已得到很好的描述。但是，急性并发症的概况知之甚少。 问题/目的：本研究的目的是确定髋部半脱位/脱位的手术治疗后并发症的发生率和危险因素，尤其是与NM儿童有关的并发症。 方法：患有NM诊断的患者和非NM患者的髋关节重建病例是通过CPT代码从2015年美国外科医生学院NSQIP-儿科数据库获得的。根据Clavien-Dindo系统将术后30天的并发症分为轻度（1级或2级）或重度（3+级）。在单因素和多因素logistic回归分析中评估患者和手术因素与术后并发症的关系。 结果：确定了1081例病例（中位年龄7.7，女性55％），其中420例（39％）患有NM诊断。 NM患者的总并发症发生率显着更高（33％比19％，p <0.001）。单因素分析表明，术后并发症与多种因素有关。多变量分析确定NM诊断（OR 1.5），年龄> 6岁（OR 1.5）或盆腔截骨（OR 1.9）是并发症的独立危险因素。 结论：在需要进行骨盆截骨术的小儿重建髋关节手术中，NM诊断与术后30天并发症风险增加有关。年龄大和手术复杂性增加也与并发症独立相关。这些发现支持对同时进行骨盆截骨术的老年患者给予特别注意，以最大程度地降低并发症发生率。

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