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Is seizure disorder a risk factor for complications following surgical treatment of hip dysplasia in the pediatric population?
Journal of Pediatric Orthopaedics B ( IF 1.1 ) Pub Date : 2022-06-27 , DOI: 10.1097/bpb.0000000000000998
Theodore Quan 1 , Jordan Pizzarro 1 , Lea Mcdaniel 1 , Joseph E. Manzi 1 , Amil R. Agarwal 1 , Frank R. Chen 1 , Sean Tabaie 1
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The impact of seizure disorders on pediatric patients who undergo hip dysplasia surgery has yet to be elucidated. This study focused on identifying the effect of seizure disorders on the incidence of complications following surgical management of hip dysplasia. Pediatric patients undergoing surgical treatment for hip dysplasia from 2012 to 2019 were identified in the National Surgical Quality Improvement Program-Pediatric database. Patients were divided into two cohorts: patients with and patients without a seizure disorder. Patient demographics, comorbidities and postoperative outcomes were compared between the two groups. Bivariate and multivariate analyses were performed. Of 10 853 pediatric patients who underwent hip dysplasia surgery, 8117 patients (74.8%) did not have a seizure disorder whereas 2736 (25.2%) had a seizure disorder. Bivariate analyses revealed that compared to patients without a seizure disorder, patients with a seizure disorder were at increased risk of developing surgical site infections, pneumonia, unplanned reintubation, urinary tract infection, postoperative transfusion, sepsis, extended operation time and length of stay and readmission (P < 0.05 for all). Following adjustment for patient demographics and comorbidities on multivariate analysis, there were no differences in any postoperative complications between pediatric patients with and without a seizure disorder. There were no differences in 30-day postoperative complications in patients with and without a seizure disorder. Due to potential decreased bone mineral density as an effect of antiepileptic drugs and the risk of femur fracture during surgery for hip dysplasia, pediatric patients with a seizure disorder should be closely monitored as they may be more susceptible to injury. Level of Evidence: III



中文翻译:

癫痫症是儿科髋关节发育不良手术治疗后并发症的危险因素吗?

癫痫发作对接受髋关节发育不良手术的儿科患者的影响尚未阐明。本研究的重点是确定癫痫发作对髋关节发育不良手术治疗后并发症发生率的影响。接受手术治疗的儿科患者在国家外科质量改进计划-儿科数据库中确定了 2012 年至 2019 年的髋关节发育不良。患者被分为两组:患有癫痫症的患者和没有癫痫症的患者。比较两组患者的人口统计学、合并症和术后结局。进行了双变量和多变量分析。在接受髋关节发育不良手术的 10853 名儿科患者中,8117 名患者(74.8%)没有癫痫发作,而 2736 名(25.2%)有癫痫发作。双变量分析显示,与没有癫痫症的患者相比,癫痫症患者发生手术部位感染、肺炎、计划外再插管、尿路感染、术后输血、败血症、所有P  < 0.05)。在多变量分析中对患者人口统计学和合并症进行调整后,有和没有癫痫症的儿科患者的术后并发症没有差异。有和没有癫痫发作的患者在术后 30 天并发症方面没有差异。由于抗癫痫药物可能会降低骨矿物质密度以及髋关节发育不良手术期间股骨骨折的风险,因此应密切监测患有癫痫症的儿科患者,因为他们可能更容易受伤。证据等级:III

更新日期:2022-07-01
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