Life expectancy in pediatric patients with cerebral palsy and neuromuscular scoliosis who underwent spinal fusion.
The aim of this study was to document the rate of survival among 288 severely affected pediatric patients (154 females, 134 males) with spasticity and neuromuscular scoliosis who underwent spinal fusion (mean age at surgery 13 years 11 months, SD 3 years 4 months), and to identify exposure variables that could significantly predict survival times. Kaplan-Meier survival analysis was performed demonstrating a mean predicted survival of 11 years 2 months after spinal surgery for this group of globally involved children with cerebral palsy (CP). Cox's proportional hazards model was used to evaluate predictive efficacy of exposure variables, such as sex, age at surgery, level of ambulation, cognitive ability, degree of coronal and sagittal plane spinal deformity, intraoperative blood loss, surgical time, days in hospital, and days in the intensive care unit. Number of days in intensive care unit after surgery and the presence of severe preoperative thoracic hyperkyphosis were the only factors affecting survival rates. This demonstrated statistically significant predictability for decreased life expectancy after spinal fusion in children with CP.
D000293:Adolescent; D002547:Cerebral Palsy / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007431:Intraoperative Complications; D007738:Kyphosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D008017:Life Expectancy; D008297:Male; D009469:Neuromuscular Junction / Q000503:physiopathology*; D011300:Preoperative Care; D012307:Risk Factors; D012600:Scoliosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D012720:Severity of Illness Index; D013123:Spinal Fusion / Q000379:methods*; D015996:Survival Rate