Impact of steroids on surgical experiences of patients with duchenne muscular dystrophy.
We studied surgical experiences within a regional cohort of patients with Duchenne muscular dystrophy, managed at a single center. Records of all patients with confirmed Duchenne muscular dystrophy who were born after 1962 were reviewed from birth until they reached study endpoints: scoliosis surgery, Achilles tendon lengthening, cataract surgery, loss to follow-up, or final follow-up point in 2009. A survival analysis was used to account for the variable follow-up duration within this cohort. By the end of the study period, 28/80 (35.0%) of boys with Duchenne muscular dystrophy had undergone spinal surgery, 22/80 (27.5%) had experienced Achilles tendon lengthening, and 6/80 (7.5%) had had cataracts removed. Moreover, 56.8% of this cohort received steroid therapy (prednisone or deflazacort; 95% confidence interval, 43.3-68.8%). Boys who had received steroid therapy were significantly less likely to undergo spinal surgery (P = 0.001), but were subsequently more likely to require cataract surgery (P = 0.005). Achilles tendon lengthening did not seem related to medication exposure. The treatment of patients with Duchenne muscular dystrophy with steroids significantly modified their surgical experience.
Dooley
Joseph M
JM
Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada. jdooley@dal.ca
Gordon
Kevin E
KE
MacSween
Judith M
JM
D000125:Achilles Tendon / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020388:Muscular Dystrophy, Duchenne / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D013256:Steroids / Q000627:therapeutic use*; D016019:Survival Analysis; D016896:Treatment Outcome
D013256:Steroids