title: Preoperative predictors of postoperative pulmonary complications in neuromuscular scoliosis.
abstract: BACKGROUND
  Neuromuscular scoliosis (NMS) is associated with progressive restrictive lung disease and an increased risk of prolonged ventilation following surgery. This study reports the experiences of a single institution and evaluates whether preoperative pulmonary function tests (PFT) can predict the development of postoperative pulmonary complications.
  
  
  METHODS
  Correlations between preoperative PFT (forced expired volume in 1 s, FEV(1); forced vital capacity, FVC) findings and postoperative pulmonary complications were searched for among 74 NMS patients who underwent surgical correction at our medical center from 2002 to 2008.
  
  
  RESULTS
  Thirty-seven patients (50%) developed a pulmonary complication. The independent factors found to contribute to the development of a pulmonary complication were: FEV(1) <40% of the predicted value (P = 0.007), FVC <39.5% of the predicted value (P = 0.005), a larger Cobb angle (>69°) (P = 0.002), and older age (>16.5 years) (P = 0.027). Of these 37 patients, 6 needed postoperative ventilation. PFT findings found to be independently associated with the need for postoperative ventilation were: FEV(1) <40% of the predicted value (P = 0.017) and FVC <39.5% of the predicted value (P = 0.015).
  
  
  CONCLUSIONS
  NMS patients with a preoperative FVC of <39.5% of the predicted value, an FEV(1) <40% of the predicted value, a Cobb angle of >69°, or age >16.5 years were found to be more likely to develop a postoperative pulmonary complication.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, College of Medicine, Korea University, 97 Guro-dong gil, Guro-gu, Seoul, 152-703, Korea.
authors.forename: Gi-Run
authors.initials: GR
authors.lastname: Kang
authors.forename: Seung-Woo
authors.initials: SW
authors.lastname: Suh
authors.forename: Il-Ok
authors.initials: IO
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008171:Lung Diseases / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D009468:Neuromuscular Diseases / Q000150:complications*; D011183:Postoperative Complications; D056910:Republic of Korea / Q000453:epidemiology; D012121:Respiration, Artificial / Q000009:adverse effects*; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012600:Scoliosis / Q000209:etiology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013997:Time Factors