Postoperative Pulmonary Complications in Complex Pediatric and Adult Spine Deformity: A Retrospective Review of Consecutive Patients Treated at a Single Site in West Africa

Overview

Journal Global Spine J

Publisher Sage Publications

Date 2020 Aug 11

PMID 32772734

Citations 1

Authors

Irene Wulff

Henry Ofori Duah

Henry Osei Tutu

Gerhard Ofori-Amankwah

Kwadwo Poku Yankey

Mabel Adobea Owiredu

Halima Bidemi Yahaya

Harry Akoto

Audrey Oteng-Yeboah

Oheneba Boachie-Adjei

Affiliations

Soon will be listed here.

Abstract

Study Design: Retrospective review of consecutive series.

Objectives: This study sought to assess the incidence, risk factors, and outcomes of pulmonary complication following complex spine deformity surgery in a low-resourced setting in West Africa.

Methods: Data of 276 complex spine deformity patients aged 3 to 25 years who were treated consecutively was retrospectively reviewed. Patients were categorized into 2 groups during data analysis based on pulmonary complication status: group 1: yes versus group 2: no. Comparative descriptive and inferential analysis were performed to compare the 2 groups.

Results: The incidence of pulmonary complication was 17/276 (6.1%) in group 1. A total of 259 patients had no events (group 2). There were 8 males and 9 females in group 1 versus 100 males and 159 females in group 2. Body mass index was similar in both groups (17.2 vs 18.4 kg/m, = .15). Average values (group 1 vs group 2, respectively) were as follows: preoperative sagittal Cobb angle (90.6° vs 88.7°, = .87.), coronal Cobb angle (95° vs 88.5°, = .43), preoperative forced vital capacity (45.3% vs 62.0%, = .02), preoperative FEV (forced expiratory volume in 1 second) (41.9% vs 63.1%, < .001). Estimated blood loss, operating room time, and surgery levels were similar in both groups. Thoracoplasty and spinal osteotomies were performed at similar rates in both groups, except for Smith-Peterson osteotomy. Multivariate logistic regression showed that every unit increase in preoperative FEV (%) decreases the odds of pulmonary complication by 9% (OR = 0.91, 95% CI 0.84-0.98, = .013).

Conclusion: The observed 6.1% incidence of pulmonary complications is comparable to reported series. Preoperative FEV was an independent predictor of pulmonary complications. The observed case fatality rate following pulmonary complications (17%) highlights the complexity of cases in underserved regions and the need for thorough preoperative evaluation to identify high-risk patients.

Citing Articles

The Efficacy of a Posterior Approach to Surgical Correction for Neglected Idiopathic Scoliosis: A Comparative Analysis According to Health-Related Quality of Life, Pulmonary Function, Back Pain and Sexual Function.

Grabala P, Helenius I, Buchowski J, Shah S Children (Basel). 2023; 10(2).

PMID: 36832428 PMC: 9955926. DOI: 10.3390/children10020299.

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