Risk factors for gastrointestinal complications after spinal fusion in children with cerebral palsy
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Risk factors for gastrointestinal complications after spinal fusion in children with cerebral palsy Bram P. Verhofste1 · Jay G. Berry1 · Patricia E. Miller1 · Charis N. Crofton1 · Brigid M. Garrity1 · Nicholas D. Fletcher2 · Michelle C. Marks3 · Suken A. Shah4 · Peter O. Newton5 · Amer F. Samdani6 · Mark F. Abel7 · Paul D. Sponseller8 on behalf of Harms Study Group3 · Michael P. Glotzbecker9 Received: 28 January 2020 / Accepted: 15 October 2020 © Scoliosis Research Society 2020
Abstract Design Prospective cerebral palsy (CP) registry review. Objectives (1) Evaluate the incidence/risk factors of gastrointestinal (GI) complications in CP patients after spinal fusion (SF); and (2) investigate the validity of the modified Clavien–Dindo–Sink classification. Background Perioperative GI complications result in increased length of stay (LOS) and patient morbidity/mortality. However, none have analyzed the outcomes of GI complications using an objective classification system. Methods A prospective/multicenter CP database identified 425 children (mean, 14.4 ± 2.9 years; range, 7.9–21 years) who underwent SF. GI complications were categorized using the modified Clavien–Dindo–Sink classification. Grades I–II were minor complications and grades III–V major. Patients with and without GI complications were compared. Results 87 GI complications developed in 69 patients (16.2%): 39 minor (57%) and 30 major (43%). Most common were pancreatitis (n = 45) and ileus (n = 22). Patients with preoperative G-tubes had 2.2 × odds of developing a GI complication compared to oral-only feeders (OR 2.2; 95% CI 0.98–4.78; p = 0.006). Similarly, combined G-tube/oral feeders had 6.7 × odds compared to oral-only (OR 6.7; 95% CI 3.10–14.66; p
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