TITLE:
Scoliosis in Children: Impact of Goal-Directed Therapies on Intraoperative and Postoperative Outcomes
AUTHORS:
Claudine Kumba, Lotfi Miladi
KEYWORDS:
Scoliosis, Children, Outcome, Goal-Directed Therapies
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.11 No.10,
October
25,
2021
ABSTRACT: Background: Scoliosis is among interventions with high postoperative complication rates due to the characteristics of the
surgery, where blood loss, transfusion and fluid requirements can be
increased. A monocentric retrospective observational study was undertaken
earlier to determine predictors of intraoperative and postoperative outcomes in
surgical patients. In this initial cohort, there were patients who underwent
scoliosis surgery, and a secondary analysis
to describe outcomes in these patients was realized and presented here. Objective: To describe intraoperative
and postoperative outcomes in patients under 18 years old in scoliosis
surgery included in the initial study and to
propose improvement and implementation measures. Methods: A secondary analysis of patients undergoing scoliosis surgery from 1 January 2014 to 17 May 2017 was
undertaken in our institution—Necker Enfants Malades university
hospital. The study was approved by the Ethics Committee. Results: There were 116 patients with a mean age of
147.5 ± 40.2 months. Twenty-eight patients (24.1%) presented intraoperative
and/or postoperative complications. The most common intraoperative complication was hemorrhagic shock in 3 patients (2.6%).
The most common postoperative organ failure was neurologic in seven patients (6%), respiratory in 3 patients (2.6%), cardio-circulatory
in 2 patients (1.7%) and renal failure in 1 patient
(0.9%). The most common postoperative infection was surgical wound sepsis in 8
patients (6.9%), urinary sepsis in 3 patients
(2.6%), and abdominal sepsis and septicemia in 2 patients
(1.7%). 12 patients (10.3%) had reoperations. Fifty-six
patients (48.3%) had intraoperative
transfusion. There was no in-hospital mortality. Conclusion: The portion of patients with intraoperative and or
postoperative complications was 24.1%, integrating goal-directed
therapies in this surgical setting could improve postoperative outcomes.