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Life expectancy in pediatric patients with cerebral palsy and neuromuscular scoliosis who underwent spinal fusion

Published online by Cambridge University Press:  16 September 2003

Athanasios I Tsirikos
Affiliation:
Department of Orthopaedics, University of Athens, KAT Hospital, Athens, Greece.
Wei-Ning Chang
Affiliation:
Department of Orthopaedics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Kirk W Dabney
Affiliation:
Department of Orthopaedics, Alfred I duPont Hospital for Children, Wilmington, USA.
Freeman Miller
Affiliation:
Department of Orthopaedics, Alfred I duPont Hospital for Children, Wilmington, USA.
Joseph Glutting
Affiliation:
University of Delaware, Newark, Delaware, USA.
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Abstract

The aim of this study was to document the rate of survival among 288 severely affected pediatric patients (154 females, 134 males) with spasticity and neuromuscular scoliosis who underwent spinal fusion (mean age at surgery 13 years 11 months, SD 3 years 4 months), and to identify exposure variables that could significantly predict survival times. Kaplan–Meier survival analysis was performed demonstrating a mean predicted survival of 11 years 2 months after spinal surgery for this group of globally involved children with cerebral palsy (CP). Cox's proportional hazards model was used to evaluate predictive efficacy of exposure variables, such as sex, age at surgery, level of ambulation, cognitive ability, degree of coronal and sagittal plane spinal deformity, intraoperative blood loss, surgical time, days in hospital, and days in the intensive care unit. Number of days in intensive care unit after surgery and the presence of severe preoperative thoracic hyperkyphosis were the only factors affecting survival rates. This demonstrated statistically significant predictability for decreased life expectancy after spinal fusion in children with CP.

Type
Original Articles
Copyright
© 2003 Mac Keith Press

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