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The influence of viral respiratory season on perioperative outcomes in patients undergoing spinal fusion for neuromuscular scoliosis

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Abstract

Purpose

Respiratory complications are common following neuromuscular scoliosis (NMS) spinal fusion. Concern exists regarding the safety to perform complicated procedures in winter months when viral respiratory illness is common. The purpose of this study was to compare perioperative outcomes in children with NMS undergoing spinal fusion during peak (November–March) or non-peak (April–October) viral season.

Methods

The Health Care and Utilization Project (HCUP) Kids’ inpatient database (KID) from 2006 to 2012 was reviewed. Children 20 years or younger who underwent spinal fusion for NMS were included. Patients were grouped by date of surgery during peak or non-peak viral season. Continuous variables were compared using t tests and categorical variables were compared using the Rao–Scott Chi-square test. Weighted logistic regression models were performed.

Results

This study identified 5082 records, including 1711 and 3371 patients who had surgery in peak and non-peak viral seasons, respectively. Patients who had spinal fusion during peak viral season were less likely to experience respiratory failure (p = 0.0008) and did not demonstrate an increased incidence of aspiration pneumonia (p = 0.26), respiratory complication (p = 0.43), or mortality (p = 0.68). Respiratory failure was associated with younger age (p = 0.0031), the presence of a tracheostomy (p < 0.0001), and the number of chronic conditions (p < 0.0001). Higher number of chronic medical conditions (mean of 5.0) was associated with an increased risk of in-hospital mortality (p < 0.0001), aspiration pneumonia (p = 0.0009), and respiratory failure (p < 0.0001).

Conclusion

Spinal fusion for NMS during peak viral season has a lower risk of respiratory failure without an increase in mortality or other complications compared to during non-peak viral season.

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References

  1. Berven S, Bradford DS (2002) Neuromuscular scoliosis: causes of deformity and principles for evaluation and management. Semin Neurol 22(2):167–178

    Article  PubMed  Google Scholar 

  2. Sharma S, Wu C, Andersen T et al (2013) Prevalence of complications in neuromuscular scoliosis surgery: a literature meta-analysis from the past 15 years. Eur Spine J 22(6):1230–1249

    Article  PubMed  Google Scholar 

  3. Rumalla K, Yarbrough CK, Pugely AJ et al (2016) Spinal fusion for pediatric neuromuscular scoliosis: national trends, complications, and in-hospital outcomes. J Neurosurg Spine 25(4):500–508

    Article  PubMed  Google Scholar 

  4. Mohamad F, Parent S, Pawelek J et al (2007) Perioperative complications after surgical correction in neuromuscular scoliosis. J Pediatr Orthop 27(4):392–397

    Article  PubMed  Google Scholar 

  5. Simon A, Prusseit J, Müller A (2011) Respiratory syncytial virus infection in children with neuromuscular impairment. Open Microbiol J 5:155–158

    Article  PubMed  PubMed Central  Google Scholar 

  6. Bloom-Feshbach K, Alonso WJ, Charu V et al (2013) Latitudinal variations in seasonal activity of influenza and respiratory syncytial virus (RSV): a global comparative review. PLoS ONE 8(2):e54445

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Nicolas RT, Hills C, Moller JH et al (2005) Early outcome after Glenn shunt and Fontan palliation and the impact of operation during viral respiratory season: analysis of a 19-year multi-institutional experience. Ann Thorac Surg 79(2):613–617

    Article  PubMed  Google Scholar 

  8. Eskedal LT, Hagemo PS, Eskild A et al (2007) A population-based study relevant to seasonal variations in causes of death in children undergoing surgery for congenital cardiac malformations. Cardiol Young 17(4):423–431

    Article  PubMed  Google Scholar 

  9. Spaeder MC, Carson KA, Vricella LA et al (2011) Impact of the viral respiratory season on postoperative outcomes in children undergoing cardiac surgery. Pediatr Cardiol 32(6):801–806

    Article  PubMed  Google Scholar 

  10. HCUP Databases. Healthcare Cost and Utilization Project (HCUP) (2006–2009) Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/databases.jsp

  11. Sedra F, Shafafy R, Sadek AR et al (2021) Perioperative optimization of patients with neuromuscular disorders undergoing scoliosis corrective surgery: a multidisciplinary team approach. Global Spine J 11(2):240–248

    Article  PubMed  Google Scholar 

  12. Barsdorf AI, Sproule DM, Kaufmann P (2010) Scoliosis surgery in children with neuromuscular disease: findings from the US National Inpatient Sample, 1997 to 2003. Arch Neurol 67(2):231–235

    Article  PubMed  Google Scholar 

  13. Kang GR, Suh SW, Lee IO (2011) Preoperative predictors of postoperative pulmonary complications in neuromuscular scoliosis. J Orthop Sci 16(2):139–147

    Article  PubMed  Google Scholar 

  14. Yuan N, Skaggs DL, Dorey F et al (2005) Preoperative predictors of prolonged postoperative mechanical ventilation in children following scoliosis repair. Pediatr Pulmonol 40(5):414–419

    Article  PubMed  Google Scholar 

  15. Miller NH, Benefield E, Hasting L et al (2010) Evaluation of high-risk patients undergoing spinal surgery: a matched case series. J Pediatr Orthop 30(5):496–502

    Article  PubMed  Google Scholar 

  16. Hull J, Aniapravan R, Chan E et al (2012) British Thoracic Society guideline for respiratory management of children with neuromuscular weakness. Thorax 67(Suppl 1):i1-40

    Article  PubMed  Google Scholar 

  17. Kang PB, Morrison L, Iannaccone ST et al (2015) Evidence-based guideline summary: evaluation, diagnosis, and management of congenital muscular dystrophy: Report of the Guideline Development Subcommittee of the American Academy of Neurology and the Practice Issues Review Panel of the American Association of Neuromuscular & Electrodiagnostic Medicine. Neurology 84(13):1369–1378

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Wang CH, Bonnemann CG, Rutkowski A et al (2010) Consensus statement on standard of care for congenital muscular dystrophies. J Child Neurol 25(12):1559–1581

    Article  PubMed  PubMed Central  Google Scholar 

  19. Winter S (1994) Preoperative assessment of the child with neuromuscular scoliosis. Orthop Clin North Am 25(2):239–245

    Article  CAS  PubMed  Google Scholar 

  20. Khirani S, Bersanini C, Aubertin G et al (2014) Non-invasive positive pressure ventilation to facilitate the post-operative respiratory outcome of spine surgery in neuromuscular children. Eur Spine J 23(Suppl 4):S406-411

    Article  PubMed  Google Scholar 

  21. Gill I, Eagle M, Mehta JS (2006) Correction of neuromuscular scoliosis in patients with preexisting respiratory failure. Spine (Phila Pa 1976) 31(21):2478–2483

  22. Deyo RA, Mirza SK, Martin BI (2010) Trends, major medical complications, and charges associated with surgery for lumbar spinal stenosis in older adults. JAMA 303(13):1259–1265

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. McDonald KM, Davies SM, Haberland CA et al (2008) Preliminary assessment of pediatric health care quality and patient safety in the United States using readily available administrative data. Pediatrics 122(2):e416–e425

    Article  PubMed  Google Scholar 

  24. Steiner C, Elixhauser A, Schnaier J (2002) The healthcare cost and utilization project: an overview. Eff Clin Pract 5(3):143–151

    PubMed  Google Scholar 

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Funding

This study was funded by the Cerebral Palsy Research Fund of Gillette Children’s Specialty Healthcare.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA

    Nicholas P. Gannon, Zachary A. Quanbeck & Daniel J. Miller

  2. Gillette Children’s Specialty Healthcare, 200 University Avenue East, St. Paul, MN, USA

    Daniel J. Miller

Authors
  1. Nicholas P. Gannon
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  2. Zachary A. Quanbeck
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Contributions

All authors whose names appeared on the submission made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work; drafted the work or revised it critically for important intellectual content; approved the version to be published; and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. NPG: design of the work, acquisition, analysis, and interpretation of data for the work, drafting of the work, revising the work critically for important intellectual content, final approval of the version to be published, agreeable to be accountable for all aspects of the work; ZAQ: design of the work, acquisition, analysis, and interpretation of data for the work, drafting of the work, revising the work critically for important intellectual content, final approval of the version to be published, agreeable to be accountable for all aspects of the work; DJM: conceptualization of work, design of the work, acquisition, analysis, and interpretation of data for the work, drafting of the work, revising the work critically for important intellectual content, final approval of the version to be published, agreeable to be accountable for all aspects of the work. All authors read and approved the final manuscript.

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Correspondence to Daniel J. Miller.

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This work is not under review by any other journal at the present. This is an original work not published elsewhere. Data are presented honestly, and without fabrication, falsification or inappropriate data manipulation.

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Gannon, N.P., Quanbeck, Z.A. & Miller, D.J. The influence of viral respiratory season on perioperative outcomes in patients undergoing spinal fusion for neuromuscular scoliosis. Spine Deform 11, 407–414 (2023). https://doi.org/10.1007/s43390-022-00593-7

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  • DOI: https://doi.org/10.1007/s43390-022-00593-7

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