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Evaluating the association between pulmonary abnormalities and complications following pediatric hip dysplasia surgery

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Developmental dysplasia of the hip (DDH) encompasses a wide range of abnormal hip development and is a common condition in the pediatric population. Congenital pulmonary abnormalities are typically mild in the pediatric population but can be associated with severe comorbid conditions. The purpose of this study was to analyze the effect of structural pulmonary/airway abnormalities on the incidence of postoperative complications following surgical management of DDH.

Methods

From 2012 to 2019, the National Surgical Quality Improvement Program-Pediatric database was utilized to identify pediatric patients undergoing surgical treatment for hip dysplasia. Patients were stratified into two groups: patients with a structural pulmonary/airway abnormality and patients without a pulmonary abnormality. Patient demographics, comorbidities, and postoperative complications were compared between the two cohorts with the use of various statistical analyses, including bivariate and multivariate analyses.

Results

Of the 10,853 patients who underwent surgical treatment for hip dysplasia, 10,157 patients (93.6%) did not have a structural pulmonary/airway abnormality whereas 696 (6.4%) had an airway abnormality. Following adjustment on multivariate analysis, patients with a structural pulmonary abnormality had an increased risk of cardiac arrest requiring cardiopulmonary resuscitation (OR 2.342; p = 0.045).

Conclusion

The results indicated that patients with a structural pulmonary abnormality had an increased risk of cardiac arrest requiring cardiopulmonary resuscitation compared to those without a pulmonary abnormality. Ensuring appropriate preoperative evaluation with a multidisciplinary team and close monitoring postoperatively is important to prevent the risk of severe outcomes in this vulnerable patient population.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, 2300 Eye St NW, Washington, DC, 20037, USA

    Jordan Pizzarro, Theodore Quan & Alex Gu

  2. Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10021, USA

    Joseph E. Manzi

  3. Department of Anesthesiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Frank R. Chen

  4. Department of Orthopaedic Surgery, Children’s National Health System, Washington, DC, USA

    Sean Tabaie

Authors
  1. Jordan Pizzarro
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  2. Theodore Quan
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  3. Joseph E. Manzi
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  4. Frank R. Chen
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  5. Alex Gu
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  6. Sean Tabaie
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Correspondence to Theodore Quan.

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Institutional review board approval was not required for this study as all data are de-identified and public. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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Pizzarro, J., Quan, T., Manzi, J.E. et al. Evaluating the association between pulmonary abnormalities and complications following pediatric hip dysplasia surgery. Eur J Orthop Surg Traumatol 33, 1193–1199 (2023). https://doi.org/10.1007/s00590-022-03276-1

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  • DOI: https://doi.org/10.1007/s00590-022-03276-1

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