Document Type
Article
Publication Date
2021
Publisher
SAGE Publications
Source Publication
Global Spine Journal
Source ISSN
2192-5682
Abstract
Study Design: Retrospective review of consecutive series. Objectives: This study sought to assess the incidence, risk factors, and outcomes of pulmonary complication following complex spine deformity surgery in a low-resourced setting in West Africa. Methods: Data of 276 complex spine deformity patients aged 3 to 25 years who were treated consecutively was retrospectively reviewed. Patients were categorized into 2 groups during data analysis based on pulmonary complication status: group 1: yes versus group 2: no. Comparative descriptive and inferential analysis were performed to compare the 2 groups. Results: The incidence of pulmonary complication was 17/276 (6.1%) in group 1. A total of 259 patients had no events (group 2). There were 8 males and 9 females in group 1 versus 100 males and 159 females in group 2. Body mass index was similar in both groups (17.2 vs 18.4 kg/m2, P ¼ .15). Average values (group 1 vs group 2, respectively) were as follows: preoperative sagittal Cobb angle (90.6� vs 88.7�, P ¼ .87.), coronal Cobb angle (95� vs 88.5�, P ¼ .43), preoperative forced vital capacity (45.3% vs 62.0%, P ¼ .02), preoperative FEV1 (forced expiratory volume in 1 second) (41.9% vs 63.1%, P < .001). Estimated blood loss, operating room time, and surgery levels were similar in both groups. Thoracoplasty and spinal osteotomies were performed at similar rates in both groups, except for Smith-Peterson osteotomy. Multivariate logistic regression showed that every unit increase in preoperative FEV1 (%) decreases the odds of pulmonary complication by 9% (OR ¼ 0.91, 95% CI 0.84-0.98, P ¼ .013). Conclusion: The observed 6.1% incidence of pulmonary complications is comparable to reported series. Preoperative FEV1 was an independent predictor of pulmonary complications. The observed case fatality rate following pulmonary complications(17%) highlights the complexity of cases in underserved regions and the need for thorough preoperative evaluation to identify high-risk patients.
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Recommended Citation
Wulff, Irene; Duah, Henry Ofori; Tutu, Henry O.; Ofori-Amankwah, Gerhard; Yankey, Kawdwo P.; Owiredu, Mabel Adobea; Yahaya, Halima Bidemi; Akoto, Harry; Oteng-Yeboah, Audrey; Boachie-Adjei, Oheneba; and FOCOS Spine Research Group, "Postoperative Pulmonary Complications in Complex Pediatric and Adult Spine Deformity: A Retrospective Review of Consecutive Patients Treated at a Single Site in West Africa" (2021). College of Nursing Faculty Research and Publications. 1190.
https://epublications.marquette.edu/nursing_fac/1190
Comments
Published version. Global Spine Journal, Vol. 11, No. 8 (October 2021): 1208-1214. DOI. © 2021 The Authors. Used with permission.
Henry Duah was affiliated with FOCOS Orthopaedic Hospital, Accra, Ghana at the time of publication.
Creative Commons Non Commercial No Derivs CC BY-NC-ND: This article is distributed under the terms of the Creative Commons Attribution-Non Commercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).