Department of Orthopedics, Mayo Clinic Arizona, 5777 E. Mayo Blvd, Phoenix, AZ, USA.
Midwestern University College of Osteopathic Medicine, 19555 N 59th Ave, Glendale, AZ, 85308, USA.
J Orthop Sci. 2022 Nov;27(6):1304-1308. doi: 10.1016/j.jos.2021.08.005. Epub 2021 Sep 14.
The incidence of orthopedic disorders amongst patients with Prader-Willi Syndrome (PWS) is high when compared to the general pediatric population. The purpose of this retrospective study was to define the most commonly performed orthopedic procedures in pediatric patients with PWS and to characterize the peri-operative outcomes of these patients.
The Kids Inpatient Database (KID) was queried to collect data and identify all pediatric patients with PWS who underwent orthopedic procedures from 2001 to 2012. A total of 3684 patients with PWS were identified, 334 of who underwent an orthopedic procedure. Population demographics, comorbidities, and specific procedures undergone were defined. The incidences of postoperative complications and length of associated hospital stay were additionally evaluated.
Mean age of patients in this sample was 10.33 years (SD 4.5). The most common comorbidities included obesity (18.1%), chronic pulmonary disease (14.1%), hypothyroidism (5.1%), hypertension (5.1%), and uncomplicated diabetes (4%). Common procedures were spinal fusion (165/334, 49%) and lower extremity procedures (50/334, 15%). Complications included acute blood loss anemia, device related complications, pneumonia, sepsis, and urinary tract infections. The overall complication rate was 35.6%. Average hospital lengths of stay for patients undergoing spinal fusion was 6.68 days (SD 4.13), lower extremity orthopedic procedure was 5.65 days (SD 7.4), and all other orthopedic procedures was 7.74 days (SD 16.3).
Orthopedic disorders are common in patients with PWS. Consequently, spinal fusions and lower extremity procedures are commonly performed in this patient population. Associated comorbid conditions may negatively impact surgical outcomes in these patients. This information should prove useful in the peri-operative management of patients with PWS undergoing orthopedic surgery and for shared decision making with families.
与普通儿科人群相比，患有普拉德-威利综合征（PWS）的患者骨科疾病的发病率较高。本回顾性研究的目的是确定患有 PWS 的儿科患者最常进行的骨科手术，并描述这些患者的围手术期结果。
从 2001 年至 2012 年，通过 Kids Inpatient Database（KID）查询收集数据并确定所有接受过骨科手术的患有 PWS 的儿科患者。共确定了 3684 名患有 PWS 的患者，其中 334 名接受了骨科手术。定义了人群人口统计学、合并症和接受的具体手术。还评估了术后并发症的发生率和相关住院时间的长短。
该样本患者的平均年龄为 10.33 岁（标准差 4.5）。最常见的合并症包括肥胖症（18.1%）、慢性肺部疾病（14.1%）、甲状腺功能减退症（5.1%）、高血压（5.1%）和无并发症的糖尿病（4%）。常见的手术是脊柱融合术（165/334，49%）和下肢手术（50/334，15%）。并发症包括急性失血性贫血、器械相关并发症、肺炎、败血症和尿路感染。总体并发症发生率为 35.6%。接受脊柱融合术的患者平均住院时间为 6.68 天（标准差 4.13），下肢骨科手术为 5.65 天（标准差 7.4），所有其他骨科手术为 7.74 天（标准差 16.3）。
骨科疾病在患有 PWS 的患者中很常见。因此，脊柱融合术和下肢手术在该患者人群中经常进行。相关合并症可能会对这些患者的手术结果产生负面影响。这些信息对于接受骨科手术的 PWS 患者的围手术期管理以及与家属共同决策非常有用。
