Department of Orthopedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
J Pediatr Orthop B. 2023 Jul 1;32(4):318-323. doi: 10.1097/BPB.0000000000000998. Epub 2022 Jun 27.
The impact of seizure disorders on pediatric patients who undergo hip dysplasia surgery has yet to be elucidated. This study focused on identifying the effect of seizure disorders on the incidence of complications following surgical management of hip dysplasia. Pediatric patients undergoing surgical treatment for hip dysplasia from 2012 to 2019 were identified in the National Surgical Quality Improvement Program-Pediatric database. Patients were divided into two cohorts: patients with and patients without a seizure disorder. Patient demographics, comorbidities and postoperative outcomes were compared between the two groups. Bivariate and multivariate analyses were performed. Of 10 853 pediatric patients who underwent hip dysplasia surgery, 8117 patients (74.8%) did not have a seizure disorder whereas 2736 (25.2%) had a seizure disorder. Bivariate analyses revealed that compared to patients without a seizure disorder, patients with a seizure disorder were at increased risk of developing surgical site infections, pneumonia, unplanned reintubation, urinary tract infection, postoperative transfusion, sepsis, extended operation time and length of stay and readmission ( P < 0.05 for all). Following adjustment for patient demographics and comorbidities on multivariate analysis, there were no differences in any postoperative complications between pediatric patients with and without a seizure disorder. There were no differences in 30-day postoperative complications in patients with and without a seizure disorder. Due to potential decreased bone mineral density as an effect of antiepileptic drugs and the risk of femur fracture during surgery for hip dysplasia, pediatric patients with a seizure disorder should be closely monitored as they may be more susceptible to injury. Level of Evidence: III.
癫痫对接受髋关节发育不良手术的儿科患者的影响尚未阐明。本研究旨在确定癫痫对髋关节发育不良手术治疗后并发症发生率的影响。我们在国家手术质量改进计划-儿科数据库中确定了 2012 年至 2019 年接受髋关节发育不良手术治疗的儿科患者。将患者分为两组：有癫痫组和无癫痫组。比较两组患者的人口统计学、合并症和术后结局。进行了双变量和多变量分析。在接受髋关节发育不良手术的 10853 名儿科患者中，8117 名（74.8%）患者无癫痫，2736 名（25.2%）患者有癫痫。双变量分析显示，与无癫痫的患者相比，有癫痫的患者发生手术部位感染、肺炎、计划性再插管、尿路感染、术后输血、败血症、手术时间延长、住院时间延长和再入院的风险增加（所有 P<0.05）。多变量分析调整患者的人口统计学和合并症后，有癫痫和无癫痫的儿科患者在任何术后并发症方面均无差异。有癫痫和无癫痫的患者在 30 天术后并发症方面无差异。由于抗癫痫药物可能导致骨密度降低以及髋关节发育不良手术中股骨骨折的风险，有癫痫的儿科患者应密切监测，因为他们可能更容易受伤。证据等级：III。
