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脊髓脊膜膨出患者的长期死亡率结果和死亡率预测因素。

Long-term mortality outcomes and mortality predictors in patients with myelomeningocele.

机构信息

Inonu University Faculty of Medicine, Department of Neurosurgery, Malatya, Turkey.

Inonu University Faculty of Medicine, Department of Pediatrics, Malatya, Turkey.

出版信息

Clin Neurol Neurosurg. 2024 Nov;246:108577. doi: 10.1016/j.clineuro.2024.108577. Epub 2024 Oct 2.

Abstract

OBJECTIVE

Despite advances, myelomeningocele remains a major cause of mortality and disability. This study aims to analyze factors influencing mortality and suggest ways to reduce it.

METHODS

We reviewed 173 patients who underwent surgery for myelomeningocele from January 2010 to December 2021. Variables affecting mortality were categorized into patient-related and indirectly related factors. Data were collected through patient file reviews and phone interviews with parents.

RESULTS

Mortality is influenced by multiple factors: female gender (3.2-fold increase), paraplegia (3.1-fold increase), absence of tethered cord release surgery (9.4-fold increase), scoliosis (4.2-fold increase), and renal failure (5.28-fold increase). Defect size and father's education level also significantly impact mortality. The overall mortality rate was 20.8 %, with hydrocephalus being the leading cause.

CONCLUSION

Mortality and disability in myelomeningocele patients remain high, with over 50 % of deaths being preventable. Effective management could significantly improve mortality rates. Long-term studies are crucial for advancing research in this field.

摘要

目的

尽管取得了进展,但脊髓脊膜膨出仍是导致死亡和残疾的主要原因。本研究旨在分析影响死亡率的因素,并提出降低死亡率的方法。

方法

我们回顾了 2010 年 1 月至 2021 年 12 月期间接受脊髓脊膜膨出手术的 173 名患者。影响死亡率的变量分为与患者相关和间接相关的因素。通过患者病历审查和与家长的电话访谈收集数据。

结果

死亡率受多种因素影响:女性(增加 3.2 倍)、截瘫(增加 3.1 倍)、未行脊髓栓系松解术(增加 9.4 倍)、脊柱侧凸(增加 4.2 倍)和肾衰竭(增加 5.28 倍)。缺陷大小和父亲的教育水平也对死亡率有显著影响。总体死亡率为 20.8%,其中脑积水是主要死因。

结论

脊髓脊膜膨出患者的死亡率和残疾率仍然很高,超过 50%的死亡是可以预防的。有效的管理可以显著降低死亡率。长期研究对于推进该领域的研究至关重要。

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