Analysis of postoperative clinical and nutritional outcomes in a cohort of adolescents following major spinal corrective surgery

Hdl Handle:
http://hdl.handle.net/10147/265252
Title:
Analysis of postoperative clinical and nutritional outcomes in a cohort of adolescents following major spinal corrective surgery
Authors:
Tarrant, R C; Harrington, M; Kiely, P J
Is Part Of:
Presentation
Affiliation:
The Department of Orthopaedic Surgery, Our Lady's Children's Hospital, Crumlin, Dublin 12
Issue Date:
Apr-2011
URI:
http://hdl.handle.net/10147/265252
Abstract:
INTRODUCTION This retrospective audit aimed to investigate postoperative complications and nutritional outcomes in a cohort of adolescent idiopathic scoliosis (AIS) and Scheuermann’s Kyphosis (SK) cases following major spinal corrective surgery. METHODS Demographic, biochemical, surgical and nutritional data were retrospectively collected on all the postoperative spinal corrrective AIS and SK cases performed in Our Lady’s Children’s Hospital (OLCHC) and the Blackrock Clinic during 2010. SPSS® was used to analyse the data. RESULTS In total, 40 spinal corrective procedures were performed in OLCHC (n=14) and the Blackrock Clinic (n=26) from Jan-Nov 2010 (mean age: 14.9 yrs; 95% AIS). The majority of subjects experienced minor postoperative complications (constipation, 92.5%; vomiting, 65%); 45% (n=18) were anaemic. Major postoperative complications included: illeus (n=5, 12.5%), pneumonia (n=4, 10%), pleural effusion (n=2, 5%) and Type I respiratory failure (n=1, 2.5%). From admission to discharge (median 10 days), the proportion of subjects having a body mass index <25th centile increased from 20% to 67.6%, respectively (P < 0.001). Postoperatively, less than one quarter of subjects (23.7%) met > 50% of their daily energy requirements; one patient was given supplementary nutrition support (parenteral). The mean % weight loss during the hospital stay was 8.2% (± SD 3.9). All cases with an available albumin level at discharge (n=24/40) were below normal (<35g/L). There was one hospital re-admission due to wound infection and weight loss. CONCLUSION Major spinal corrective surgery in the AIS/SK population is associated with an increased malnutrition risk which is a well recognised marker of poor outcomes and increased hospital costs. To minimise postoperative weight loss and identify high risk malnutriton cases, nutritionally screening these patients on admission ± dietetic referral, and early initiation of supplementary nutrition postoperatively as appropriate, should be considered in this patient group.
Item Type:
Presentation
Language:
en
Keywords:
NUTRITION; BODY MASS INDEX; MUSCULOSKELETAL DISORDERS; YOUNG PEOPLE; SURGERY; ADOLESCENT IDIOPATHIC SCOLIOSIS; SCHEUERMANN'S KYPHOSIS; POSTOPERATIVE COMPLICATIONS
Local subject classification:
SURGERY IN ADOLESCENT IDIOPATHIC SCOLIOSIS; POSTOPERATIVE COMPLICATIONS; NUTRITION; BODY MASS INDEX
Sponsors:
The Department of Orthopaedic Surgery, Our Lady's Children's Hospital, Crumlin, Dublin 12

Full metadata record

DC FieldValue Language
dc.contributor.authorTarrant, R Cen_GB
dc.contributor.authorHarrington, Men_GB
dc.contributor.authorKiely, P Jen_GB
dc.date.accessioned2013-01-14T14:00:39Z-
dc.date.available2013-01-14T14:00:39Z-
dc.date.issued2011-04-
dc.identifier.urihttp://hdl.handle.net/10147/265252-
dc.description.abstractINTRODUCTION This retrospective audit aimed to investigate postoperative complications and nutritional outcomes in a cohort of adolescent idiopathic scoliosis (AIS) and Scheuermann’s Kyphosis (SK) cases following major spinal corrective surgery. METHODS Demographic, biochemical, surgical and nutritional data were retrospectively collected on all the postoperative spinal corrrective AIS and SK cases performed in Our Lady’s Children’s Hospital (OLCHC) and the Blackrock Clinic during 2010. SPSS® was used to analyse the data. RESULTS In total, 40 spinal corrective procedures were performed in OLCHC (n=14) and the Blackrock Clinic (n=26) from Jan-Nov 2010 (mean age: 14.9 yrs; 95% AIS). The majority of subjects experienced minor postoperative complications (constipation, 92.5%; vomiting, 65%); 45% (n=18) were anaemic. Major postoperative complications included: illeus (n=5, 12.5%), pneumonia (n=4, 10%), pleural effusion (n=2, 5%) and Type I respiratory failure (n=1, 2.5%). From admission to discharge (median 10 days), the proportion of subjects having a body mass index <25th centile increased from 20% to 67.6%, respectively (P < 0.001). Postoperatively, less than one quarter of subjects (23.7%) met > 50% of their daily energy requirements; one patient was given supplementary nutrition support (parenteral). The mean % weight loss during the hospital stay was 8.2% (± SD 3.9). All cases with an available albumin level at discharge (n=24/40) were below normal (<35g/L). There was one hospital re-admission due to wound infection and weight loss. CONCLUSION Major spinal corrective surgery in the AIS/SK population is associated with an increased malnutrition risk which is a well recognised marker of poor outcomes and increased hospital costs. To minimise postoperative weight loss and identify high risk malnutriton cases, nutritionally screening these patients on admission ± dietetic referral, and early initiation of supplementary nutrition postoperatively as appropriate, should be considered in this patient group.en_GB
dc.description.sponsorshipThe Department of Orthopaedic Surgery, Our Lady's Children's Hospital, Crumlin, Dublin 12en_GB
dc.language.isoenen
dc.relation.ispartofPresentationen_GB
dc.subjectNUTRITIONen_GB
dc.subjectBODY MASS INDEXen_GB
dc.subjectMUSCULOSKELETAL DISORDERSen_GB
dc.subjectYOUNG PEOPLEen_GB
dc.subjectSURGERYen_GB
dc.subjectADOLESCENT IDIOPATHIC SCOLIOSISen_GB
dc.subjectSCHEUERMANN'S KYPHOSISen_GB
dc.subjectPOSTOPERATIVE COMPLICATIONSen_GB
dc.subject.otherSURGERY IN ADOLESCENT IDIOPATHIC SCOLIOSISen_GB
dc.subject.otherPOSTOPERATIVE COMPLICATIONSen_GB
dc.subject.otherNUTRITIONen_GB
dc.subject.otherBODY MASS INDEXen_GB
dc.titleAnalysis of postoperative clinical and nutritional outcomes in a cohort of adolescents following major spinal corrective surgeryen_GB
dc.typePresentationen
dc.contributor.departmentThe Department of Orthopaedic Surgery, Our Lady's Children's Hospital, Crumlin, Dublin 12en_GB
dc.description.provinceLeinsteren
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