Patient selection: spine surgery in a patient with cerebral palsy
Outcome: any major complication (divided into pulmonary, gastroinestinal, other medical, neurologic, wound infection, unplanned staged surgery and instrumentation related
Risk factors for major perioperative complications:
(1) staged procedure
(2) greater preoperative kyphosis (affecting T2 to T12)
(3) greater estimated blood loss (EBL)
where:
• The mean EBL for patients with complications was 2,843 mL +/- 1,732 mL. Patients without complications had an EBL ranging from 400 to 2,806 mL. The risk would therefore be an EBL > 2,800 mL.
• Kyphosis in patients with complications ranged from 27 to 69 degrees vs 16 to 63 degrees in patients without complications.
Factors associated with fewer complications:
(1) use of an antifibrinolytic agent
