Nur CANBOLAT, Suna ARAT, Tugce YENİOCAK, Fuat BİLGİLİ, Mehmet İlke BÜGET

DÜZELTİCİ OSTEOTOMİ YAPILAN SEREBRAL PALSİ SEKELLİ ÇOCUKLARDA MORBİDİTEYİ ETKİLEYEN FAKTÖRLER

Amaç: Serebral palsi (SP), ilerleyici olmayan hasara bağlı hareket ve duruş bozuklukları ile karakterize nörogelişimsel bir hastalıktır. Femur varizasyon-derotasyon osteotomisi, SP’li hastalarda femoral anteversiyonu düzeltmek için yapılan cerrahi bir işlemdir. Bu çalışmanın amacı, düzeltici osteotomi uygulanan SP sekeli çocuklarda morbiditeyi etkileyen faktörleri belirlemektir.Gereç ve Yöntem: 2007-2020 yılları arasında SP sekeli olan ve düzeltme osteotomisi yapılan çocuklar çalışmaya dahil edildi. Hastalara ait bilgiler arşiv dosyalarından elde edildi ve retrospektif olarak değerlendirildi. 105 hasta perioperatif morbiditeye göre: Grup 1 (morbidite yok) 62 hasta ve grup 2 (morbidite var) 43 hasta olarak iki gruba ayrıldı.Bulgular: İki grup arasında yaş ve vücut kitle indeksi açısından anlamlı fark yoktu. ASA skorları Grup 2’de anlamlı olarak yüksek bulundu (p=0,006). Prognostik nutrisyonel indeks Grup 2’de anlamlı olarak daha düşüktü (p=0,001). Hastane yatış süresi ve yoğun bakım yatış süresi açısından anlamlı fark yoktu.Sonuç: Malnütrisyon, SP sekeli olan çocuk hastalarda postoperatif morbiditede artışa neden olan kritik bir faktördür. Varizasyon-derotasyon osteotomisi planlanan SP sekeli hastalarda postoperatif morbiditeyi azaltmak için hasta bazında tedavi planı hazırlanabilir.

Anahtar Kelimeler:

Serebral palsi, varizasyon-derotasyon oste- otomisi, malnutrisyon, prognostik nutrisyonel indeks

FACTORS AFFECTING MORBIDITY IN CHILDREN WITH CEREBRAL PALSY SEQUELAE WHO UNDERWENT CORRECTIVE OSTEOTOMY

Objective: Cerebral palsy (CP) is a neurodevelopmental disease characterized by movement and posture disorders due to non-progressive damage. Femur varization-derotation osteotomy is a surgical procedure performed to correct femoral anteversion in patients with CP. The aim of this study is to determine the factors affecting morbidity in children with CP sequelae who underwent corrective osteotomy.Materials and Methods: Children with CP sequelae who underwent correction osteotomy were included in the study between 2007 and 2020. Information about the patients was obtained from the archived files and evaluated retrospectively. 105 patients were divided into two groups according to the perioperative morbidity: Group 1 (no morbidity) including 62 patients and group 2 (presence of morbidity) including 43 patients.Results: We did not report any significant differences between group 1 and 2 in terms of age and body mass index. In Group 2, ASA scores were higher significantly (p=0.006). Prognostic nutritional index was significantly lower in Group 2 (p=0.001). There was no significant difference in length of hospital and intensive care unit stay.Conclusion: Malnutrition is an important factor that causes an increase in postoperative morbidity in pediatric patients with CP sequelae. In patients with CP sequelae planned for varization-derotation osteotomy, a treatment plan can be prepared on a patient basis to reduce postoperative morbidity.

Keywords:

Cerebral palsy, varization-derotation osteotomy, malnutrition, prognostic nutritional index,

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