Post-Operative Complications of Spina Bifida Patients Undergoing Urological Laparotomy: a Multi-Institutional Analysis

• Published in: Urology (Ridgewood, N.J.)
• Main Authors: Loftus, Christopher J., M.D, Moore, David C., M.D, Cohn, Joshua A., M.D, Milam, Douglas F., M.D, Dmochowski, Roger R., M.D, Wood, Dan, M.D, Kaufman, Melissa R., M.D, Wood, Hadley M., M.D. FACS
• Format: Journal Article
• Language: English
• Published: 2017
• Subjects: Urology; peri-operative; complications; spina bifida; laparotomy
• ISSN: 0090-4295
• DOI: 10.1016/j.urology.2017.06.019

Abstract Objective To characterize peri-operative morbidity and mortality of adult spina bifida patients undergoing laparotomy. Methods We retrospectively studied the post-operative complications of 59 operations of spina bifida patients undergoing abdominal laparotomies for urological indications at three institutions. We evaluated post-operative complications using the Clavien-Dindo classification scale. Results The overall complication rate was 91.5%. The most common complications were ileus, pressure ulcers, urinary tract infection, wound infection. Over 40% of patients developed a class 3 or 4 complication requiring subsequent surgery or intensive care unit admission. The hospital readmission rate was 42% and was correlated with higher grade complications. On multivariable analysis, only older age was significantly associated with grade of complication. Conclusions These data demonstrate that adult patients with spina bifida comprise a unique population that faces extremely high surgical risk even in centers of excellence. As spina bifida patients live longer lives thanks to modern medicine, there is a timely opportunity for research on peri-operative management in these patients to improve post-surgical outcomes.