WORLD JOURNAL OF PLASTIC SURGERY
مجله جهانی جراحی پلاستیک
WJPS
Medical Sciences
http://wjps.ir
1
admin
2228-7914
2252-0724
8
10.61186/wjps
14
8888
13
en
jalali
1395
10
1
gregorian
2017
1
1
6
1
online
1
fulltext
en
Effect of Perioperative Management on Outcome of Patients after Craniosynostosis Surgery
عمومى
General
مقالات اصيل
Original Article
<p><strong>BACKGROUND</strong></p>
<p>Craniosynostosis results from premature closure of one or more cranial sutures, leading to deformed calvaria and craniofacial skeleton at birth. Postoperative complications and outcome in intensive care unit (ICU) is related to surgical method and perioperative management. This study determined the perioperative risk factors, which affect outcome of patients after craniosynostosis surgery.</p>
<p><strong>METHODS</strong></p>
<p>In a retrospective study, 178 patients with craniosynostosis who underwent primary cranial reconstruction were included. Postoperative complications following neurosurgical procedures including fever in ICU, level of consciousness, re-intubation, and blood, urine, and other cultures were also performed and their association with the main outcomes (length of ICU stay) were analyzed.</p>
<p><strong>RESULTS</strong></p>
<p>Factors independently associated with a longer pediatric ICU stay were fever (OR=1.59, 95% CI=1.25-4.32; <em>p</em>=0.001), perioperative bleeding (OR=2.25, 95% CI=1.65-3.65; <em>p</em>=0.01), age (having surgery after the first 5 years) (OR=1.59, 95% CI=1.33-3.54, <em>p</em>=0.016) and infection (OR=2.17, 95% CI=1.83-7.46; <em>p</em>=0.002). Mean blood loss during surgery was significantly higher in patients whose duration of ICU was longer than 4 days compare to less than 4 day (<em>p</em>=0.026). Amount of bleeding significantly was correlated to duration of surgery (r=0.70, <em>p</em>=0.001) and patient's age (r=0.23, <em>p</em>=0.44).</p>
<p><strong>CONCLUSION</strong></p>
<p>perioperative management particularly blood loss could deteriorate patients outcome and length of stay in ICU and hospital. Infections in ICU could deteriorate outcomes.</p>
Craniosynostosis, Pediatric, Intensive care unit, Operation
48
53
http://wjps.ir/browse.php?a_code=A-10-207-1&slc_lang=en&sid=1
Abdoljalil
Kalantar Hormozi
kalantarj@yahoo.com
10031947532846002955
10031947532846002955
No
Department of Craniomaxillofacial Surgery, Mofid Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Nastaran
Mahdavi
10031947532846002956
10031947532846002956
No
Department of Pediatric Anaesthesiology, Mofid Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Mohammad Mehdi
Foroozanfar
10031947532846002957
10031947532846002957
No
Department of Pediatric Anaesthesiology, Mofid Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Seyed Sajad
Razavi
10031947532846002958
10031947532846002958
No
Department of Pediatric Anaesthesiology, Mofid Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Seyed Amir
Mohajerani
10031947532846002959
10031947532846002959
No
Department of Pediatric Anaesthesiology, Mofid Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Ahmad
Eghbali
10031947532846002960
10031947532846002960
No
Department of Pediatric Anaesthesiology, Mofid Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Amir Ali
Mafi
amirali.mafi@gmail.com
10031947532846002961
10031947532846002961
No
Shahid Beheshti University of Medical Sciences, Tehran, Iran
Haleh
Hashemzadeh
10031947532846002962
10031947532846002962
No
Department of Craniomaxillofacial Surgery, Mofid Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Alireza
Mahdavi
alirezamahdavi78@yahoo.com
10031947532846002963
10031947532846002963
Yes
Department of Pediatric Anaesthesiology, Mofid Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran