The Role of Prognostic Factors in Peri¬operative Adverse Events and Complications in Children with Cleft Palate Re¬pair.

Öz

Amaç: Dudak damak yarığı (CLP) deformitesi en sık görülen kraniyofasiyal malformasyon türüdür ve genellikle infant döneminde cerrahi olarak düzeltilir. CLP onarımı geçiren çocukların anestezi yönetimi birçok zorluğu barındırır. Bu çalışmada yarık damak (CP) onarımı uygulanan çocuklarda prognostik faktörlerin perioperatif komplikasyonlara etkisinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Bu çalışmada 2015-2020 yılları arasında üçüncü basamak bir hastanede yarık damak ameliyatı geçiren çocuk olgular retrospektif olarak incelendi. Birincil sonuç ölçütü, perioperatif olumsuz sonuç oranıydı. Bulgular: Hava yolu ve solunum komplikasyonları, yoğun bakıma yatış, kan transfüzyonu ve tekrar operasyon gereksinimi dahil olmak üzere tüm perioperatif advers olay insidansı %40,7 (n=88) ve solunumsal komplikasyon insidansı %28,7 (n=62) olarak bulundu. Ayrıca, düşük vücut ağırlığı (OR 0.69, %95 GA 1.18-1.78, p=0.000), komorbidite, eşlik eden sendrom varlığı (OR 7.19, %95 GA 2.02-25.60, p=0.000) ve yarık dudak (OR 2.73, %95 GA 1,10–6,73, p=0,030) ve tam tip yarık damak (OR 0,33, %95 GA 1,22–7,46, p=0,017) perioperatif advers olaylar için risk faktörleriydi. Sonuç: Bu çalışmada, CP onarımı yapılan çocuklarda düşük kilo, komorbidite, eşlik eden sendrom varlığı, yarık dudak varlığı, komplet tip yarık damak ile perioperatif advers olay gelişme riski arasında anlamlı ilişki bulundu.

Anahtar Kelimeler

• Yarık damak
• yarık dudak
• zor hava yolu
• perioperatif komplikasyonlar
• zayıflık

The Role of Prognostic Factors in Perioperative Adverse Events and Complications in Children with Cleft Palate Repair

Abstract

Aim: Cleft lip and palate (CLP) deformity is the most common type of craniofacial malformation and is usually corrected surgically in infancy. Anesthetic management of children undergoing CLP repair has many challenges. In this study, it was aimed to evaluate the effect of prognostic factors on perioperative complications in children with cleft palate (CP) repair. Methods: In this study, pediatric cases who underwent cleft palate surgery in a tertiary care hospital between 2015 and 2020 were analyzed retrospectively. The primary outcome measure was perioperative adverse outcomes rate. Results: The incidence of all perioperative adverse events including airway, and respiratory complications, ICU admission, blood transfusion and re-operation requirement was determined as 40.7% (n=88) and the incidence of respiratory adverse events was found as 28.7% (n=62). Moreover, low body weight (OR 0.69, 95% CI 1.18-1.78, p<0.001), comorbidity, concomitant presence of syndrome (OR 7.19, 95% CI 2.02-25.60, p<0.001) and cleft lip (OR 2.73, 95% CI 1.10–6.73, p=0.030), and complete type of cleft palate (OR 0.33, 95% CI 1.22–7.46, p=0.017) were risk factors for perioperative adverse events. Conclusions: In this study, a significant relationship was found between underweight, comorbidity, the presence of concomitant syndrome, cleft lip, complete type of cleft palate and the risk of developing perioperative adverse events in children with CP repair.

Keywords

• Cleft palate
• cleft lip
• difficult airway
• perioperative complications
• underweight

Kaynakça

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