Duan Yaqin,Wu Shuihua,Hu Jihong,et al.Analysis of influencing factors for postoperative neurological functional outcomes in children with craniosynostosis and neurodevelopmental disorders[J].Journal of Clinical Pediatric Surgery,2025,(02):179-183.[doi:10.3760/cma.j.cn101785-202312027-013]
Analysis of influencing factors for postoperative neurological functional outcomes in children with craniosynostosis and neurodevelopmental disorders
- Keywords:
- Craniosynostosis; Rehabilitative Intervention; Neurodevelopmental Disorders; Influencing Factors
- Abstract:
- Objective To explore the influencing factors for the effectiveness of postoperative rehabilitative interventions in children with craniosynostosis (CS) plus neurodevelopmental disorders. Methods Retrospective analysis was conducted for the relevant clinical data of 41 CS children plus neurodevelopmental disorders undergoing postoperative rehabilitative interventions from September 2016 to March 2023.The influencing factors for the effectiveness of postoperative rehabilitative interventions were evaluated based upon the differential scores of developmental quotient (DQ) from the first and last assessments using Gesell Developmental Schedule (GDS).They were classified into a "good efficacy group" (n=27) if DQ score difference between the first and last GDS assessments was ≥10 points and a "poor efficacy group" (n=14) if DQ score difference <10 points.The relevant data collected for both groups included gender,age at surgery,type of CS,education level of primary caregivers,first and last GDS DQ scores,assessment age,age at the start of rehabilitative intervention,total duration of rehabilitation and follow-up time.The influencing factors for postoperative rehabilitation were then examined. Results Univariate analysis of two groups revealed statistically significant differences in postoperative first DQ score [44.50(18.75,62.25) vs.69.00(62.00,78.00),Z=-3.259,P=0.001],age at the start of rehabilitative intervention [28.00(17.5,36.75) vs.14.00(9.00,18.00) month,Z=-3.358,P=0.000]and total duration of rehabilitation [7.500(2.50,12.75) vs.14.00 (12.00,18.00) month,Z=-2.604,P=0.008](P<0.05).These variables were then included in multivariate Logistic regression analysis.The results indicated that postoperative first DQ score (OR=1.140,95%CI:1.044-1.246),age at the start of rehabilitative intervention (OR=0.919,95%CI:0.849-0.996) and total rehabilitative duration (OR=1.314,95%CI:1.016-1.698) were independent influencing factors for the effectiveness of postoperative rehabilitation.Based upon the cut-off values,comparisons of DQ score differences were made between two groups:postoperative first DQ ≥52.5 vs. <52.5,total rehabilitative duration ≥9.5 vs. <9.5 month and age at the start of rehabilitative intervention ≥22.5 vs. <22.5 month.The differences were statistically significant (P<0.05). Conclusions Group with postoperative first DQ ≥52.5 had better rehabilitative outcomes than group with DQ <52.5.Similarly,group with total rehabilitative duration ≥ 9.5 month had better outcomes than group with <9.5 month of rehabilitation and group with rehabilitation start age ≥ 22.5 month showed better outcomes than group aged <22.5 month.The milder postoperative neurodevelopmental impairment,the earlier rehabilitative intervention,the longer rehabilitative duration and the better rehabilitative outcomes.
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Memo
收稿日期:2023-12-12。
基金项目:湖南省残疾人康复科研项目(2021XK0221);湖南省科技厅临床医学研究中心项目(2021SK4018);湖南省自然科学基金资助项目(2025JJ50682)
通讯作者:吴水华,Email:292454021@qq.com