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- Talk
- 21/09/2021
- UK
Can the Physiological Vulnerability Score Predict Outcomes of Hip Reconstruction in Children with Severe Neuromuscular Disability?
Description
In this presentation, Stephanie Buchan discusses research conducted at Southampton Children's Hospital, focusing on the Physiological Vulnerability Score (PVS) and its role in predicting the outcomes of hip reconstruction surgery in children with severe neuromuscular disabilities. She explains the components and application of the PVS, which employs a validated scoring system to assess the physiological needs and vulnerabilities of pediatric patients, particularly those requiring palliative care.
Buchan elaborates on two main orthopedic procedures—VDRO (Varus Derotation Osteotomy) and pelvic osteotomy—used to address hip migration in these complex cases. The lack of clear guidance on the suitability and appropriateness of surgical interventions in such patients is highlighted, making this project particularly relevant.
The methodology included a retrospective review of medical notes to evaluate preoperative PVS and correlate it with postoperative outcomes such as length of hospital stay and complications, graded by the Clavien-Dindo system. The study encompassed 68 patients, with a mean age of 12 years, and findings revealed a significantly higher vulnerability score for those undergoing combined pelvic osteotomy surgeries, which also resulted in increased complication rates and longer recovery times.
Buchan concludes that the PVS effectively guides surgical planning by identifying high-risk patients needing early intervention. The presentation emphasizes enhancing informed consent processes for families by better preparing them for the surgical journey ahead. The discussion also suggests potential avenues for future research, including the need to explore the relationship between PVS and GMFCS (Gross Motor Function Classification System) scores in the context of treatment outcomes.