Long-term mortality outcomes and mortality predictors in patients with myelomeningocele

Clin Neurol Neurosurg. 2024 Nov:246:108577. doi: 10.1016/j.clineuro.2024.108577. Epub 2024 Oct 2.

Abstract

Objective: Despite advances, myelomeningocele remains a major cause of mortality and disability. This study aims to analyze factors influencing mortality and suggest ways to reduce it.

Methods: We reviewed 173 patients who underwent surgery for myelomeningocele from January 2010 to December 2021. Variables affecting mortality were categorized into patient-related and indirectly related factors. Data were collected through patient file reviews and phone interviews with parents.

Results: Mortality is influenced by multiple factors: female gender (3.2-fold increase), paraplegia (3.1-fold increase), absence of tethered cord release surgery (9.4-fold increase), scoliosis (4.2-fold increase), and renal failure (5.28-fold increase). Defect size and father's education level also significantly impact mortality. The overall mortality rate was 20.8 %, with hydrocephalus being the leading cause.

Conclusion: Mortality and disability in myelomeningocele patients remain high, with over 50 % of deaths being preventable. Effective management could significantly improve mortality rates. Long-term studies are crucial for advancing research in this field.

Keywords: Long-term outcome; Mortality predictors; Mortality rates; Myelomeningocele.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Hydrocephalus / mortality
  • Hydrocephalus / surgery
  • Infant
  • Male
  • Meningomyelocele* / complications
  • Meningomyelocele* / mortality
  • Meningomyelocele* / surgery
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Young Adult