Comorbidities Associated with Early Mortality in Adults with Spina Bifida

Objective The purpose of this quality improvement project was to identify secondary conditions and medical comorbidities in adult patients with spina bifida and to determine which factors were associated with an earlier age of death. Design Retrospective chart review of 487 patients who attended the University of Pittsburgh Medical Center (UPMC) Adult Spina Bifida Clinic between August 1, 2005 and June 6, 2017. Results Out of 487 patients who had received care at the UPMC Adult Spina Bifida Clinic, 48 were deceased. The most commonly reported causes of death included infection, respiratory failure, renal failure, shunt malfunction and metastatic cancer. Underlying comorbidities and secondary conditions included hydrocephalus, Chiari II malformation, tethered cord, scoliosis, and abnormal renal function. In deceased patients, earlier age of death was significantly associated with myelomeningocele (MMC) subtype and the presence of hydrocephalus and Chiari II malformation. Conclusion Clinicians treating individuals with spina bifida should be aware of the potential for earlier mortality in individuals with MMC, hydrocephalus, and Chiari II malformation, especially with regard to infection, respiratory failure, renal failure, shunt malfunction, and cancer. Correspondence should be directed to: Brad E. Dicianno, MD, Human Engineering Research Laboratories, Bakery Square, 6425 Penn Avenue, Suite 400, Pittsburgh PA 15206. 412-822-3700. (dicianno@pitt.edu) Author disclosures: This study has not previously been presented or published in any form. This study was supported by the Department of Physical Medicine and Rehabilitation at the University of Pittsburgh School of Medicine. The authors have no competing conflicts of interest or financial incentives related to this quality improvement project. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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