Risk factors associated with short-term complications and mortality after pediatric spinal arthrodesis.
Neurosurg Focus
; 43(4): E7, 2017 Oct.
Article
en En
| MEDLINE
| ID: mdl-28965454
ABSTRACT
OBJECTIVE Spinal arthrodesis is routinely performed in the pediatric population. However, there is limited information on the short-term outcomes of pediatric patients who have undergone spine fusion. Thus, the authors conducted a retrospective review of the Pediatric National Surgical Quality Improvement Program (NSQIP) database to determine the short-term mortality, complication, reoperation, and readmission rates of pediatric patients who underwent spinal arthrodesis for all indications. METHODS The Pediatric NSQIP database was queried for all patients who underwent spinal arthrodesis between 2012 and 2014. Patient demographics, comorbidities, body mass index, American Society of Anesthesiologists classification, and operative time were abstracted. Short-term mortality, reoperation, and readmission rates and complications were also noted. Univariate and multivariate analyses were performed to delineate patient risk factors that influence short-term mortality, complications, reoperation, and readmission rates. RESULTS A total of 4420 pediatric patients who underwent spinal fusion were identified. Common indications for surgical intervention included acquired/idiopathic scoliosis or kyphoscoliosis (71.2%) and genetic/syndromic scoliosis (10.7%). The mean patient age was 13.7 ± 2.9 years, and 70% of patients were female. The overall 30-day mortality was 0.14%. Multivariate analysis showed that female sex and pulmonary comorbidities significantly increased the odds of reoperation, with odds ratios of 1.43 and 1.78, respectively. CONCLUSIONS In the NSQIP database for pediatric patients undergoing spinal arthrodesis for all causes, there was a 3.6% unplanned reoperation rate, a 3.96% unplanned readmission rate, and a 9.0% complication rate. This analysis provides data for risk stratification of pediatric patients undergoing spinal arthrodesis, allowing for optimized care.
Palabras clave
ACS = American College of Surgeons; ASA = American Society of Anesthesiologists; BMI = body mass index; NSQIP; NSQIP = National Surgical Quality Improvement Program; SSI = surgical site infection; UTI = urinary tract infection; arthrodesis; complications; fusion; mortality; pediatric; readmission; reoperation; short-term outcomes; spine
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
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Artrodesis
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Enfermedades de la Columna Vertebral
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Child
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Female
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Humans
/
Male
Idioma:
En
Revista:
Neurosurg Focus
Asunto de la revista:
NEUROCIRURGIA
Año:
2017
Tipo del documento:
Article