Predictive factors for adverse outcomes in pediatric patients undergoing low-risk skin and soft tissue surgery: A database analysis of 6730 patients

Eric C. Cheon*, Anthony B. Longhini, Joseph Lee, Jennifer Hansen, Narasimhan Jagannathan, Gildasio S De Oliveira Jr, Santhanam Suresh

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background: There is a paucity of data regarding risk stratification of pediatric patients presenting for low-risk skin and soft tissue surgery. Aims: We sought to determine the incidence and independent predictors of postoperative complications and unplanned 30-day readmission in a cohort of children undergoing low-risk skin and soft tissue surgery. Methods: The study included pediatric patients who underwent minor procedures of the skin and soft tissue at continuously enrolled American College of Surgeons National Surgical Quality Improvement Program Pediatric hospitals over a two-year period. The primary outcome was a 30-day postoperative complication composite. The secondary outcome was unplanned 30-day readmission. Results: The final analysis included 6,730 patients. There were a total of 170 postoperative complications among 152 patients (2.23%) with the majority of complications being either wound-related or postoperative mechanical ventilation. The independent predictors for an increased risk of postoperative complication were American Society of Anesthesiologists classification ≥3 and nutritional deficiency. There were 41 unplanned readmissions (0.61%). The presence of a postoperative wound complication or a postoperative pulmonary complication during the index hospital stay was an independent risk factor for unplanned 30-day readmission. Conclusion: Pediatric patients with American Society of Anesthesiologists classification ≥3 and nutritional deficiency undergoing low-risk surgery are at risk for the development of postoperative complications. Patients who develop wound and postoperative pulmonary complications are at higher risk for unplanned 30-day readmission. Identification of these higher risk patients may allow the anesthesiologist to implement targeted therapies to minimize the likelihood of occurrence of these complications.

Original languageEnglish (US)
Pages (from-to)44-50
Number of pages7
JournalPaediatric anaesthesia
Volume29
Issue number1
DOIs
StatePublished - Jan 2019

Keywords

  • ambulatory surgery
  • anesthesia
  • child
  • patient readmission
  • postoperative complications
  • postoperative period

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Anesthesiology and Pain Medicine

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