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 language | English (US) |
|---|---|
| Pages (from-to) | 44-50 |
| Number of pages | 7 |
| Journal | Paediatric anaesthesia |
| Volume | 29 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2019 |
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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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Predictive factors for adverse outcomes in pediatric patients undergoing low-risk skin and soft tissue surgery : A database analysis of 6730 patients. / Cheon, Eric C.; Longhini, Anthony B.; Lee, Joseph; Hansen, Jennifer; Jagannathan, Narasimhan; De Oliveira, Gildasio S.; Suresh, Santhanam.
In: Paediatric anaesthesia, Vol. 29, No. 1, 01.2019, p. 44-50.Research output: Contribution to journal › Article
TY - JOUR
T1 - Predictive factors for adverse outcomes in pediatric patients undergoing low-risk skin and soft tissue surgery
T2 - A database analysis of 6730 patients
AU - Cheon, Eric C.
AU - Longhini, Anthony B.
AU - Lee, Joseph
AU - Hansen, Jennifer
AU - Jagannathan, Narasimhan
AU - De Oliveira, Gildasio S.
AU - Suresh, Santhanam
PY - 2019/1
Y1 - 2019/1
N2 - 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.
AB - 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.
KW - ambulatory surgery
KW - anesthesia
KW - child
KW - patient readmission
KW - postoperative complications
KW - postoperative period
UR - http://www.scopus.com/inward/record.url?scp=85059260789&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85059260789&partnerID=8YFLogxK
U2 - 10.1111/pan.13550
DO - 10.1111/pan.13550
M3 - Article
C2 - 30447169
AN - SCOPUS:85059260789
VL - 29
SP - 44
EP - 50
JO - Paediatric Anaesthesia
JF - Paediatric Anaesthesia
SN - 1155-5645
IS - 1
ER -