Risk factors associated with short-term complications and mortality after pediatric spinal arthrodesis

Nancy Abu-Bonsrah, C. Rory Goodwin, Gezzer Ortega, Fizan Abdullah, Edward Cornwell, Rafael D. De la Garza-Ramos, Mari L. Groves, Michael Ain, Paul D. Sponseller, Daniel M. Sciubba

Research output: Contribution to journalArticle

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 shortterm 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.

LanguageEnglish (US)
Article numberE7
JournalNeurosurgical Focus
Volume43
Issue number4
DOIs
StatePublished - 2017

Fingerprint

Arthrodesis
Pediatrics
Mortality
Reoperation
Quality Improvement
Scoliosis
Databases
Comorbidity
Multivariate Analysis
Spinal Fusion
Operative Time
Spine
Body Mass Index
Odds Ratio
Demography
Lung

Keywords

  • Arthrodesis
  • Complications
  • Fusion
  • Mortality
  • NSQIP
  • Pediatric
  • Readmission
  • Reoperation
  • Short-term outcomes
  • Spine

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Abu-Bonsrah, N., Rory Goodwin, C., Ortega, G., Abdullah, F., Cornwell, E., De la Garza-Ramos, R. D., ... Sciubba, D. M. (2017). Risk factors associated with short-term complications and mortality after pediatric spinal arthrodesis. Neurosurgical Focus, 43(4), [E7]. DOI: 10.3171/2017.7.FOCUS17313

Risk factors associated with short-term complications and mortality after pediatric spinal arthrodesis. / Abu-Bonsrah, Nancy; Rory Goodwin, C.; Ortega, Gezzer; Abdullah, Fizan; Cornwell, Edward; De la Garza-Ramos, Rafael D.; Groves, Mari L.; Ain, Michael; Sponseller, Paul D.; Sciubba, Daniel M.

In: Neurosurgical Focus, Vol. 43, No. 4, E7, 2017.

Research output: Contribution to journalArticle

Abu-Bonsrah N, Rory Goodwin C, Ortega G, Abdullah F, Cornwell E, De la Garza-Ramos RD et al. Risk factors associated with short-term complications and mortality after pediatric spinal arthrodesis. Neurosurgical Focus. 2017;43(4). E7. Available from, DOI: 10.3171/2017.7.FOCUS17313
Abu-Bonsrah, Nancy ; Rory Goodwin, C. ; Ortega, Gezzer ; Abdullah, Fizan ; Cornwell, Edward ; De la Garza-Ramos, Rafael D. ; Groves, Mari L. ; Ain, Michael ; Sponseller, Paul D. ; Sciubba, Daniel M./ Risk factors associated with short-term complications and mortality after pediatric spinal arthrodesis. In: Neurosurgical Focus. 2017 ; Vol. 43, No. 4.
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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 shortterm 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.",
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AU - Abu-Bonsrah,Nancy

AU - Rory Goodwin,C.

AU - Ortega,Gezzer

AU - Abdullah,Fizan

AU - Cornwell,Edward

AU - De la Garza-Ramos,Rafael D.

AU - Groves,Mari L.

AU - Ain,Michael

AU - Sponseller,Paul D.

AU - Sciubba,Daniel M.

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N2 - 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 shortterm 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.

AB - 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 shortterm 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.

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KW - Complications

KW - Fusion

KW - Mortality

KW - NSQIP

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KW - Readmission

KW - Reoperation

KW - Short-term outcomes

KW - Spine

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