NDLI: Assessment of the impact of comorbidities on perioperative complications in pediatric neurosurgery.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Patel, Akash J. Sivaganesan, Ahilan Bollo, Robert J. Brayton, Alison Luerssen, Thomas G. Jea, Andrew
Description	Author Affiliation: Patel AJ ( Division of Pediatric Neurosurgery, Texas Children's Hospital, Department of Neurosurgery, Baylor College of Medicine, Houston, Texas.)
Abstract	OBJECT: Recent attempts to control health care costs focus on reducing or eliminating payments for complications, hospital-acquired conditions, and provider preventable conditions, with payment restrictions applied uniformly. A patient's preexisting comorbidities likely influence the perioperative complication incidence. This relationship has not previously been examined in pediatric neurosurgery. METHODS: The authors conducted a retrospective assessment of prospectively collected relevant patient comorbidities and morbidity and mortality events at a large pediatric neurosurgical unit over a 5-year period. The authors examined the impact of specific comorbidities and the cumulative effect of multiple comorbidities on complication incidence. RESULTS: A total of 1990 patients underwent 3195 procedures at the authors' institution during the 5-year study period. Overall, 396 complications were analyzed; 298 patients (15.0%) experienced at least one complication. One or more comorbidities were present in 45.9% of patients. Renal comorbidities were clearly associated with the increased incidence of complications (p = 0.02), and they were specifically associated with infection (p = 0.006). Neurological comorbidities had a borderline association with complications (p = 0.05), and they were specifically associated with death (p = 0.037). A patient's having more comorbidities did not correlate with an increased risk of a perioperative complication (p = 0.8275). CONCLUSIONS: The complication incidence in pediatric neurosurgery is variable and may be influenced by the type of neurosurgical procedure and patient-related factors. While patient-related factors beyond the control of the provider can significantly impact complications and hospital-acquired conditions in pediatric neurosurgery, an increasing number of comorbidities do not correlate with an increased risk of complications per patient.
File Format	HTM / HTML
ISSN	19330707
Issue Number	5
Volume Number	13
e-ISSN	19330715
Journal	Journal of Neurosurgery: Pediatrics
Language	English
Publisher	American Association of Neurological Surgeons
Publisher Date	2014-05-01
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	Adverse Effects Comorbidity Humans Mortality Child, Preschool Male Discipline Neurosurgery Epidemiology Discipline Pediatrics Morbidity Journal Article Incidence Neurosurgical Procedures Time Factors Etiology Female Retrospective Studies Postoperative Complications Child
Content Type	Text
Resource Type	Article
Subject	Neurology (clinical) Surgery Pediatrics, Perinatology and Child Health

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