244. Risk Factors Associated with Complications/Sequelae in Pediatric Patients with Osteomyelitis

Abstract Background Osteoarticular infections are serious invasive pathologies in the pediatric population. They have high morbidity, especially if antimicrobial treatment is inadequate and late. Based on pediatric series patients with osteomyelitis require prolonged antibiotic schemes, long stay and high hospital costs, multiple surgical procedures and develop short and long-term sequelae. Methods A retrospective, observational, longitudinal and analytical study was conducted in patients under 17 years of age diagnosed with osteomyelitis at the National Institute of Pediatrics from January 2009 to January 2019. Demographic information, clinical presentation, microbiological, treatment and six-month follow-up were recorded. Results A total of 109 patients were included, 57 (52%) males with median age of 98 (1-205) months with predominance in previous healthy (66%). By temporality, the chronic form predominated in 72%. The history of trauma was identified in 26% and fracture 19%. The most affected bone was femur 26%. Blood culture was performed in 55%, secretion culture in 52.2% with isolation in 56%. Methicillin-susceptible Staphylococcus aureus (MSSA) was the main agent identified. Complications occurred in 37%, the most frequent was surgical wound infection in 13% followed by fracture 11%. Risk factors for complications were chronic osteomyelitis RR 5.7 (CI 1.8-17.9), Sepsis/Shock RR 3.8 (CI 1.08-13-8) and MSSA infections RR 2.7 (CI 1.01-7.5); Risk factors for surgical site infection included initial fracture RR 3.5 (CI 1-11), local ulcer RR 4.2 (CI 1.3-13.06) and MSSA infection RR 5.9 (CI 1.8-19.4). Risk factors for limitation to movement included chronic osteomyelitis RR 4.87 (CI 1.6-14), fever RR 2.5 (CI 1.15-5.5), Sepsis/shock RR 5.3 (CI 1.3-20) (p 0.013) and MSSA infection RR 4.1 (CI 1.4-11.9). Conclusion Osteomyelitis is still a health problem in our country. The diagnosis of osteomyelitis may be challenging as lack of suspicion often leads to delayed diagnosis. Knowledge of the risk factors for complications in pediatric patients could be useful to give early and proper antibiotic and surgical treatment. It is a priority to have a multidisciplinary team for the diagnosis and treatment of osteoarticular infections. Disclosures All Authors: No reported disclosures

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NURS-10. IMPROVEMENTS IN A BEHAVIORAL TRAINING AND PHARMACOLOGICAL ANXIOLYSIS ALGORITHM FOR INCREASED COMPLIANCE IN PEDIATRIC PATIENTS IN PREPARATION FOR RADIATION THERAPY: A RETROSPECTIVE ANALYSIS

Neuro-Oncology ◽

10.1093/neuonc/noaa222.629 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii422-iii423

Author(s):

Judy Tran ◽

Jennifer Holt ◽

Danielle Crump ◽

Anita Shea ◽

Lin Whetzel ◽

...

Keyword(s):

Risk Factors ◽

Pediatric Patients ◽

Pediatric Population ◽

Statistical Significance ◽

Radiation Risk ◽

Proton Radiation ◽

Behavioral Training ◽

Duration Of Treatment ◽

Behavioral Compliance ◽

Patients At Risk

Abstract BACKGROUND In the pediatric population, the probability of compliance with radiation involves multifactorial elements. Younger pediatric patients often require anesthesia to ensure accurate delivery of radiotherapy. The purpose of this analysis was to refine our algorithm in pediatric patients to better identify children who would benefit from behavioral training and/or anxiolyxis intervention with the goal of minimizing anesthesia use. METHOD Retrospective data was collected from electronic medical records from 150 pediatric oncology patients <18 years old, treated with photon and proton radiation at our center from August 2016 to December 2019. We identified potential socio-developmental treatment factors thought to impact behavioral compliance and categorized risk factors based on an algorithm to determine risk for noncompliance with radiotherapy. RESULTS Six categories demonstrated statistical significance (p<0.05) in their influence on behavioral compliance during radiotherapy: age category (specifically age <7: Odds ratio [OR] 3.0, 95% Confidence Interval [CI] 1.0, 9.1), need for sedation with prior imaging studies (p<0.001), parental premonition of requiring anesthesia for successful treatment (p<0.001), duration of treatment, primary language (p<0.001), and use of total body irradiation (OR 3.1, 95% CI 1.1, 9.3). CONCLUSION Identification of pre-radiation risk factors allowed for better recognition of patients at risk for treatment non-compliance and for requiring daily sedation. Future studies should focus on implementing the algorithm prospectively in an effort to identify and direct early intervention with behavioral training and/or anxiolytics to minimize the need for sedation.

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Risk Assessment and Outcome of Venous Thromboembolism in Pediatric Population in an Academic Care Center of a Low-Middle Income Country

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029621995895 ◽

2021 ◽

Vol 27 ◽

pp. 107602962199589

Author(s):

Muhammed Wahhaab Sadiq ◽

Ronika Devi Ukrani ◽

Aiman Arif ◽

Inaara Akbar ◽

Sadaf Altaf ◽

...

Keyword(s):

Risk Factors ◽

Pulmonary Embolism ◽

Pediatric Patients ◽

Pediatric Population ◽

Care Center ◽

Tertiary Care ◽

Middle Income Country ◽

Income Country ◽

Tertiary Care Center ◽

Middle Income

Venous thromboembolism (VTE) is a recognized complication of hospital stay in young patients in many developed countries, but such an information is largely unavailable from a low middle-income country (LMIC). This study aimed at identifying the frequency, risk factors, treatment options and outcome of deep venous thrombosis/pulmonary embolism (DVT/PE) in pediatric population in a tertiary care center from a LMIC. International classification of disease, ninth revision (ICD-9) was used to identify VTE in patients aged 0-18 years during January 2011 to September 2019. In-house computerized system was used to collect data for demographics, clinical and laboratory details. SPSS version 19 was used to analyzed data. The study was approved by Institutional ethical review committee (3872-Pat-ERC-15). During the study period, 134617 pediatric patients were hospitalized, DVT/PE was observed in 77 unique patients (47 males and 30 females) with a median (IQR) age of 14 (5-16) years equivalent to 5.9 VTE events /10,000 hospital admissions. Malignancy, community acquired infections and autoimmune diseases were the predominant risk factors (75%) in adolescent age-group while surgery for congenital heart anomalies was the primary reason (71%) in infants. Overall, lower extremity thrombosis was the most frequent (51%) followed by pulmonary embolism (25%). and upper extremity thrombosis (24%). Enoxaparin and unfractionated heparin were mainly used to treat VTE and all-cause mortality was 13% in the cohort studied. We observed substantial VTE events in pediatric patients during their hospital stay in a tertiary care center of a low-middle income country.

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Incidence Rate and Risk Factors for Recurrent Clostridium difficile Infection in Pediatric At-Risk Groups

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.872 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s294-s294

Author(s):

Verinsa Mouajou ◽

Lucila Baldassarre

Keyword(s):

Risk Factors ◽

At Risk ◽

Clostridium Difficile ◽

Pediatric Patients ◽

Pediatric Population ◽

Risk Groups ◽

Fisher Exact Test ◽

Targeted Prevention ◽

Secondary Immunodeficiency ◽

Increased Risk

Background: Recurrence rates and risk factors of Clostridium difficile infection (CDI) are well established in adults, though little is known about the rate of recurrent CDI (rCDI) within the pediatric population. The purpose of this study was to identify rates and risk factors of rCDI in pediatric at-risk groups to guide the optimization of targeted prevention efforts against disease recurrence. Methods: We report on the ongoing retrospective cohort study of pediatric patients at the CHU Sainte-Justine with a laboratory confirmed diagnosis of CDI between April 1, 2012, and March 31, 2017. Incidence rates of rCDI were obtained per 100 cases. Frequencies of rCDI were compared using the Fisher exact test. Univariate and multivariate logistic regression were used to identify risk factors for rCDI. Two-tailed P < .05 was considered significant. All statistical calculations were performed using R version 3.5.2 software. Results: Of 80 patients analyzed with CDI, 16 had rCDI, for a rCDI rate in this population of 20%. Most recurrences were observed in secondarily immunosuppressed patients including, but not limited to, oncology patients undergoing chemotherapy and/or radiotherapy (30.4%) and patients with inflammatory bowel disease (IBD, 29.2%). Patients that were administered vancomycin orally (PO) had recurrent infection less often than patients that administered metronidazole PO or IV (8.3% vs 23.4%, respectively). This trend was observed in all at-risk patient groups. Patients with secondary immunodeficiency had 7.4 times increased odds of recurrence compared to nonimmunodeficient patients (adjusted OR, 7.43,; 95% CI, 1.84–50.4; P = .0126). Conclusions: Initial vancomycin PO therapy seems to be associated with a lower risk of recurrence. Pediatric patients with IBD and with secondary immunodeficiency are at increased risk of rCDI. Given that these populations have an increased underlying risk of diarrhea, it would be worthwhile to determine whether toxin is actually produced (EIA testing) and to prioritize prevention efforts.Funding: NoneDisclosures: None

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What Neuromonitoring Changes Can Be Expected During Hip Arthroscopy in the Pediatric Population?

The American Journal of Sports Medicine ◽

10.1177/0363546519889038 ◽

2019 ◽

Vol 48 (2) ◽

pp. 409-414

Author(s):

Trevor J. Shelton ◽

Akash Patel ◽

Lauren Agatstein ◽

Brian M. Haus

Keyword(s):

Risk Factors ◽

Hip Arthroscopy ◽

Peroneal Nerve ◽

Pediatric Patients ◽

Tibial Nerve ◽

Pediatric Population ◽

Emg Activity ◽

Posterior Tibial Nerve ◽

Posterior Tibial ◽

Emg Signal

Background: As its indications have evolved, hip arthroscopy is now performed more frequently in pediatric patients. However, despite this increase, there is a lack of evidence in the literature about its safety in this population in regard to traction injury of the nerves of the lower extremity. Purpose: To determine neuromonitoring changes of the sciatic, femoral, and obturator nerves during hip arthroscopy in the pediatric population and determine the rate of and risk factors for clinical neurapraxia. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review was performed of all pediatric patients who underwent hip arthroscopy with neuromonitoring from December 2013 to October 2018. Neuromonitoring included somatosensory evoked potentials (SSEPs) in the peroneal and posterior tibial nerves and electromyography (EMG) signal for the obturator, femoral, and peroneal and posterior tibial nerves. Traction was applied using a radiolucent traction table. We recorded total traction time, surgery time, SSEP changes >50% after traction application, and EMG activity. We also recorded whether there was a clinical neurapraxia and when nerve function returned, and analyzed surgical and patient characteristic data for risk factors for neurapraxia. Results: A total of 89 patients had hip arthroscopy (median traction time, 69 minutes). SSEP changes >50% occurred in 78% of patients in the peroneal nerve and 73% in the posterior tibial nerve. EMG activity was observed in 9% of patients in the obturator nerve, 8% in the femoral nerve, 12% in the peroneal nerve, and 8% in the posterior tibial nerve. Clinical neurapraxia was seen in 19% of patients in either the peroneal nerve or posterior tibial nerve but resolved by 2 days postoperatively. Those who sustained a neurapraxia had a 32-minute longer surgery and 6-minute longer traction time. The clinical rate of neurapraxia of the pudendal nerve was 0%. Conclusion: Neuromonitoring changes are common during hip arthroscopy and nearly 1 in 5 pediatric patients will have some decreased sensation in either the peroneal or the posterior tibial nerve that resolves within 1 to 2 days after surgery. In pediatric patients, longer surgery and traction times during hip arthroscopy are associated with a higher rate of neurapraxia than that reported for adults.

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Aggressive Prophylactic Treatments for Postoperative Nausea and Vomiting Improve Outcomes in Pediatric Adenotonsillectomy Procedure

The Journal of Pediatric Pharmacology and Therapeutics ◽

10.5863/1551-6776-25.4.303 ◽

2020 ◽

Vol 25 (4) ◽

pp. 303-308

Author(s):

Tatyana Demidovich ◽

Orlando Perez-Franco ◽

Marco Silvestrini-Suarez ◽

Pin Yue

Keyword(s):

Risk Factors ◽

High Risk ◽

General Anesthesia ◽

Postoperative Nausea ◽

Pediatric Patients ◽

Pediatric Population ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Antiemetic Drugs ◽

Pacu Stay

OBJECTIVE Postoperative nausea and vomiting (PONV) is an extremely common side effect of general anesthesia that is difficult to manage. We tested a hypothesis that an aggressive prophylactic intervention with additional antiemetic drugs will reduce the incidence of PONV in a high-risk pediatric population undergoing adenotonsillectomy. METHODS In this retrospective study, pediatric patients undergoing adenotonsillectomy were screened for their risk factors for PONV. Patients who had 3 or more risk factors were identified as high risk and received either scopolamine patch preoperatively (for patients over 40 kg body weight) or diphenhydramine immediately postextubation in addition to ondansetron and dexamethasone, which are given routinely. Incidences of PONV within the first 60 minutes of a postanesthesia care unit (PACU) stay were collected and analyzed. RESULTS Overall postoperative vomiting rates during the first hour of a PACU stay were 4.3% for the group that was treated with dexamethasone and ondansetron only and 3.9% for the group that was treated with additional antiemetic drugs. Aggressive prophylactic management of PONV did reduce the rate of nausea and vomiting in a group of high-risk patients (p < 0.0001). The postoperative antiemetic drug usage was also decreased during the first 60 minutes of a PACU stay. However, the approach did not reduce the overall rate of PONV for the entire study population (p = 0.1612 for nausea and p = 0.0678 for vomiting). CONCLUSION Aggressive intraoperative management of PONV with additional antiemetic drugs are beneficial in high-risk pediatric population. Intraoperative diphenhydramine usage decreased the rate of PONV. However, preoperative scopolamine patch prevention did not improve PONV, which may be related to the drug's longer onset of action. Our result suggests that current clinical practice is undertreating PONV in pediatric patients receiving general anesthesia.

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Blunt cerebrovascular injury in pediatric trauma: a national database study

Journal of Neurosurgery Pediatrics ◽

10.3171/2019.5.peds18765 ◽

2019 ◽

Vol 24 (4) ◽

pp. 451-460 ◽

Cited By ~ 1

Author(s):

Dominic A. Harris ◽

Danielle E. Sorte ◽

Sandi K. Lam ◽

Andrew P. Carlson

Keyword(s):

Risk Factors ◽

Skull Base ◽

Pediatric Patients ◽

Motor Vehicle ◽

Pediatric Population ◽

Adult Population ◽

Pediatric Trauma ◽

National Database ◽

Blunt Cerebrovascular Injury ◽

Cerebrovascular Injury

OBJECTIVEThe incidence of blunt cerebrovascular injury (BCVI) has not been well characterized in the pediatric population. The goal of this study was to describe the incidence, patient characteristics, and risk factors for pediatric patients with cerebrovascular injuries.METHODSThe authors collected data from the Kids’ Inpatient Database (KID), a nationally representative database of pediatric admissions, for years 2000, 2003, 2006, 2009, and 2012.RESULTSAmong an estimated 646,549 admissions for blunt trauma, 2150 were associated with BCVI, an overall incidence of 0.33%. The incidence of BCVI nearly doubled from 0.24% in 2000 to 0.49% in 2012. Patients 4 to 13 years of age were less likely to have BCVI than those in the youngest (0–3 years) and oldest age groups comprising adolescents (14–17 years) and young adults (18–20 years). BCVIs were associated with cervical (adjusted OR [aOR] 4.6, 95% CI 3.8–5.5), skull base (aOR 3.0, 95% CI 2.5–3.6), clavicular (aOR 1.4, 95% CI 1.1–1.8), and facial (aOR 1.2, 95% CI 1.0–1.5) fractures, as well as intracranial hemorrhage (aOR 2.7, 95% CI 2.2–3.2) and traumatic brain injury (aOR 2.0, 95% CI 1.7–2.3). Mechanism of injury was also independently associated with BCVI: motor vehicle collision (aOR 1.7, 95% CI 1.3–2.2) and struck pedestrian (aOR 1.4, 95% CI 1.0–1.9). Among pediatric patients with BCVI, 37.4% had cerebral ischemic infarction with an in-hospital mortality of 12.7%, and patients with stroke had 20% mortality.CONCLUSIONSThe incidence of pediatric BCVI is increasing, likely due to increased use of screening, but remains lower than that in the adult population. Risk factors include the presence of cervical, facial, clavicular, and skull base fractures, similar to that of the adult population. Diagnosed BCVI is associated with a relatively high incidence of stroke with increased morbidity and mortality. The use of adult screening criteria is likely reasonable given the similarity in the risk factors identified in this study. Further studies are needed to investigate the role of treatment with antiplatelet agents or anticoagulation.

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Analysis of Unplanned Intensive Care Unit Admissions in Postoperative Pediatric Patients

Journal of Intensive Care Medicine ◽

10.1177/0885066616661152 ◽

2016 ◽

Vol 32 (3) ◽

pp. 204-211 ◽

Cited By ~ 5

Author(s):

Elizabeth K. Landry ◽

Rodney A. Gabriel ◽

Sascha Beutler ◽

Richard P. Dutton ◽

Richard D. Urman

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Pediatric Patients ◽

Pediatric Population ◽

Multivariate Logistic Regression Analysis ◽

Data Set ◽

Icu Admission ◽

Increased Risk ◽

Wide Range

Background: Currently, there are only a few retrospective, single-institution studies that have addressed the prevalence and risk factors associated with unplanned admissions to the pediatric intensive care unit (ICU) after surgery. Based on the limited amount of studies, it appears that airway and respiratory complications put a child at increased risk for unplanned ICU admission. A more extensive and diverse analysis of unplanned postoperative admissions to the ICU is needed to address risk factors that have yet to be revealed by the current literature. Aim: To establish a rate of unplanned postoperative ICU admissions in pediatric patients using a large, multi-institution data set and to further characterize the associated risk factors. Methods: Data from the National Anesthesia Clinical Outcomes Registry were analyzed. We recorded the overall risk of unplanned postoperative ICU admission in patients younger than 18 years and performed univariate and multivariate logistic regression analysis to identify the associated patient, surgical, and anesthetic-related characteristics. Results: Of the 324 818 cases analyzed, 211 reported an unexpected ICU admission. There was an increased likelihood of unplanned postoperative ICU in infants (age <1 year) and children who were classified as American Society of Anesthesiologists physical status classification of III or IV. Likewise, longer case duration and cases requiring general anesthesia were also associated with unplanned ICU admissions. Conclusion: This study establishes a rate of unplanned ICU admission following surgery in the heterogeneous pediatric population. This is the first study to utilize such a large data set encompassing a wide range of practice environments to identify risk factors leading to unplanned postoperative ICU admissions. Our study revealed that patient, surgical, and anesthetic complexity each contributed to an increased number of unplanned ICU admissions in the pediatric population.

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THE EPIDEMIOLOGY OF DEVELOPMENTAL DYSPLASIA OF THE HIP IN MALES

Acta Ortopédica Brasileira ◽

10.1590/1413-785220202801215936 ◽

2020 ◽

Vol 28 (1) ◽

pp. 26-30 ◽

Cited By ~ 1

Author(s):

Ellen de Oliveira Goiano ◽

Miguel Akkari ◽

Juliana Pietrobom Pupin ◽

Claudio Santili

Keyword(s):

Risk Factors ◽

Medical Records ◽

Pediatric Population ◽

Delayed Diagnosis ◽

Developmental Dysplasia ◽

Acetabular Index ◽

Age At Diagnosis ◽

Level Of Evidence ◽

Cross Sectional ◽

Dysplasia Of The Hip

ABSTRACT Developmental Dysplasia of the Hip (DDH) is one of the most common orthopedic hip diseases of the pediatric population. There is a predominance in females and patients with known risk factors. Objective: To evaluate the characteristics of DDH in a reference center and compare them with the literature. Methods: This is a cross-sectional observational study based on the review of medical records and radiographs from which epidemiological data such as laterality, age at diagnosis, acetabular index, radiographic classification and others were collected. Results: A total of 297 medical records were found between May 1974 and June 2009. Of those, 147 patients (216 affected hips) were eligible for the survey. Most of the patients came from the state of São Paulo (91.1%), were born in autumn/winter (66.7%), reported as Caucasians (76.9%), with bilateral involvement (46.9%) and mean age at diagnosis of 22.8 months. Conclusion: The most frequent type of DDH was high dislocation (28.7%), and the acetabular index progressively increased with the age. The International Hip Dysplasia Institute classification was found to be more reproducible than Tönnis classification. Delayed diagnosis was associated with the absence of risk factors and with bilaterality. Level of Evidence III, Retrospective comparative study.

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Characterizing the Risk Factors Associated With Venous Thromboembolism in Pediatric Patients After Central Venous Line Placement

The Journal of Pediatric Pharmacology and Therapeutics ◽

10.5863/1551-6776-20.5.358 ◽

2015 ◽

Vol 20 (5) ◽

pp. 358-366

Author(s):

Sarah Wisecup ◽

Shannan Eades ◽

Yuliya Turiy

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

Pediatric Patients ◽

Pediatric Population ◽

Central Line ◽

Central Venous Line ◽

Central Venous ◽

Retrospective Case ◽

Line Placement ◽

Increased Risk

OBJECTIVES: With the apparent increase in venous thromboembolism noted in the pediatric population, it is important to define which children are at risk for clots and to determine optimal preventative therapy. The purpose of this study was to determine the risk factors for venous thromboembolism in pediatric patients with central venous line placement. METHODS: This was an observational, retrospective, case-control study. Control subjects were patients aged 0 to 18 years who had a central venous line placed. Case subjects had a central line and a radiographically confirmed diagnosis of venous thromboembolism. RESULTS: A total of 150 patients were included in the study. Presence of multiple comorbidities, particularly the presence of a congenital heart defect (34.7% case vs. 14.7% control; p < 0.005), was found to put pediatric patients at increased risk for thrombosis. Additionally, the administration of parenteral nutrition through the central line (34.7% case vs. 18.7% control; p = 0.03) and location of the line increased the risk for clot formation. CONCLUSIONS: With increased awareness of central venous line–related thromboembolism, measures should be taken to reduce the number and duration of central line placements, and further studies addressing the need for thromboprophylaxis should be conducted.

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

Neurosurgical FOCUS ◽

10.3171/2017.7.focus17313 ◽

2017 ◽

Vol 43 (4) ◽

pp. E7 ◽

Cited By ~ 6

Author(s):

Nancy Abu-Bonsrah ◽

C. Rory Goodwin ◽

Gezzer Ortega ◽

Fizan Abdullah ◽

Edward Cornwell ◽

...

Keyword(s):

Risk Factors ◽

Pediatric Patients ◽

Pediatric Population ◽

Unplanned Readmission ◽

Limited Information ◽

Short Term ◽

Readmission Rates ◽

Improvement Program ◽

Short Term Mortality ◽

Spinal Arthrodesis

OBJECTIVESpinal 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.METHODSThe 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.RESULTSA 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.CONCLUSIONSIn 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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