Purpose: To describe 30-day outcomes following craniotomy for arteriovenous malformation in children and identify risk factors for readmission, reoperation, and perioperative complication using the National Surgical Quality Improvement Program (NSQIP) Pediatric database.
Methods: Patients aged 0-18 years who underwent surgery for arteriovenous malformations (years 2015-2016) were identified from the NSQIP Pediatric database. Descriptive statistics, uni-variate, and multi-variate regression analysis were performed using preoperative and perioperative data. The outcome of interest was postoperative adverse event including reoperation within 30 days, readmission within 30 days, discharge to rehab, and the complications wound infection/dehiscence, pneumonia, unplanned reintubation, pulmonary embolism (PE), renal insufficiency, urinary tract infection (UTI), stroke, venous thromboembolism (VT), and sepsis.
Results: 167 patients were identified who met study criteria. 58% were male, and the majority had an ASA classification of 3 or greater (68%). 96 (57%) patients were found to have a preoperative comorbidity, with the most common comorbidity being seizure disorder (54 patients, 32%). 76 patients (46%) had documented perioperative events or complications. The incidence of wound infection/dehiscence was 4%; and of pneumonia, PE, unplanned reintubation, renal insufficiency, UTI, stroke, VT, sepsis were <1%. There were no deaths. The incidence of unplanned reoperation was 10% and unplanned readmission was 12%. Most (90%) were discharged to home. Operative time (p = .0001, OR = 9.53), emergent surgery status (p = .0001, OR = 8.19) and preoperative comorbidities (p = .007) were found to be significant predictors of poor outcome.
Conclusion: In the NSQIP-P dataset, the incidence of perioperative complications and suboptimal outcomes among patients undergoing AVM resection were low.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jocn.2019.08.059 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The pediatric Brain Injury Guidelines: a retrospective clinical validation study.
J Neurosurg Pediatr
January 2025
4Department of Neurosurgery, Children's Hospital Colorado Anschutz Medical Campus, Aurora; and.
Objective: Pediatric traumatic brain injury (TBI) represents a significant public health concern and source of resource utilization. The aim of this study was to establish the ability of the previously published pediatric Brain Injury Guidelines (pBIG) to identify patients with traumatic intracranial hemorrhage (ICH) who might not require routine repeat neuroimaging, neurosurgical consultation, or hospital admission in a large level I and level II trauma cohort.
Methods: Pediatric patients who presented with traumatic ICH between 2018 and 2022 at the included institutions were retrospectively reviewed and sorted into pBIG categories using clinical and radiographic criteria.
Utilization of transitional care management services and 30-day readmission.
PLoS One
January 2025
Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States of America.
Transitional care management (TCM) visits have been shown to reduce 30-day readmissions, but it is unclear whether the decrease arises from the TCM visit itself or from clinic-level changes to meet the requirements of the TCM visits. We conducted a cross-sectional analysis using data from Northwell Health to examine the association between the type of post-discharge follow-up visits (TCM visits versus non-TCM visits based on billing) and 30-day readmission. Furthermore, we assessed whether being seen by a provider who frequently utilizes TCM visits or the TCM visit itself was associated with 30-day readmission.
View Article and Find Full Text PDFRobotic sugarbaker parastomal hernia repair: updated series and outcomes.
Hernia
January 2025
Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, 1025 Morehead Medical Drive Suite 300, Charlotte, NC, 28204, USA.
Purpose: To present updated outcomes after previously describing a novel technique for the robotic repair of parastomal hernias.
Methods: Patients who underwent parastomal hernia repair with a robotic Sugarbaker technique at a tertiary hernia center were identified from an institutional database. The approach involves mesh placement in the intraperitoneal or preperitoneal position after closure of the fascial defect.
Evaluation of Peer Review of Percutaneous Coronary Intervention Operator Performance.
Circ Cardiovasc Qual Outcomes
January 2025
Division of Cardiology, Department of Medicine, University of Washington, Seattle (J.A.D., E.J.S., D.H.A.).
Background: Case-based peer review of percutaneous coronary intervention (PCI) is used by many hospitals for quality improvement and to make decisions regarding physician competency. However, there are no studies testing the reliability or validity of peer review for PCI performance evaluation.
Methods: We recruited interventional cardiologists from 12 Veterans Affairs Health System facilities throughout the United States to provide PCI cases for review.
Perioperative emergency laparotomy pathway for patients undergoing emergency laparotomy: A propensity score matched study.
Ann Acad Med Singap
December 2024
Department of Surgery, Ng Teng Fong General Hospital, Singapore.
Introduction: Emergency laparotomy (EL) is associated with high morbidity and mortality, often exceeding 10%. This study evaluated the impact of the EMergency Laparotomy Audit (EMLA) interdisciplinary perioperative pathway on patient outcomes, hospital costs and length of stay (LOS) within a single centre.
Method: A prospective cohort study was conducted from August 2020 to July 2023.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!