Frequency and Predictors of Concurrent Complications in Multi-suture Release for Syndromic Craniosynostosis

Overview

Journal Childs Nerv Syst

Specialty Pediatrics

Date 2023 Jul 18

PMID 37462812

Authors

Sujay Rajkumar

Daniel S Ikeda

Michaela Scanlon

Margaret Shields

John R Kestle

Jillian Plonsker

Michael Brandel

David D Gonda

Michael Levy

Donald J Lucas

Pamela M Choi

Vijay M Ravindra

Affiliations

Soon will be listed here.

Abstract

Purpose: Understanding the complication profile of craniosynostosis surgery is important, yet little is known about complication co-occurrence in syndromic children after multi-suture craniosynostosis surgery. We examined concurrent perioperative complications and predictive factors in this population.

Methods: In this retrospective cohort study, children with syndromic diagnoses and multi-suture involvement who underwent craniosynostosis surgery in 2012-2020 were identified from the National Surgical Quality Improvement Program-Pediatric database. The primary outcome was concurrent complications; factors associated with concurrent complications were identified. Correlations between complications and patient outcomes were assessed.

Results: Among 5,848 children identified, 161 children (2.75%) had concurrent complications: 129 (2.21%) experienced two complications and 32 (0.55%) experienced ≥ 3. The most frequent complication was bleeding/transfusion (69.53%). The most common concurrent complications were transfusion/superficial infection (27.95%) and transfusion/deep incisional infection (13.04%) or transfusion/sepsis (13.04%). Two cardiac factors (major cardiac risk factors (odds ratio (OR) 3.50 [1.92-6.38]) and previous cardiac surgery (OR 4.87 [2.36-10.04])), two pulmonary factors (preoperative ventilator dependence (OR 3.27 [1.16-9.21]) and structural pulmonary/airway abnormalities (OR 2.89 [2.05-4.08])), and preoperative nutritional support (OR 4.05 [2.34-7.01]) were independently associated with concurrent complications. Children who received blood transfusion had higher odds of deep surgical site infection (OR 4.62 [1.08-19.73]; p = 0.04).

Conclusions: Our results indicate that several cardiac and pulmonary risk factors, along with preoperative nutritional support, were independently associated with concurrent complications but procedural factors were not. This information can help inform presurgical counseling and preoperative risk stratification in this population.

Citing Articles

Experiences of surgical complications and reoperations in nonsyndromic sagittal synostosis patients in Oulu.

Svalina A, Serlo W, Sinikumpu J, Salokorpi N Childs Nerv Syst. 2024; 40(12):3983-3991.

PMID: 38940955 PMC: 11579183. DOI: 10.1007/s00381-024-06519-0.

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