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Analysis Of Acute Adverse Postoperative Outcomes After Craniosynostosis Surgery: Identifying Predictors Of Complications
Shirley M Dong
Jonathan Y Lee, MD
Joseph E Losee, MD
Jesse A Goldstein, MD
University of Pittsburgh School of Medicine
2017-02-14
Presenter: Shirley M Dong
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The program director is responsible for making a statement within the confines of the box below specific to how much of the work on this project represents the original work of the resident. All authors/submitters of each abstract should discuss this with their respective program director for accurate submission of information as well as the program director's approval for inclusion of his/her electronic signature.
Director Name: Vu T Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background
Perioperative complications after craniosynostosis (CS) surgical repair have been described through the use of large datasets. These datasets are limited in their clinical resolution, which can result in considerable variability of reported complication rates. In this study, we review our experience with CS surgical repair to characterize postoperative adverse events and identify patient factors predictive of complications.
Methods
This is a retrospective cohort study at our institution (2010-present) reviewing a database of CS patients. Post-operative adverse events were rated as complications or insignificant events by 5 blinded physicians.
Results
One hundred twenty six patients undergoing 136 separate procedures met inclusion criteria. Twenty-one patients (16.7%) were syndromic. The average number of synostotic sutures was 1.36. Patients had an average stay of 1.571.11 days in the ICU. One hundred fourteen postoperative events were identified. Fifteen of those events were deemed significant with moderate agreement among the physician panel (κ=0.551, p<0.0005). The most common event was respiratory distress. Weight at birth, age at surgery, weight at surgery, ASA rating, perioperative RBCs/weight (kg), and estimated perioperative blood loss were not significantly correlated with postoperative complications. The number of synostotic sutures (p=0.00205) and the length of the operation (p=0.0287) were associated with postoperative complications.
Conclusions
This study demonstrates a comparable rate of complications (14.2%) after craniosynostosis surgical repair. Number of sutures closed and length of surgical procedures may be predictive of postoperative complications. Further study characterizing the diagnosis and management of these events can help determine the necessity of postoperative ICU admittance.
