Perioperative Factors Associated with Prolonged Intensive Care Unit and Hospital Length of Stay after Pediatric Neurosurgery

Perioperative Factors Associated with Prolonged Intensive Care Unit and Hospital Length of Stay after Pediatric Neurosurgery

Author Mekitarian Filho, Eduardo Autor UNIFESP Google Scholar
Carvalho, Werther Brunow de Autor UNIFESP Google Scholar
Cavalheiro, Sergio Autor UNIFESP Google Scholar
Horigoshi, Nelson Kazunobu Google Scholar
Freddi, Norberto Antonio Google Scholar
Institution Universidade de São Paulo (USP)
Hosp Israelita Albert Einstein
Santa Catarina Hosp
Universidade Federal de São Paulo (UNIFESP)
Abstract Objectives: This study aims to describe the association between different postoperative complications and the length of hospital stay among children undergoing neurosurgical procedures. Methods: A retrospective cohort study was carried out between May 2004 and May 2009 in a tertiary community hospital. All postoperative complications following neurosurgical procedures and their association with the main outcomes [length of intensive care unit (ICU) and hospital stay] were investigated in a univariate and multivariate analysis. Results: the medical records of 198 patients treated during the study period were reviewed. the most frequently performed surgeries were ventriculoperitoneal shunting (16.7%), correction of craniosynostosis (30%) and brain tumor resections (28.3%). of the 198 patients eligible for this analysis, 79 (39.9%) suffered from at least one complication. the most frequent complications were fever (30.3%), hypothermia (16%), postextubation laryngitis (15.1%) and postoperative bleeding (7%). Factors independently associated with a longer pediatric ICU stay were fever (odds ratio 1.39, 95% confidence interval 1.1-3.2; p = 0.001), laryngitis (odds ratio 2.24, 95% confidence interval 1.8-5.2; p = 0.001), postoperative bleeding requiring reoperation (odds ratio 1.8, 95% confidence interval 1.4-3.9; p < 0.001) and infection (odds ratio 3.71, 95% confidence interval 1.8-12.4; p = 0.033). Fever (odds ratio 2.54, 95% confidence interval 2-7.4; p = 0.001) and infection (odds ratio 11.23, 95% confidence interval 4-22.4; p = 0.003) were related to the total length of the patient's hospital stay. Conclusions: in this study population, most elective neurosurgical procedures were not associated with significant complications, and morbidity and mortality were low. Some complications significantly influenced patients' outcomes and should be monitored for early diagnosis. This study may improve our understanding and identification of postoperative outcomes in pediatric neurosurgery. Copyright (C) 2012 S. Karger AG, Basel
Keywords Morbidity
Mortality
Neurosurgery
Pediatrics
Intensive care units
Risk factors
Language English
Date 2011-01-01
Published in Pediatric Neurosurgery. Basel: Karger, v. 47, n. 6, p. 423-429, 2011.
ISSN 1016-2291 (Sherpa/Romeo, impact factor)
Publisher Karger
Extent 423-429
Origin http://dx.doi.org/10.1159/000339312
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000308125400006
URI http://repositorio.unifesp.br/handle/11600/33214

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