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Open Access 18-07-2023 | Craniosynostosis | Original Article

Frequency and predictors of concurrent complications in multi-suture release for syndromic craniosynostosis

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

Published in: Child's Nervous System | Issue 1/2024

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.

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Title: Frequency and predictors of concurrent complications in multi-suture release for syndromic craniosynostosis
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
Publication date: 18-07-2023
Publisher: Springer Berlin Heidelberg
Keyword: Craniosynostosis
Published in: Child's Nervous System / Issue 1/2024
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-023-06076-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Frequency and predictors of concurrent complications in multi-suture release for syndromic craniosynostosis

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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