Thirty-day outcomes after postnatal myelomeningocele repair: a National Surgical Quality Improvement Program Pediatric database analysis.

摘要: OBJECTIVE Due to improved nutrition and early detection, myelomeningocele repair is a relatively uncommon procedure. Although previous studies have reviewed surgical trends predictors of outcomes, they relied largely on single-hospital experiences or databases centered hospital admission data. Here, the authors report 30-day outcomes pediatric patients undergoing postnatal from national prospective database. They sought investigate association between preoperative intraoperative factors occurrence complications, readmissions, unplanned return operating room events. METHODS The 2013 American College Surgeons National Surgical Quality Improvement Program Pediatric database (NSQIP-P) was queried for all repair. Patients were subdivided basis size ( 5 cm). Preoperative variables, characteristics, postoperative events tabulated prospectively collected Three separate complication, readmission, analyzed using univariate multivariate logistic regression. Rates associated CSF diversion operations their timing also analyzed. RESULTS A total 114 included; 54 had defect smaller than cm, 60 larger cm. shunts placed concurrently in 8% cases. There 42 NSQIP-defined complications 31 (27%); these included wound infections, addition others. Postoperative most common occurred 27 (24%). Forty (35%) at least one subsequent surgery within 30 days. Twenty-four (21%) returned initial shunt placement. Unplanned readmission 11% Both complication statistically with age CONCLUSIONS NSQIP-P allows examination perioperative In this cohort, over one-quarter experienced rate significantly higher who first 24 hours birth after 1st day life. highlight limitations investigating advocate importance disease-specific data collection.