A risk calculator predicting postoperative adverse events in neonates undergoing major abdominal or thoracic surgery

Anne M. Stey, Brian D. Kenney, R. Lawrence Moss, Bruce L. Hall, Loren Berman, Mark E. Cohen, Kari Kraemer, Clifford Y. Ko, Charles D. Vinocur

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Purpose This study sought to demonstrate the feasibility of a risk calculator for neonates undergoing major abdominal or thoracic surgery with good discriminative ability. Methods The American College of Surgeons' National Surgical Quality Improvement Program Pediatric (ACS-NSQIP-P) 2011-12 data were queried for neonates who underwent major abdominal or thoracic surgery. The outcome of interest was the occurrence of any adverse event, including mortality, within 30-days postoperatively. The preoperative clinical characteristics significantly associated with any adverse event were used to build a multivariate model. The model's discriminative ability was assessed with the area under the receiver operating characteristic curve (AUROC). The model was split-set validated with 2013 data. Results A total of 2967 neonates undergoing major abdominal or thoracic surgery were identified. The overall rate of adverse events was 23.3%. Sixteen variables were found to be associated with adverse events. Four variables increased the odds of adverse events at least two-fold: dirty or infected wound class [odds ratio (OR) = 2.1] dialysis (OR = 3.8), hepatobiliary disease (OR = 2.1), and inotropic agent use (OR = 2.6). The AUROC = 0.79 for development data and 0.77 on split-set validation. Conclusion Preoperatively estimating the probability of postoperative adverse events in neonates undergoing major abdominal or thoracic surgery with good discrimination is feasible.

Original languageEnglish
Pages (from-to)987-991
Number of pages5
JournalJournal of Pediatric Surgery
Volume50
Issue number6
DOIs
StatePublished - Jun 1 2015

Keywords

  • Neonatal surgery
  • Risk calculator

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    Stey, A. M., Kenney, B. D., Moss, R. L., Hall, B. L., Berman, L., Cohen, M. E., Kraemer, K., Ko, C. Y., & Vinocur, C. D. (2015). A risk calculator predicting postoperative adverse events in neonates undergoing major abdominal or thoracic surgery. Journal of Pediatric Surgery, 50(6), 987-991. https://doi.org/10.1016/j.jpedsurg.2015.03.023