Freilich et al identified risk factors for surgical complications in pediatric patients undergoing urologic procedures. These can help to identify a patient who may require more aggressive management or an alternative management strategy. The authors are from Chidlren's Hospital Boston.
Patient selection: pediatric patient undergoing a urologic operation
Outcome: surgical complication within 35 days of the procedure
Complications rate: 1.1% with just over half rlated to technique
Parameters:
(1) body weight
(2) pulmonary comorbidity
(3) hematologic comorbidity
(4) duration of surgical procedure
(5) type of anesthesia
|
Parameter |
Finding |
Points |
OR |
|
weight for age and gender |
>= 5th percentile |
0 |
1 |
|
|
< 5th percentile |
1 |
5.2 |
|
pulmonary comorbidity |
absent |
0 |
1 |
|
|
present |
1 |
2.6 |
|
hematologic comorbidity |
absent |
0 |
1 |
|
|
present |
1 |
6 |
|
duration of operation |
<= 2 hours |
0 |
1 |
|
|
> 2 hours |
1 |
8.3 |
|
type of anesthesia |
intravenous |
1 |
4.6 |
|
|
other |
0 |
1 |
number of risk factors associated with surgical complications =
= SUM(points for all 5 parameters)
An additional parameter ("other medications") was associated with reduced surgical complications. Unfortunately "other medications" was not defined.
Interpretation:
• The risk of complications was lowest with a pediatric patient with none of the risk factors AND "other medications".
• The highest risk for complications was in a pediatric patient with all 5 of the risk factors and not taking "other medications".
Specialty: Anesthesiology
