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Increased complications in pediatric surgery are associated with comorbidities and not with Down syndrome itself.
- Source :
-
The Journal of surgical research [J Surg Res] 2018 Oct; Vol. 230, pp. 125-130. Date of Electronic Publication: 2018 May 25. - Publication Year :
- 2018
-
Abstract
- Background: Down syndrome (DS) is a genetic condition associated with multiple comorbidities. While physicians may perceive that DS patients have more postoperative complications, the literature remains unclear. This study compared postoperative complications for children with and without DS who underwent abdominal and thoracic procedures.<br />Methods: The National Surgical Quality Improvement Program Pediatric was queried for patients aged <18 years, who underwent abdominal and noncardiac thoracic operations (by Current Procedural Terminology codes) from 2012 to 2015. The analysis compared patients based on the presence or absence of DS. The primary outcome was a composite of all postoperative complications as defined by the National Surgical Quality Improvement Program Pediatric. The analysis utilized chi-square, Student's t-test, and univariate and multiple logistic regression.<br />Results: There were 91,478 patients included, of which 1476 (1.6%) had a diagnosis of DS. Patients with DS had higher rates of preoperative nutritional support (38.8% versus 15.0%), developmental delay (61.9% versus 10.4%), and cardiac risk factors (76.5% versus 13.8%). The overall rate of postoperative complications was 11.1%, with a greater proportion in DS patients (16.2% versus 10.8%, P < 0.001). On univariate analysis, DS was associated with increased odds of postoperative complications (odds ratio 1.6 95% confidence interval 1.4-1.9) compared with the non-DS group; however, DS was not a risk factor after adjusting for other covariates (adjusted odds ratio 0.86 95% confidence interval 0.7-1.1).<br />Conclusions: A higher proportion of postoperative complications were observed in patients with DS. However, after adjusting for other risk factors, DS was not an independent risk factor. The increased rate of complications is likely related to the presence of multiple comorbidities in DS.<br /> (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Child
Child, Preschool
Comorbidity
Female
Humans
Incidence
Infant
Male
Postoperative Complications etiology
Retrospective Studies
Risk Factors
Digestive System Surgical Procedures adverse effects
Down Syndrome epidemiology
Postoperative Complications epidemiology
Thoracic Surgical Procedures adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1095-8673
- Volume :
- 230
- Database :
- MEDLINE
- Journal :
- The Journal of surgical research
- Publication Type :
- Academic Journal
- Accession number :
- 30100027
- Full Text :
- https://doi.org/10.1016/j.jss.2018.04.010