Prospective review of a single center's general pediatric neurosurgical intraoperative and postoperative complication rates

Clinical article

Erik J. van Lindert M.D., Ph.D. 1 , Hans Delye M.D., Ph.D. 1 , and Jody Leonardo M.D. 2
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  • 1 Department of Neurosurgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; and
  • 2 Department of Neurosurgery, University at Buffalo, State University of New York, Buffalo, New York
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Object

The authors conducted a study to compare the complication rate (CR) of pediatric neurosurgical procedures in a general neurosurgery department to the CRs that are reported in the literature and to establish a baseline of CR for further targeted improvement of quality neurosurgical care.

Methods

The authors analyzed the prospectively collected data from a complication registration of 1000 consecutive pediatric neurosurgical procedures in 581 patients from the beginning of the registration in January 2004 through August 2008. A pediatric neurosurgeon was involved in 50.5% of the procedures. All adverse events (AEs) from induction of anesthesia until 30 days postoperatively were recorded.

Results

Overall, 229 complications were counted in 202 procedures. The overall CR was 20.2%, with a 2.7% intraoperative CR and a 17.5% postoperative CR. Tumor surgery was associated with the highest CR (32.7%), followed by CSF disorders (21.8%). The mortality rate was 0.3%. An unplanned return to the operating room in relation to an AE happened in 10.5% of all procedures and in 52% of procedures associated with AEs, the majority of which were related to CSF disorders.

Conclusions

The CR in pediatric neurosurgical procedures was significant, and more than half of the patients with an AE required a repeat surgical procedure. Analysis of CRs should be a prerequisite for the prevention of complications and for the development of targeted interventions to reduce the CR (for example, infection rates).

Abbreviations used in this paper:AE = adverse event; CR = complication rate; ETV = endoscopic third ventriculostomy; NSQIP = National Surgical Quality Improvement Program; RTOR = return to operating room.

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Contributor Notes

Address correspondence to: Erik J. van Lindert, M.D., Ph.D., Department of Neurosurgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein-Zuid 10, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. email: e.vanlindert@nch.umcn.nl.

Please include this information when citing this paper: published online November 15, 2013; DOI: 10.3171/2013.9.PEDS13222.

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