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In-hospital mortality and morbidity of pediatric scoliosis surgery in Japan: Analysis using a national inpatient database.

Abstract Several previous reports have elucidated the mortality and incidence of complications after pediatric scoliosis surgery using nationwide databases. However, all of these studies were conducted in North America. Hence, this study aimed to identify the incidence and risk factors for in-hospital mortality and morbidity in pediatric scoliosis surgery, utilizing the Diagnosis Procedure Combination database, a national inpatient database in Japan.We retrospectively extracted data for patients aged less than 19 years who were admitted between 01 June 2010 and 31 March 2013 and underwent scoliosis surgery with fusion. The primary outcomes were in-hospital death and postoperative complications, including surgical site infection, ischemic heart disease, acute renal failure, pneumonia, stroke, disseminated intravascular coagulation, pulmonary embolism, and urinary tract infection.We identified 1,703 eligible patients (346 males and 1,357 females) with a mean age of 14.1 years. There were no deaths among the patients. At least one postoperative complication was found in 49 patients (2.9%). The most common complication was surgical site infection (1.4%). The multivariable logistic regression analysis showed that male sex (odds ratio, 2.22; 95% confidence interval, 1.28-3.70), comorbid diabetes (7.00; 1.56-31.51), and use of allogeneic blood transfusion (3.43; 1.86-6.41) were associated with the occurrence of postoperative complications. The present nationwide study elucidated the incidence and risk factors for in-hospital mortality and morbidity following surgery for pediatric scoliosis in an area other than North America. Diabetes was identified for the first time as a risk factor for postoperative complications in pediatric scoliosis surgery.
PMID
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Authors

Mayor MeshTerms

Hospital Mortality

Keywords
Journal Title medicine
Publication Year Start




PMID- 29620642
OWN - NLM
STAT- MEDLINE
DCOM- 20180416
LR  - 20180416
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 14
DP  - 2018 Apr
TI  - In-hospital mortality and morbidity of pediatric scoliosis surgery in Japan:
      Analysis using a national inpatient database.
PG  - e0277
LID - 10.1097/MD.0000000000010277 [doi]
AB  - Several previous reports have elucidated the mortality and incidence of
      complications after pediatric scoliosis surgery using nationwide databases.
      However, all of these studies were conducted in North America. Hence, this study 
      aimed to identify the incidence and risk factors for in-hospital mortality and
      morbidity in pediatric scoliosis surgery, utilizing the Diagnosis Procedure
      Combination database, a national inpatient database in Japan.We retrospectively
      extracted data for patients aged less than 19 years who were admitted between 01 
      June 2010 and 31 March 2013 and underwent scoliosis surgery with fusion. The
      primary outcomes were in-hospital death and postoperative complications,
      including surgical site infection, ischemic heart disease, acute renal failure,
      pneumonia, stroke, disseminated intravascular coagulation, pulmonary embolism,
      and urinary tract infection.We identified 1,703 eligible patients (346 males and 
      1,357 females) with a mean age of 14.1 years. There were no deaths among the
      patients. At least one postoperative complication was found in 49 patients
      (2.9%). The most common complication was surgical site infection (1.4%). The
      multivariable logistic regression analysis showed that male sex (odds ratio,
      2.22; 95% confidence interval, 1.28-3.70), comorbid diabetes (7.00; 1.56-31.51), 
      and use of allogeneic blood transfusion (3.43; 1.86-6.41) were associated with
      the occurrence of postoperative complications. The present nationwide study
      elucidated the incidence and risk factors for in-hospital mortality and morbidity
      following surgery for pediatric scoliosis in an area other than North America.
      Diabetes was identified for the first time as a risk factor for postoperative
      complications in pediatric scoliosis surgery.
FAU - Taniguchi, Yuki
AU  - Taniguchi Y
AD  - Department of Orthopedic Surgery, The University of Tokyo Hospital.
FAU - Oichi, Takeshi
AU  - Oichi T
AD  - Department of Orthopedic Surgery, The University of Tokyo Hospital.
FAU - Ohya, Junichi
AU  - Ohya J
AD  - Department of Orthopedic Surgery, Japanese Red Cross Medical Center.
FAU - Chikuda, Hirotaka
AU  - Chikuda H
AD  - Department of Orthopedic Surgery, The University of Tokyo Hospital.
FAU - Oshima, Yasushi
AU  - Oshima Y
AD  - Department of Orthopedic Surgery, The University of Tokyo Hospital.
FAU - Matsubayashi, Yoshitaka
AU  - Matsubayashi Y
AD  - Department of Orthopedic Surgery, The University of Tokyo Hospital.
FAU - Matsui, Hiroki
AU  - Matsui H
AD  - Department of Clinical Epidemiology and Health Economics, School of Public
      Health, The University of Tokyo.
FAU - Fushimi, Kiyohide
AU  - Fushimi K
AD  - Department of Health Policy and Informatics, Tokyo Medical and Dental University 
      Graduate School, Tokyo, Japan.
FAU - Tanaka, Sakae
AU  - Tanaka S
AD  - Department of Orthopedic Surgery, The University of Tokyo Hospital.
FAU - Yasunaga, Hideo
AU  - Yasunaga H
AD  - Department of Clinical Epidemiology and Health Economics, School of Public
      Health, The University of Tokyo.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Databases, Factual
MH  - Female
MH  - *Hospital Mortality
MH  - Humans
MH  - Incidence
MH  - Japan/epidemiology
MH  - Male
MH  - Morbidity
MH  - Orthopedic Procedures/methods/*mortality
MH  - Postoperative Complications/etiology/*mortality
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Scoliosis/*mortality/*surgery
EDAT- 2018/04/06 06:00
MHDA- 2018/04/17 06:00
CRDT- 2018/04/06 06:00
PHST- 2018/04/06 06:00 [entrez]
PHST- 2018/04/06 06:00 [pubmed]
PHST- 2018/04/17 06:00 [medline]
AID - 10.1097/MD.0000000000010277 [doi]
AID - 00005792-201804060-00020 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Apr;97(14):e0277. doi: 10.1097/MD.0000000000010277.