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Intraoperative complications in pediatric neurosurgery: review of 1807 cases
Erik J van Lindert1, Sebastian Arts2, Laura M Blok2
1Departments of 1 Neurosurgery and.
Insights
Intraoperative complications occurred in 3.5% of pediatric neurosurgery procedures, with most linked to the surgery itself. This data aids informed consent and improving pediatric neurosurgical care.
Area of Science:
- Pediatric Neurosurgery
- Surgical Complications
- Anesthesiology
Background:
- Limited literature exists on intraoperative complication rates in pediatric neurosurgery.
- Understanding these rates is crucial for informed consent and improving patient care.
Purpose of the Study:
- To determine the intraoperative complication rate for pediatric neurosurgical procedures.
- To provide data for informed consent and establish a baseline for care improvement.
Main Methods:
- Analysis of a consecutive cohort from a clinical complication registration database.
- Inclusion of all pediatric neurosurgical procedures from January 2004 to July 2012.
- Study included 1807 procedures in patients under 17 years old.
Main Results:
- 64 intraoperative complications occurred in 62 patients (3.5% of procedures).
- Intraoperative mortality was 0.17% (3 patients).
- Complications were primarily neurosurgical (78%) versus anesthesiological (22%).
- Highest rates were in cerebrovascular (7.7%) and tumor surgery (7.4%).
- Cerebrovascular complications were most frequent (33%).
Conclusions:
- Intraoperative complications are not rare in pediatric neurosurgery.
- Awareness of complication rates is essential for prevention.
- Data supports informed consent and targeted improvements in pediatric neurosurgical care.
Abstract:
OBJECTIVE Minimal literature exists on the intraoperative complication rate of pediatric neurosurgical procedures with respect to both surgical and anesthesiological complications. The aim of this study, therefore, was to establish intraoperative complication rates to provide patients and parents with information on which to base their informed consent and to establish a baseline for further targeted improvement of pediatric neurosurgical care. METHODS A clinical complication registration database comprising a consecutive cohort of all pediatric neurosurgical procedures carried out in a general neurosurgical department from January 1, 2004, until July 1, 2012, was analyzed. During the study period, 1807 procedures were performed on patients below the age of 17 years. RESULTS Sixty-four intraoperative complications occurred in 62 patients (3.5% of procedures). Intraoperative mortality was 0.17% (n = 3). Seventy-eight percent of the complications (n = 50) were related to the neurosurgical procedures, whereas 22% (n = 14) were due to anesthesiology. The highest intraoperative complication rates were for cerebrovascular surgery (7.7%) and tumor surgery (7.4%). The most frequently occurring complications were cerebrovascular complications (33%). CONCLUSIONS Intraoperative complications are not exceptional during pediatric neurosurgical procedures. Awareness of these complications is the first step in preventing them.
