Pediatric Surgical Risk Assessment Tools: A Systematic Review

Area of Science:

• Pediatric Surgery
• Clinical Risk Assessment
• Systematic Review

Background:

• Pediatric surgical risk assessment tools aid in predicting postoperative complications.
• These tools support preoperative counseling and surgical decision-making for pediatric patients.
• Existing tools aim for broad applicability across various pediatric surgical specialties.

Purpose of the Study:

• To systematically review and compare existing pediatric surgical risk assessment tools.
• To identify tools applicable across multiple pediatric surgical specialties.
• To evaluate the predictive performance of these risk assessment tools.

Main Methods:

• Systematic literature review adhering to Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines.
• Inclusion criteria focused on broadly applicable pediatric preoperative risk assessment tools for complications or mortality.
• Quality and risk of bias were assessed using the Newcastle-Ottawa Scale.

Main Results:

• Four studies met the inclusion criteria for the systematic review.
• Common risk factors identified across tools include cardiovascular disease, neurological disease, and prematurity.
• The developed risk score models demonstrated good to strong concordance with inpatient mortality or postoperative complications (c-statistic 0.77–0.98).

Conclusions:

• Novel, generally applicable pediatric surgical risk assessment tools were identified for preoperative risk stratification.
• Further research is necessary to evaluate the generalizability of these tools across diverse populations and surgical procedures.