Pediatric elective therapeutic procedure complications: A multicenter cohort analysis

Area of Science:

• Pediatric Gastroenterology
• Endoscopic Procedures
• Patient Safety

Background:

• Understanding of therapeutic endoscopic procedure-associated complications in pediatric patients is limited.
• This study addresses the need for data on significant complications in children undergoing these procedures.

Purpose of the Study:

• To determine the frequency of significant complications in pediatric patients following principal therapeutic endoscopic procedures.
• To identify risk factors and common complications associated with pediatric therapeutic endoscopy.

Main Methods:

• Retrospective multi-institutional analysis of the Pediatric Hospital Information System database.
• Utilized ICD-9-CM, Clinical Transaction Classification, and Current Procedural Terminology codes.
• Included demographic, comorbidity, procedure type, and post-procedure outcomes (mortality, unplanned admissions).

Main Results:

• 18,018 pediatric patients underwent therapeutic endoscopy; 0.74% experienced significant complications requiring admission within 5 days.
• Complications were most frequent on the day of or 1 day post-procedure.
• Hispanic race, chronic comorbidities (especially GI), variceal ablation, and endoscopic dilatation were associated with higher complication rates.

Conclusions:

• Significant postoperative complications leading to unplanned admissions are rare in pediatric therapeutic endoscopy.
• Medically frail children with chronic gastrointestinal conditions are at higher risk.
• Variceal ablation and esophageal dilatation procedures carry the highest risk of complications.