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Postoperative Pneumonia Risk in Children With Neurologic and Neuromuscular Disorders

Alexander J Strzalkowski1, Patrice Melvin1, Sangeeta Mauskar1

  • 1Complex Care, Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts.

Hospital Pediatrics
|November 20, 2024
PubMed

Insights

Postoperative pneumonia (PoP) in children with complex chronic conditions varies significantly by hospital and surgery type. Children with multiple comorbidities face the highest PoP risk, necessitating further research for prevention strategies.

Area of Science:

  • Pediatric Surgery
  • Critical Care Medicine
  • Epidemiology

Background:

  • Children with neurologic and neuromuscular complex chronic conditions (NNCCCs) require surgical interventions.
  • Understanding the risks associated with these procedures is crucial for patient outcomes.

Purpose of the Study:

  • To assess the prevalence, characteristics, and risk factors of postoperative pneumonia (PoP) in children with NNCCCs.
  • To analyze PoP rates across different surgery types, hospitals, and patient comorbidities.

Main Methods:

  • Retrospective analysis of 63,732 inpatient surgical encounters from 2016-2020 in 45 children's hospitals.
  • Utilized International Classification of Diseases, 10th Revision, Clinical Modification codes to identify NNCCCs and PoP within 7 days of surgery.
  • Rao-Scott chi-squared tests and estimating equations were used to assess PoP likelihood based on procedure type, hospital, and clinical characteristics.

Main Results:

  • The overall prevalence of 7-day PoP was 1.1% (688 cases), with significant variation across hospitals (0.4% to 3.0%).
  • Highest PoP rates were observed in bone marrow transplant (12.5%), solid organ transplantation (8.1%), and cardiothoracic surgery (4.5%).
  • Patients with four or more coexisting chronic conditions had a significantly higher likelihood of developing PoP (OR 10.69).

Conclusions:

  • Significant variability in PoP exists among children with NNCCCs, influenced by hospital and surgical procedure.
  • Children with multimorbidity are at a substantially elevated risk for PoP.
  • Further research is essential to develop strategies for mitigating PoP risk in this vulnerable pediatric population.
Abstract

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